Er：YAG激光辅助龈下刮治和根面平整术治疗牙周炎的Meta分析

汪林静 杨明聪

[关键词] 慢性牙周炎;Er：YAG 激光;龈下刮治和根面平整术;Meta分析

[中图分类号] R781.42          [文献标识码] B          [文章编号] 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

牙周炎是人類最常见的慢性感染性疾病之一，主要特征为牙齿支持组织的进行性破坏，甚至造成牙齿的松动、脱落[1]。龈下刮治和根面平整术（Scaling and root planing，SRP）是目前最主要且最有效的治疗方法[2]。然而，单独的SRP有一定的局限性，有时并不能有效清除病变的牙周组织，如对于深牙周袋及窄小的根分叉区域，因器械无法到达而难以去除牙结石及坏死根面组织。同时有研究显示，手工器械及超声器械行龈下刮治及根面平整时均可能会去掉过多的牙根表面的牙骨质或破坏牙根表面的形态，同时形成玷污层，从而不利于牙周软组织的愈合[2-3]。