Nengwen Huang, Yang Li, Wen Li, Rui Zhao, Yanjing Ou, Jiang Chen, Jinjin Li
{"title":"激光在非手术治疗种植体周围炎中的临床疗效：系统综述和荟萃分析。","authors":"Nengwen Huang, Yang Li, Wen Li, Rui Zhao, Yanjing Ou, Jiang Chen, Jinjin Li","doi":"10.1186/s40729-024-00570-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To systematically assess studies regarding the efficacy of lasers in the nonsurgical treatment of peri-implantitis.</p><p><strong>Methods: </strong>Electronic and manual searches were performed by two reviewers independently. Randomized controlled trials (RCTs) comparing lasers vs. mechanical debridement or air abrasive on primary outcome (probing depth (PD)) and secondary outcomes (bone loss, bleeding on probing (BOP), clinical attachment level (CAL) and plaque index (PI)) were included. Data extraction and quality assessment were conducted independently. Weighted mean difference (WMD) or standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for continuous outcomes. Publication bias, leave-one-out analysis and GRADE assessment were conducted.</p><p><strong>Result: </strong>13 eligible publications were included in the review and 12 in the meta-analysis. Solid-state lasers significantly improved in PD (WMD = -0.39, 95% CI (-0.70, -0.09), p = 0.01, moderate-certainty evidence), BOP (SMD =-0.76, 95% CI (-1.23, -0.28), p = 0.002, moderate-certainty evidence) and CAL (WMD =-0.19, 95% CI (-0.39, -0.00), p = 0.05, moderate-certainty evidence), but not in bone loss (WMD = 0.03, 95% CI (-0.13, 0.18), p = 0.74, low-certainty evidence) and PI (SMD =-0.19, 95% CI (-0.42, 0.04), p = 0.11, moderate-certainty evidence) compared with the control group. However, the diode lasers showed no clinical advantages. No publication bias was detected, and leave-one-out analysis confirmed the robustness of findings.</p><p><strong>Conclusion: </strong>In the nonsurgical treatment of peri-implantitis, solid-state lasers yielded positive influence in term of PD, BOP and CAL, while diode laser provided no beneficial effect. Future well-designed large RCTs are still needed, considering the limitations of included studies.</p><p><strong>Clinical relevance: </strong>This review aimed to guide clinicians in choosing the appropriate laser for peri-implantitis, enhancing treatment strategies and attaining better outcomes.</p>","PeriodicalId":14076,"journal":{"name":"International Journal of Implant Dentistry","volume":"10 1","pages":"54"},"PeriodicalIF":3.1000,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564455/pdf/","citationCount":"0","resultStr":"{\"title\":\"The clinical efficacy of laser in the nonsurgical treatment of peri-implantitis: a systematic review and meta-analysis.\",\"authors\":\"Nengwen Huang, Yang Li, Wen Li, Rui Zhao, Yanjing Ou, Jiang Chen, Jinjin Li\",\"doi\":\"10.1186/s40729-024-00570-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To systematically assess studies regarding the efficacy of lasers in the nonsurgical treatment of peri-implantitis.</p><p><strong>Methods: </strong>Electronic and manual searches were performed by two reviewers independently. Randomized controlled trials (RCTs) comparing lasers vs. mechanical debridement or air abrasive on primary outcome (probing depth (PD)) and secondary outcomes (bone loss, bleeding on probing (BOP), clinical attachment level (CAL) and plaque index (PI)) were included. Data extraction and quality assessment were conducted independently. Weighted mean difference (WMD) or standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for continuous outcomes. Publication bias, leave-one-out analysis and GRADE assessment were conducted.</p><p><strong>Result: </strong>13 eligible publications were included in the review and 12 in the meta-analysis. 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引用次数: 0
摘要
目的系统评估有关激光在非手术治疗种植体周围炎方面疗效的研究：由两名审稿人独立进行电子和人工检索。纳入了在主要结果（探诊深度 (PD)）和次要结果（骨质流失、探诊出血 (BOP)、临床附着水平 (CAL) 和斑块指数 (PI)）方面比较激光与机械清创或气磨的随机对照试验 (RCT)。数据提取和质量评估均独立进行。对于连续性结果，计算加权平均差（WMD）或标准化平均差（SMD）和 95% 置信区间（CI）。结果：13篇符合条件的文献被纳入综述，12篇被纳入荟萃分析。固体激光明显改善了PD（WMD = -0.39，95% CI (-0.70, -0.09)，p = 0.01，中度确定性证据）、BOP（SMD =-0.76，95% CI (-1.23, -0.28)，p = 0.002，中度确定性证据）和CAL（WMD =-0.19，95% CI (-0.39, -0.00)，p = 0.05，中度确定性证据）。00），p = 0.05，中度确定性证据），但与对照组相比，骨质流失（WMD = 0.03，95% CI (-0.13, 0.18)，p = 0.74，低度确定性证据）和 PI（SMD =-0.19，95% CI (-0.42, 0.04)，p = 0.11，中度确定性证据）则没有改善。然而，二极管激光器并没有显示出临床优势。研究未发现发表偏倚，撇除分析证实了研究结果的可靠性：结论：在种植体周围炎的非手术治疗中，固体激光在PD、BOP和CAL方面产生了积极的影响，而二极管激光则没有提供有益的效果。考虑到纳入研究的局限性，未来仍需要设计良好的大型 RCT：本综述旨在指导临床医生选择合适的激光治疗种植体周围炎，改进治疗策略，取得更好的疗效。
The clinical efficacy of laser in the nonsurgical treatment of peri-implantitis: a systematic review and meta-analysis.
Objective: To systematically assess studies regarding the efficacy of lasers in the nonsurgical treatment of peri-implantitis.
Methods: Electronic and manual searches were performed by two reviewers independently. Randomized controlled trials (RCTs) comparing lasers vs. mechanical debridement or air abrasive on primary outcome (probing depth (PD)) and secondary outcomes (bone loss, bleeding on probing (BOP), clinical attachment level (CAL) and plaque index (PI)) were included. Data extraction and quality assessment were conducted independently. Weighted mean difference (WMD) or standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for continuous outcomes. Publication bias, leave-one-out analysis and GRADE assessment were conducted.
Result: 13 eligible publications were included in the review and 12 in the meta-analysis. Solid-state lasers significantly improved in PD (WMD = -0.39, 95% CI (-0.70, -0.09), p = 0.01, moderate-certainty evidence), BOP (SMD =-0.76, 95% CI (-1.23, -0.28), p = 0.002, moderate-certainty evidence) and CAL (WMD =-0.19, 95% CI (-0.39, -0.00), p = 0.05, moderate-certainty evidence), but not in bone loss (WMD = 0.03, 95% CI (-0.13, 0.18), p = 0.74, low-certainty evidence) and PI (SMD =-0.19, 95% CI (-0.42, 0.04), p = 0.11, moderate-certainty evidence) compared with the control group. However, the diode lasers showed no clinical advantages. No publication bias was detected, and leave-one-out analysis confirmed the robustness of findings.
Conclusion: In the nonsurgical treatment of peri-implantitis, solid-state lasers yielded positive influence in term of PD, BOP and CAL, while diode laser provided no beneficial effect. Future well-designed large RCTs are still needed, considering the limitations of included studies.
Clinical relevance: This review aimed to guide clinicians in choosing the appropriate laser for peri-implantitis, enhancing treatment strategies and attaining better outcomes.
期刊介绍：
The International Journal of Implant Dentistry is a peer-reviewed open access journal published under the SpringerOpen brand. The journal is dedicated to promoting the exchange and discussion of all research areas relevant to implant dentistry in the form of systematic literature or invited reviews, prospective and retrospective clinical studies, clinical case reports, basic laboratory and animal research, and articles on material research and engineering.
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