Baghani Zahra, Karrabi Malihe, Assarzadeh Hossein
Dept. of Periodontics, Faculty of Dentistry, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Dept. of Prosthodotics, Faculty of Dentistry Sabzevar University of Medical Sciences, Sabzevar, Iran.
J Dent (Shiraz). 2024 Dec 1;25(4):296-308. doi: 10.30476/dentjods.2023.98616.2098. eCollection 2024 Dec.
Antimicrobial photodynamic therapy (aPDT) is a protocol proposed for reduction of bacterial load in deep dentin caries in primary and permanent dentitions. However, considering the difference in the morphology of dentinal tubules in primary and permanent teeth, the effect of this treatment may be different on the two dentition types.
This systematic review and meta-analysis aimed to assess the effect of type of dentition as a determinant of microbial load reduction by aPDT in deep dentin caries.
An electronic search was conducted in Scopus, Web of Science, Cochrane, Medline, and Embase databases, from the first record until April 30, 2022. After article screening by three reviewers, seven studies were included in this meta-analysis. The mean log of () count, count, and the entire bacteria in the cavity before and after aPDT was calculated with 95% confidence interval (CI), and compared between the two groups of primary and permanent teeth by the random effect model. The I test was applied to assess the heterogeneity of the findings. Publication bias was evaluated by visual examination of the funnel-plot symmetry.
Of 7 retrieved articles, analysis of 3 studies on permanent teeth showed that aPDT caused a significant reduction in total bacterial count in the cavity [SMD: 0.64, 95% CI:(0.31, 0.96), = 0.0001), count [SMD: 0.92, 95% CI:(0.58, 1.25), < 0.0001], and [SMD: 1.1, 95% CI:(0.76, 1.45), < 0.00001)]. Analysis of the remaining 4 studies on primary teeth indicated that aPDT had a significant effect only on count [SMD: 0.60, 95% CI:(0.23, 0.97), = 0.001), and its effect on total bacterial count of the cavity [SMD: 0. 90, 95% CI:(-0.02, 1.82), = 0.05] and [SMD: 0.18, 95% CI:(-0.29, 0.64), = 0.45)] was not significant.
The results showed that aPDT could serve as an effective adjunct for reduction of microbial load in permanent teeth.
抗菌光动力疗法（aPDT）是一种为减少乳牙和恒牙深龋牙本质中细菌数量而提出的方案。然而，考虑到乳牙和恒牙牙本质小管形态的差异，这种治疗方法对两种牙列类型的效果可能不同。
本系统评价和荟萃分析旨在评估牙列类型作为aPDT降低深龋牙本质中微生物负荷的决定因素的作用。
在Scopus、科学网、Cochrane、Medline和Embase数据库中进行电子检索，检索时间从第一条记录至2022年4月30日。在三位审阅者对文章进行筛选后，本荟萃分析纳入了七项研究。计算aPDT治疗前后龋洞内（）计数、计数和总细菌数的平均对数，并采用随机效应模型在乳牙和恒牙两组之间进行比较。应用I检验评估研究结果的异质性。通过直观检查漏斗图对称性来评估发表偏倚。
在检索到的7篇文章中，对3项关于恒牙的研究分析表明，aPDT可使龋洞内总细菌数显著减少[标准化均数差（SMD）：0.64，95%置信区间（CI）：（0.31，0.96），=0.0001]，计数[SMD：0.92，95%CI：（0.58，1.25），<0.0001]，以及[SMD：1.1，95%CI：（0.76，1.45），<0.00001]。对其余4项关于乳牙的研究分析表明，aPDT仅对计数有显著影响[SMD：0.60，95%CI：（0.23，0.97），=0.001]，而其对龋洞内总细菌数[SMD：0.90，95%CI：（-0.02，1.82），=0.05]和[SMD：0.18，95%CI：（-0.29，0.64），=0.45]的影响不显著。
结果表明，aPDT可作为减少恒牙中微生物负荷的有效辅助手段。
