Network meta-analysis of studies included in the Clinical Practice Guideline on the nonsurgical treatment of chronic periodontitis.
Network meta-analysis of studies included in the Clinical Practice Guideline on the nonsurgical treatment of chronic periodontitis.
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DOI：
10.1111/jcpe.12726
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发表时间：
2017-06
影响因子：
6.7
通讯作者：
Chu H
中科院分区：
文献类型：
--
作者：
John MT;Michalowicz BS;Kotsakis GA;Chu H
最近ADA委托的慢性牙周炎非手术治疗临床实践指南提供了最详尽的关于洁治和根面平整术（SRP）的临床试验资料库。这个网络荟萃分析比较了两个候选人。根据临床实践指南中74项研究中9名患者的36项临床依恋水平（CAL）增益的间接比较，进行了星形网络荟萃分析。所有成对差异都伴随着较宽的置信区间，并且没有一个样本在统计学上显著上级另一个样本。局部盐酸多西环素和半导体激光光动力疗法分别排名第一和第二的可能性最高。发表偏倚很明显，影响小的研究少于预期。由于缺乏这些研究，估计治疗效果夸大了20%。在6-12个月内，与单独SRP相比，辅助治疗可使CAL增益提高约三分之一mm，但两组间无显著差异。这种增益的患者感知受益尚不清楚，因为CAL是由临床医生进行的物理测量，而不是以患者为导向的结果。发表偏倚夸大了观察到的治疗效果。
The recent ADA-commissioned Clinical Practice Guideline on the nonsurgical treatment of chronic periodontitis has provided the most exhaustive library of clinical trials on scaling and root planing (SRP) with or without adjuncts. This network meta-analysis compared the adjuncts against each other. A star-shaped network meta-analysis was performed based on 36 indirect comparisons of clinical attachment level (CAL) gains among nine adjuncts in 74 studies from the Clinical Practice Guideline. All pairwise differences were accompanied by wide confidence intervals, and none of the adjuncts was statistically significantly superior to another. Local doxycycline hyclate and photodynamic therapy with a diode laser had the highest probabilities for ranking first and second, respectively. Publication bias was evident, with fewer than expected studies with small effects. The lack of these studies inflated the treatment effects by an estimated by 20%. Adjuncts improve CAL gain by about a third of a mm over 6-12 months compared to SRP alone, but no significant differences were found among the adjuncts. The patient-perceived benefit of this gain is unclear because CAL is a physical measure made by the clinician and not a patient-oriented outcome. Publication bias inflated the observed treatment effects.
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影响因子：
2.9
作者：
John MT;Reissmann DR;Feuerstahler L;Waller N;Baba K;Larsson P;Celebić A;Szabo G;Rener-Sitar K
通讯作者：
Rener-Sitar K
影响因子：
18.6
作者：
Labriola, A;Needleman, I;Moles, DR
通讯作者：
Moles, DR
影响因子：
4.5
作者：
Jansen, Jeroen P.;Fleurence, Rachael;Cappelleri, Joseph C.
通讯作者：
Cappelleri, Joseph C.
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
4.8
作者：
Palmer, Tom M.;Peters, Jaime L.;Moreno, Santiago G.
通讯作者：
Moreno, Santiago G.