Er：YAG激光輔助齦下刮治和根面平整術(shù)治療牙周炎的Meta分析

汪林靜 楊明聰

[關(guān)鍵詞] 慢性牙周炎;Er：YAG 激光;齦下刮治和根面平整術(shù);Meta分析

[中圖分類號(hào)] R781.42? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2021）20-0080-05

Meta-analysis of Er：YAG laser-assisted subgingival scaling and root planing in treatment of periodontitis

WANG Linjing1， 2， 3? ?YANG Mingcong1， 2， 3

1.Department of Periodontology， Stomatology Hospital of Chongqing Medical University， Chongqing? ?401147， China; 2.Chongqing Key Laboratory of Oral Diseases and Biomedicine， Chongqing? ?401147， China; 3.Chongqing Key Laboratory of Oral Biomedical Engineering of Higher Education， Chongqing? ?401147， China

[Abstract] Objective To evaluate the difference in clinical efficacy between erbium：yttrium-aluminum-garnet （Er：YAG） laser-assisted subgingival scaling and root planing （SRP） and simple SRP in the treatment of periodontitis using evidence-based medicine method. Methods Chinese and English databases， such as Pubmed， Embase， Cochrane Library， CNKI， Wanfang and Weipu， were used to search randomized controlled trials （RCT） that compared Er： YAG laser-assisted subgingival SRP and simple SRP in the treatment of periodontist from the establishment of databases to November 30， 2020. Literatures were screened by two researchers independently and strictly according to the inclusion and exclusion criteria. Evaluation of literature quality and data extraction were performed. Statistical analysis was conducted using stata14.0 software. Results? Nine RCTs were included. The PD and PI values of the Er：YAG laser-assisted SRP group were significantly lower than those of the SRP group at the 3-month follow-up after treatment （PD： SMD=-0.434， 95%CI：-0.844， -0.024）， I2： 66.3%， P=0.038; PI： SMD=-0.516， 95%CI：-0.978， -0.054， I2： 45.7%， P=0.029）. The PD and CAL values of the Er：YAG laser-assisted SRP group were significantly lower than those of the SRP group at the 6-month follow-up after treatment（PD： SMD=-0.402， 95%CI：-0.695，-0.108）， I2： 16.2%， P=0.007; CAL： SMD=-0.316， 95%CI：-0.608，-0.025， I2： 0.0%， P=0.034）. Conclusion Compared with SRP， Er：YAG laser-assisted SRP can produce better results in the short and medium term in the treatment of periodontitis. It can be used routinely in periodontal non-surgical treatment.

[Key words] Chronic periodontitis; Er：YAG laser; Subgingival scaling and root planing; Meta-analysis

牙周炎是人類最常見的慢性感染性疾病之一，主要特征為牙齒支持組織的進(jìn)行性破壞，甚至造成牙齒的松動(dòng)、脫落[1]。齦下刮治和根面平整術(shù)（Scaling and root planing，SRP）是目前最主要且最有效的治療方法[2]。然而，單獨(dú)的SRP有一定的局限性，有時(shí)并不能有效清除病變的牙周組織，如對(duì)于深牙周袋及窄小的根分叉區(qū)域，因器械無法到達(dá)而難以去除牙結(jié)石及壞死根面組織。同時(shí)有研究顯示，手工器械及超聲器械行齦下刮治及根面平整時(shí)均可能會(huì)去掉過多的牙根表面的牙骨質(zhì)或破壞牙根表面的形態(tài)，同時(shí)形成玷污層，從而不利于牙周軟組織的愈合[2-3]。