Er:YAG激光应用于慢性牙周炎治疗的临床疗效meta分析

张奕; 李永凯; 潘兰兰; 李静; 刘秋月; 向学熔

doi:doi:10.14128/j.cnki.al.20193901.180

应用激光, 2019, 39 (1): 180, 网络出版: 2019-04-16

Er:YAG激光应用于慢性牙周炎治疗的临床疗效meta分析

The Effects of Er:YAG Laser Therapy in the Treatment of Chronic Periodontitis: A Meta-Analysis

论文大纲

张奕 ^*李永凯潘兰兰李静刘秋月向学熔

作者单位

重庆医科大学附属口腔医院, 口腔疾病与生物医学重庆市重点实验室, 重庆市高校市级口腔生物医学工程重点实验室, 重庆 401147

Er:YAG激光慢性牙周炎 meta分析 Er:YAG laser chronic periodontitis SRP SRP meta-analysis

摘要

目的: 运用循证医学的方法系统地评价, Er:YAG激光相较于传统龈下刮治及根面平整术(Scaling and root planing, SRP)在治疗慢性牙周炎(Chronic periodontitis, CP)中的临床疗效。方法: 检索PubMed、EMbase、The Cochrane Library、中国知网、维普、万方等电子数据库, 收集自建库到2018年9月公开发表的关于Er:YAG激光与单独使用SRP比较, 用于治疗CP的临床随机对照试验。由2名研究员按照纳入和排除标准独立筛选文献、质量评价和数据提取, 使用Revman5.3.3软件进行统计分析。结果: 共纳入11篇RCT, meta结果显示短中期内, 应用Er:YAG激光与单独使用SRP治疗CP相比, 其牙周探诊深度(Periodontal probing depth, PPD)差异无统计学意义［MD＝0.05, 95% CI(-0.01, 0.12), P＝0.12］, 而临床附着丧失水平(Clinical attach loss, CAL)在治疗后3个月, SRP组优于Er:YAG激光组［MD＝0.13, 95% CI(0.02, 0.24), P＝0.02］, 6个月时, 两组差异无统计学意义。结论: 现有证据显示, 与传统SRP相比, Er:YAG激光在短中期临床疗效上尚不能体现出明显的治疗优势。

Abstract

Objective: to assess the clinical efficacy of Er:YAG laser compared with traditional scaling and root planing (SRP) in the treatment of chronic periodontitis (CP) by evidence-based medicine. Methods: Electronic databases including PubMed, EMbase, The Cochrane Library, CNKI, VIP data and Wanfang data were searched to collect literatures which are randomized controlled trials of Er:YAG laser and SRP alone for the treatment of CP from establishment to September 2018. Two researchers independently screened the literature, quality evaluation and data extraction in accordance with inclusion and exclusion criteria, and Revman5.3.3 software was applied for statistical analysis. Results: a total of 11 RCTs were included. The meta results showed no significant difference in periodontal probing depth (PPD) between the Er:YAG laser and the SRP alone［MD＝0.05, 95% CI(-0.01, 0.12), P＝0.12), and clinical attachment loss (CAL), SRP group was superior to Er:YAG laser group ［MD＝0.13, 95% CI(0.02,0.24), P＝0.02］, 3 months after treatment. There was no statistically significant difference between the two groups after 6 months. Conclusion: the existing evidence shows that Er:YAG laser has no obvious therapeutic advantage compared with traditional SRP in short-term and medium-term clinical efficacy.

参考文献

[1] HOLTFRETER B, ALBANDAR J M, DIETRICH T, et al.Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies［J］.Journal of Clinical Periodontology, 2015, 42(5): 407-412.

[2] NASCIMENTO G G, LEITE F R M, SCHEUTZ F, et al.Periodontitis: from infection to inflammation［J］.Current Oral Health Reports, 2017, 4(4): 301-308.

[3] TELES R P, HAFFAJEE A D, SOCRANSKY S S.Microbiological goalsof periodontal therapy［J］.Periodontology, 2006(42): 180-218.

[4] VAN DER WEIJDEN G A, TIMMERMAN M F.A systematic review on the clinical efficacy of subgingival debridement in the treatment of chronic periodontitis［J］.Journal of Clinical Periodontology, 2002, 29(S3): 55-71.

[5] GRAZIANI F, KARAPETSA D, ALONSO B, et al.Nonsurgicalandsurgical treatment of periodontitis: how many options for one disease ［J］Periodontol, 2017, 75(1): 152-188.

[6] AOKI A, ANDO Y, WATANABE H, et al.In vitro studies on laser scaling of subgingival calculus with an erbium:YAG laser［J］.Journal of Periodontology, 1994, 65(12): 1097-1106.

[7] AOKI A, MIURA M, AKIYAMA F, et al.In vitro evaluation of Er:YAG laser scaling of subgingival calculus in comparison with ultrasonic scaling［J］.Journal of Periodontal Research, 2000, 35(5): 266-277.

[8] YANEVA B K, ZAGORCHEV P I, FIRKOVA E I, et al.In vitro study of temperature changes in pulp chamber during root planing procedure using Er:YAG laser［J］.Folia Medica, 2016, 58(3): 206-210.

[9] CEKICI A, MADEN I, YILDIZ S, et al.Evaluation of blood cell attachment on Er:Yag laser applied root surface using scanning electron microscopy［J］.International Journal of Medical Sciences, 2013, 10(5): 560-566.

[10] THEODORO L H, ZEZELL D M, GARCIA V G, et al.Comparative analysis of root surface smear layer removal by different etching modalities or erbium: yttrium-aluminum-garnet laser irradiation.A scanning electron microscopy study［J］.Lasers in Medical Science, 2010, 25(4): 485-491.

[11] TALEBI-ARDAKANI M R, TORSHABI M, KARAMI E, et al.Comparison of Er:YAG laser and hand instrumentation on the attachment of cultured human gingival fibroblasts to periodontally involved root surfaces［J］.Journal of Lasers in Medical Sciences, 2017, 8(S1): 51-55.

[12] AMID R, GHOLAMI G A, MOJAHEDI M, et al.Effects of root debridement with hand curettes and Er:YAG laser on chemical properties and ultrastructure of periodontally-diseased root surfaces using spectroscopy and scanning electron microscopy［J］.Journal of Lasers in Medical Sciences, 2017, 8(2): 66-71.

[13] BADRAN Z, BOUTIGNY H, STRUILLOU X, et al.Clinical outcomes after nonsurgical periodontal therapy with an Er:YAG laser device: a randomized controlled pilot study［J］.Photomedicine and Laser Surgery, 2012, 30(7): 347-353.

[14] FENG XIANGHUI, LU RUIFANG, HE LU.A short-term clinical evaluation of periodontal treatment with an Er:YAG laser for patients with chronic periodontitis: a split-mouth controlled study［J］.Journal of Peking University (Health Sciences), 2011, 43(6): 886-890.

[15] GRZECH-LESNIAK K, SCULEAN A, GASPIRC B.Laser reduction of specific microorganisms in the periodontal pocket using Er:YAG and Nd:YAG lasers: a randomized controlled clinical study［J］.Lasers in Medical Science, 2018, 33(7): 1461-1470.

[16] GRZECH-LESNIAK K, MATYS J, DOMINIAK M.Comparison of the clinical and microbiological effects of antibiotic therapy in periodontal pockets following laser treatment An in vivo study［J］.Journal of Investigative and Clinical Dentistry, 2018, 19(1): 201.

[17] LOPES B M V, THEODORO L H, MELO R F, et al.Clinical and microbiologic follow-up evaluations after non-surgical periodontal treatment with erbium:YAG Laser and scaling and root planing［J］.Journal of Periodontology, 2010, 81(5): 682-691.

[18] ROTUNDO R, NIERI M, CAIRO F, et al.Lack of adjunctive benefit of Er:YAG laser in non-surgical periodontal treatment: a randomized split-mouth clinical trial［J］.Journal of Clinical Periodontology, 2010, 37(6): 526-533.

[19] SCHWARZ F, SCULEAN A, GEORG T, et al.Periodontal treatment with an Er:YAG laser compared to scaling and root planing.A controlled clinical study［J］.Journal of Periodontology, 2001, 72(3): 361-367.

[20] SOO L, LEICHTER J W, WINDLE J, et al.A comparison of Er:YAG laser and mechanical debridement for the non-surgical treatment of chronic periodontitis: a randomized, prospective clinical study［J］.Journal of Clinical Periodontology, 2012, 39(6): 537-545.

[21] 王月, 李薇薇, 张凤秋.Er:YAG激光治疗慢性牙周炎临床疗效观察［J］.北京口腔医学, 2017, 25(3): 140-144.

[22] 牛家慧, 李创, 赵丽, 等.Er:YAG激光对慢性牙周炎患者龈沟液中细胞因子的影响［J］.解放军预防医学杂志, 2018, 36(5): 657-660.

[23] YASUTAKA KOMATSU, TOSHIYA MOROZUMI, DAISUKE ABE, et al.Effects of erbium-doped: yttrium aluminum garnet (Er:YAG) laser on bacteremia due to scaling and root planing［J］.Journal of Lasers in Medical Sciences, 2012, 3(4): 175-184.

张奕, 李永凯, 潘兰兰, 李静, 刘秋月, 向学熔. Er:YAG激光应用于慢性牙周炎治疗的临床疗效meta分析[J]. 应用激光, 2019, 39(1): 180. Zhang Yi, Li Yongkai, Pan Lanlan, Li Jing, Liu Qiuyue, Xiang Xuerong. The Effects of Er:YAG Laser Therapy in the Treatment of Chronic Periodontitis: A Meta-Analysis[J]. APPLIED LASER, 2019, 39(1): 180.

Er:YAG激光应用于慢性牙周炎治疗的临床疗效meta分析

关于本站 Cookie 的使用提示

全站搜索

Er:YAG激光应用于慢性牙周炎治疗的临床疗效meta分析

相关论文

相关资讯

关于本站 Cookie 的使用提示

全站搜索