The benefit of antimicrobial photodynamic therapy to mechanical debridement in the treatment of smokers with peri-implant diseases: a systematic review and meta-analysis
The benefit of antimicrobial photodynamic therapy to mechanical debridement in the treatment of smokers with peri-implant diseases: a systematic review and meta-analysis
复制标题
抗菌光动力疗法对机械清创治疗吸烟者种植体周围疾病的益处：系统评价和荟萃分析
DOI：
10.1007/s10103-022-03592-2
复制
发表时间：
2022-07
影响因子：
2.1
通讯作者：
Bin Shi
中科院分区：
文献类型：
--
作者：
Yaoyu Zhao;Qi Yan;Xinyu Wu;Fang Hua;Bin Shi
抗菌光动力疗法(APDT)已被提出作为种植体周围疾病的辅助治疗策略。这项系统性综述旨在确定APDT作为机械清创的辅助手段是否对患有种植体周围疾病的吸烟者有额外的好处。随机对照试验(RCT)在吸烟者中评估了单独机械清创与机械清创+APDT的临床结果，被认为有资格纳入。主要结果是探诊时出血(BOP)，次要结果包括探诊深度(PD)、斑块指数(PI)和顶骨丢失(CBL)。使用随机效应模型进行Meta分析，以95%的可信区间(CI)计算平均差值(MD)。根据《建议评估、发展和评价(等级)》对证据质量进行评定。共纳入四项随机对照试验(188名参与者)。APDT组术后3个月的PD(MD=-1.26，95%CI=-2.19~-0.32，P=0.008)和PI(MD=-10.6%，95%CI=-14.46~-6.74%，P=0.0001)均明显优于机械清理组。术后3个月探诊出血(BOP)差异无统计学意义(MD=-0.60%，95%CI=-2.36~1.16%，P=0.50)。光敏剂亚组分析显示，亚甲基蓝(MB)对PD(MD=-1.2 3，95%CI=-2.41~-0.0 5，p=0.0 4)和PI(MD=-12.33，95%CI=-14.74~-9.92，p<；0.00001)有显著差异。在本研究范围内，与单独使用机械清创相比，联合使用APDT在3个月的随访中更有效地减少吸烟者的PD和PI。亚甲基蓝是一种可预测的APDT光敏剂。然而，由于纳入的研究数量有限，方法上的缺陷，以及研究之间的异质性，这些发现应该被谨慎地解释。
Antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunctive treatment strategy for peri-implant diseases. This systematic review aimed to determine whether aPDT as an adjunct to mechanical debridement has an additional benefit for smokers with peri-implant diseases. Randomized controlled trials (RCTs), which evaluated the clinical outcomes of mechanical debridement alone versus mechanical debridement + aPDT among smokers, were considered eligible to be included. The primary outcome was bleeding on probing (BOP) and secondary outcomes included probing depth (PD), plaque index (PI), and crestal bone loss (CBL). Meta-analyses using a random-effects model were conducted to calculate the mean difference (MD) with a 95% confidence interval (CI). The quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of four RCTs (188 participants) were included. The aPDT group showed significantly improved PD (MD = - 1.26, 95% CI = - 2.19 to - 0.32, p = 0.008) and PI (MD = - 10.6%, 95% CI = - 14.46 to - 6.74%, p = 0.0001) compared with mechanical debridement group at 3-month follow-up. No significant difference in bleeding on probing (BOP) was observed at 3-month follow-up (MD = - 0.60%, 95% CI = - 2.36 to 1.16%, p = 0.50). The subgroup analyses on photosensitizers demonstrated significant differences between the two groups on PD (MD = - 1.23, 95% CI = - 2.41 to - 0.05, p = 0.04) and PI (MD = - 12.33, 95% CI = - 14.74 to - 9.92, p < 0.00001) by the use of methylene blue (MB). Within the limitation of this study, compared with mechanical debridement alone, combined use of aPDT was more effective in reducing PD and PI in smokers at 3-month follow-up. MB was a predictable photosensitizer for aPDT. However, the findings should be interpreted with caution due to the limited number of included studies, methodological deficiencies, and heterogeneity between studies.
登录
查看更多内容
影响因子：
3.7
作者：
Semlali A;Witoled C;Alanazi M;Rouabhia M
通讯作者：
Rouabhia M
DOI：
10.11607/prd.2546
发表时间：
2017-08
期刊：
The International journal of periodontics & restorative dentistry
影响因子：
--
作者：
F. Verdugo
通讯作者：
F. Verdugo
影响因子：
--
作者：
H. Hirooka;S. Renvert
通讯作者：
H. Hirooka;S. Renvert
影响因子：
5.5
作者：
Joseph B;Janam P;Narayanan S;Anil S
通讯作者：
Anil S
影响因子：
6.7
作者：
Heitz-Mayfield, Lisa J. A.
通讯作者：
Heitz-Mayfield, Lisa J. A.