Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, ErQi District, Zhengzhou, Henan, China.
Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 46 Yangqiao Zhong Lu, Gulou District, Fuzhou, Fujian, China.
Int J Implant Dent. 2024 Nov 14;10(1):54. doi: 10.1186/s40729-024-00570-x.
To systematically assess studies regarding the efficacy of lasers in the nonsurgical treatment of peri-implantitis.
Electronic and manual searches were performed by two reviewers independently. Randomized controlled trials (RCTs) comparing lasers vs. mechanical debridement or air abrasive on primary outcome (probing depth (PD)) and secondary outcomes (bone loss, bleeding on probing (BOP), clinical attachment level (CAL) and plaque index (PI)) were included. Data extraction and quality assessment were conducted independently. Weighted mean difference (WMD) or standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for continuous outcomes. Publication bias, leave-one-out analysis and GRADE assessment were conducted.
13 eligible publications were included in the review and 12 in the meta-analysis. Solid-state lasers significantly improved in PD (WMD = -0.39, 95% CI (-0.70, -0.09), p = 0.01, moderate-certainty evidence), BOP (SMD =-0.76, 95% CI (-1.23, -0.28), p = 0.002, moderate-certainty evidence) and CAL (WMD =-0.19, 95% CI (-0.39, -0.00), p = 0.05, moderate-certainty evidence), but not in bone loss (WMD = 0.03, 95% CI (-0.13, 0.18), p = 0.74, low-certainty evidence) and PI (SMD =-0.19, 95% CI (-0.42, 0.04), p = 0.11, moderate-certainty evidence) compared with the control group. However, the diode lasers showed no clinical advantages. No publication bias was detected, and leave-one-out analysis confirmed the robustness of findings.
In the nonsurgical treatment of peri-implantitis, solid-state lasers yielded positive influence in term of PD, BOP and CAL, while diode laser provided no beneficial effect. Future well-designed large RCTs are still needed, considering the limitations of included studies.
This review aimed to guide clinicians in choosing the appropriate laser for peri-implantitis, enhancing treatment strategies and attaining better outcomes.
系统评估激光在非手术治疗种植体周围炎方面的疗效的研究。
两位评审员分别进行电子和手动检索。纳入比较激光与机械清创或喷砂比较的随机对照试验（RCT）（主要结局（探诊深度（PD））和次要结局（骨损失，探诊出血（BOP），临床附着水平（CAL）和菌斑指数（PI））。独立进行数据提取和质量评估。计算连续结局的加权均数差（WMD）或标准化均数差（SMD）和 95%置信区间（CI）。进行发表偏倚、逐一剔除分析和 GRADE 评估。
综述纳入了 13 篇符合条件的出版物，meta 分析纳入了 12 篇。固态激光在 PD（WMD = -0.39，95%CI（-0.70，-0.09），p = 0.01，中等确定性证据）、BOP（SMD =-0.76，95%CI（-1.23，-0.28），p = 0.002，中等确定性证据）和 CAL（WMD =-0.19，95%CI（-0.39，-0.00），p = 0.05，中等确定性证据）方面有显著改善，但在骨损失（WMD = 0.03，95%CI（-0.13，0.18），p = 0.74，低确定性证据）和 PI（SMD =-0.19，95%CI（-0.42，0.04），p = 0.11，中等确定性证据）方面与对照组相比无临床优势。然而，二极管激光没有显示出临床优势。未发现发表偏倚，逐一剔除分析证实了研究结果的稳健性。
在种植体周围炎的非手术治疗中，固态激光在 PD、BOP 和 CAL 方面产生了积极影响，而二极管激光则没有有益效果。鉴于纳入研究的局限性，仍需要进行设计良好的大型 RCT 研究。
本综述旨在指导临床医生选择合适的激光治疗种植体周围炎，增强治疗策略，获得更好的结果。
