“经常在消过毒的池子里游泳可能会增加污渍的形成”，“牙周病可能不会导致冠心病”，以及“西红柿可能降低口腔癌的风险”。

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Evidence-Based Dental Practice Pub Date : 2023-09-09 DOI:10.1016/j.jebdp.2023.101925

THILINI N. JAYASINGHE (REVIEWERS), AXEL SPAHR (REVIEWERS)

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引用次数: 0

摘要

castro Dos Santos NC, Furukawa MV, Oliveira-Cardoso I, Cortelli JR, Feres M, Van Dyke T, Rovai ES。使用omega-3脂肪酸作为非手术牙周病治疗的辅助治疗是否对牙周炎的治疗有额外的好处?系统回顾和荟萃分析。中华牙周病杂志，2011;31(3):357 - 357。doi: 10.1111 / jre.12984。2022年3月3日PMID: 35243637。本研究由<s:1>圣保罗研究基金会(FAPESP)资助，资助项目分别为2020/05875-9 (NCCS)、2020/05874-2 (MF)和2019/14846-5 (ESR)。研究类型/设计系统回顾和荟萃分析。描述PICO的人群或描述系统评价和荟萃分析评价的研究选择。该系统综述和荟萃分析纳入了伴有或不伴有2型糖尿病(>2年)的中度至未经治疗的晚期慢性重度牙周炎患者。他们从埃及、印度、巴西和波兰等国的各个诊所招募，包括各自的医院或大学。排除标准包括孕妇和干预前三个月内使用过抗生素的患者。[从PICO中找出关键干预措施并进行比较。例如，对调查补充维生素D对牙周骨骼健康影响的研究的回顾:所有研究都必须包括针对特定研究组(>60岁的妇女)的特定干预措施(每日补充维生素D)。尽可能具体，使用尽可能多的人能理解的语言。本系统综述和荟萃分析研究了补充omega-3脂肪酸对牙周临床参数的影响，主要是临床附着水平(CAL)和牙周探诊深度(PPD)。在40-58岁的人群中，所有的研究都必须包括膳食补充omega-3脂肪酸，以辅助非手术牙周治疗。在一些研究中没有报告性别分布，而有些研究仅包括女性或两性。一项研究特别纳入了平均年龄为50岁的绝经后妇女)。所有纳入的8项研究均为平行随机对照试验。研究中使用的鱼油补充剂类型主要包括EPA(二十碳五烯酸)和DHA(二十二碳六烯酸)，它们是长链omega-3多不饱和脂肪酸(omega-3s)，量从700毫克到3000毫克不等，有或没有其他补充剂(如烷基甘油、角鲨烯、维生素A和D3)或药物(低剂量阿司匹林:75mg-100mg)。补充时间为8至26周。[确定PICO的结果。这是指被认为与暴露、危险因素或感兴趣的干预有关的原发疾病、状况或治疗结果。在这里，只有一个应该被确认。尽可能具体，使用尽可能多的人能理解的语言。例如，主要结果是每日补充维生素D后可测量的牙槽骨丢失的放射学减少，并在5年期间每年进行评估- or -主要结果是成功解决前根尖周围脓肿和使用热塑性根管材料非手术治疗后愈合的放射学证据。再次治疗后1年、1 - 3年、3年或更晚进行评估。临床附着丧失(CAL)和牙周探诊深度(PPD)是本系统评价和荟萃分析的主要结果。次要观察结果为PPD>=5mm部位、出血或穿刺部位(BOP)数量和牙龈指数(GI)的变化。在6个月的研究中，测量间隔为基线、12周和26周，而在3个月的研究中，测量间隔为BL、6周和12周或基线、4周和12周。临床参数在基线和8周进行评估，为期两个月的研究。[通常，这里应该出现一个具有置信区间的效果度量。如果进行了荟萃分析，提供用于研究间比较的关键统计指标。否则，简要总结报告的主要结果。综合估计显示，总体PPD(牙周袋深度)减少了0.42 mm (95% CI: 0.15, 0.68, p = 0.002, I2 = 85%)， CAL(临床附着损失)增加了0.58 mm (95% CI 0.24, 0.92)， p = 0.007, I2 = 85%)。此外，亚组分析显示，omega-3仅对全身健康的受试者有显著的PPD降低作用(WMD: 0.52;95% ci: 0.10, 0.94;p = 0.002, I2 = 89%)。系统健康(WMD: 0.65;95% ci: 0.18, 1.11;p = 0.006, I2 = 90%)和2型糖尿病受试者(WMD: 0.33;95% ci: 0.06, 0.60;p = 0.02, I2 = 0%)表明补充omega-3后CAL增加显著改善。亚群分析显示，没有低剂量阿司匹林的研究显示PPD显著降低(WMD: 0.44;95% ci: 0.03, 0.84;p = 0.04, I2 = 87%)。然而，无论使用低剂量阿司匹林，均观察到显著的CAL增加。关于牙龈炎症(BOP和GI)，荟萃分析显示只有BOP有显著降低(WMD: 4.55;95% ci: 2.00, 7.10;p = 0.0005, I2 = 0%)。此外，亚群分析表明，上述改善仅在全身健康的患者中观察到(WMD: 4.77;95% ci: 0.83, 8.71;p = 0.02, I2 = 21%)。 [作者报告了关于关键研究因素与结果测量之间关系的主要发现是什么?]这项系统综述和荟萃分析的作者得出结论，包括随机临床试验在内的研究表明，omega-3脂肪酸显著降低了PPD或增加了CAL。他们认为，与单独对牙周炎患者进行非手术牙周治疗相比，使用omega-3脂肪酸膳食补充剂作为非手术牙周治疗的辅助手段，可以在CAL增加和PPD减少方面提供额外的好处。

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DIETARY SUPPLEMENTATION OF OMEGA-3 FATTY ACIDS COULD BE USED AS AN ADJUNCT THERAPY TO NONSURGICAL PERIODONTAL TREATMENT

Article Title and Bibliographic Information

Castro Dos Santos NC, Furukawa MV, Oliveira-Cardoso I, Cortelli JR, Feres M, Van Dyke T, Rovai ES. Does the use of omega-3 fatty acids as an adjunct to nonsurgical periodontal therapy provide additional benefits in the treatment of periodontitis? A systematic review and meta-analysis. J Periodontal Res. 2022 Jun;57(3):435-447. doi: 10.1111/jre.12984. Epub 2022 Mar 3. PMID: 35243637.

Source of Funding

This study was funded by São Paulo Research Foundation (FAPESP) under awards 2020/05875-9 (to NCCS), 2020/05874-2 (to MF), and 2019/14846-5 (to ESR).

Type of Study/Design

Systematic review and meta-analysis.

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来源期刊

Journal of Evidence-Based Dental Practice DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

6.00

自引率

16.70%

发文量

105

审稿时长

28 days

期刊介绍： The Journal of Evidence-Based Dental Practice presents timely original articles, as well as reviews of articles on the results and outcomes of clinical procedures and treatment. The Journal advocates the use or rejection of a procedure based on solid, clinical evidence found in literature. The Journal''s dynamic operating principles are explicitness in process and objectives, publication of the highest-quality reviews and original articles, and an emphasis on objectivity.