Oral Health Prev Dent. 2024 Sep 17;22:479-486. doi: 10.3290/j.ohpd.b5750814.
The aim of the present systematic review and meta-analysis was to assess the efficacy of non-surgical periodontal therapy (NSPT) with adjunct photodynamic therapy (aPDT) in reducing periodontal inflammation and haemoglobin A1c (HbA1c) levels in patients with diabetes mellitus (DM).
The focused question was 'Does NSPT with adjunct aPDT help reduce periodontal inflammation and HbA1c levels in patients with DM?' The PICO (patient/population, intervention, comparison and outcomes) was formatted as follows: Patients (P): Participants diagnosed with DM; Intervention (I): NSPT with adjunct PDT for the treatment of periodontitis; Control (C): NSPT alone or NSPT with adjunct systemic antibiotic therapy; and Outcome (O): Changes in HbA1c levels. The inclusion criteria comprised RCTs specifically evaluating the impact of NSPT on HbA1c levels in diabetic patients, with a specific focus on interventions involving NSPT with and without adjunct aPDT. The literature search was performed in accordance with the Preferred reporting items for systematic reviews and meta-analysis. Indexed databases were searched without time and language restrictions using various keywords. Forest plots were created to illustrate the effects of the different studies and the global estimation.
Five RCTs were included and processed for data extraction. The number of participants ranged from 12 to 45 patients with medically diagnosed type-2 DM. In all RCTs, aPDT was done using a diode laser with wavelengths ranging between 660 and 810 nm. Three and two RCTs had moderate and high RoB, respectively. In two RCTs, NSPT with adjunct aPDT reported no improvement in clinical periodontal parameters. Two studies reported that NSPT with adjunct aPDT significantly reduces periodontal probing depth compared to NSPT alone. Four of the five RCTs reported that NSPT+PDT does not influence HbA1c levels.
NSPT with or without adjunct aPDT does not affect HbA1c levels in patients with type-2 DM.
本系统评价和荟萃分析的目的是评估非手术牙周治疗（NSPT）联合光动力疗法（aPDT）辅助治疗在降低糖尿病患者牙周炎症和糖化血红蛋白（HbA1c）水平方面的疗效。
关注的问题是“NSPT 联合 aPDT 辅助治疗是否有助于降低糖尿病患者的牙周炎症和 HbA1c 水平？” PICO（患者/人群、干预、比较和结果）格式如下：患者（P）：诊断为糖尿病的参与者；干预（I）：NSPT 联合 PDT 治疗牙周炎；对照组（C）：NSPT 单独或 NSPT 联合全身抗生素治疗；结果（O）：HbA1c 水平的变化。纳入标准包括专门评估 NSPT 对糖尿病患者 HbA1c 水平影响的 RCT，特别关注涉及 NSPT 联合和不联合 aPDT 辅助治疗的干预措施。文献检索按照系统评价和荟萃分析的首选报告项目进行。索引数据库在没有时间和语言限制的情况下使用各种关键词进行搜索。森林图用于说明不同研究的效果和全球估计值。
共纳入 5 项 RCT 并进行数据提取。参与者人数从 12 到 45 人不等，均为经医学诊断的 2 型糖尿病患者。在所有 RCT 中，aPDT 均使用波长在 660 至 810nm 之间的二极管激光进行。有 3 项和 2 项 RCT 分别具有中度和高度 RoB。在 2 项 RCT 中，NSPT 联合 aPDT 并未改善临床牙周参数。有 2 项研究报告称，与 NSPT 单独治疗相比，NSPT 联合 aPDT 显著降低牙周探诊深度。5 项 RCT 中的 4 项报告称，NSPT+PDT 不影响 HbA1c 水平。
NSPT 联合或不联合 aPDT 不影响 2 型糖尿病患者的 HbA1c 水平。
