PDF(Pubmed)
Abstract：
This network meta-analysis aims to compare the clinical efficacy of seven non-surgical therapies for peri-implant disease, including laser treatment, photobiomodulation therapy (PBMT), photodynamic therapy (PDT), systemic antibiotics (SA), probiotics, local antimicrobials (LA), and air-powder polishing (APP) combined with mechanical debridement (MD). We conducted searches in four electronic databases, namely PubMed, Embase, Web of Science, and The Cochrane Library, to identify randomized controlled trials of non-surgical treatments combined with MD for individuals (aged at least 18 years) diagnosed with peri-implantitis or peri-implant mucositis with a minimum of 3 months follow-up. The outcomes of the study were the reduction in pocket probing depth (PPD) and bleeding on probing (BoP), plaque index (PLI), clinical attachment level (CAL), and marginal bone loss (MBL). We employed a frequency random effects network meta-analysis model to combine the effect sizes of the trials using standardized mean difference (SMD) and 95% confidence intervals (CIs). Network meta-analyses include network plots, paired comparison forest plots, league tables, funnel plots, surface under the cumulative ranking area (SUCRA) plots, and sensitivity analysis plots. The results showed that, for peri-implantitis, PBMT +MD demonstrated the highest effect in improving PPD (SUCRA = 75.3%), SA +MD showed the highest effect in improving CAL (SUCRA = 87.4%, SMD = 2.20, and 95% CI: 0.38 to 4.02) and MBL (SUCRA = 99.9%, SMD = 3.92, and 95% CI. 2.90 to 4.93), compared to MD alone. For peri-implant mucositis, probiotics +MD demonstrated the highest effect in improving PPD (SUCRA = 100%) and PLI (SUCRA = 83.2%), SA +MD showed the highest effect in improving BoP (SUCRA = 88.1%, SMD = 0.77, and 95% CI: 0.27 to 1.28), compared to MD alone. Despite the ranking established by our study in the treatment of peri-implant disease, decisions should still be made with reference to the latest treatment guidelines. There is still a need for more high-quality studies to provide conclusive evidence and especially a need for studies regarding direct comparisons between multiple treatment options.
摘要：
这项网络荟萃分析旨在比较七种非手术疗法治疗种植体周围疾病的临床疗效。包括激光治疗,光生物调节疗法（PBMT），光动力疗法（PDT），全身性抗生素（SA），益生菌，局部抗菌剂（LA），和空气粉末抛光（APP）结合机械清创（MD）。我们在四个电子数据库中进行了搜索，即PubMed,Embase,WebofScience,和Cochrane图书馆,针对诊断为种植体周围炎或种植体周围黏膜炎的个体(年龄至少18岁),确定非手术治疗联合MD的随机对照试验,并进行至少3个月的随访.研究的结果是口袋探查深度（PPD）和探查出血（BoP）的减少，菌斑指数（PLI），临床依恋水平(CAL)，和边缘骨丢失（MBL）。我们采用频率随机效应网络荟萃分析模型，使用标准化平均差（SMD）和95％置信区间（CI）将试验的效应大小进行组合。网络荟萃分析包括网络图，配对比较森林地块，排行榜,漏斗图,累积排序面积(SUCRA)地块下的表面，和敏感性分析图。结果表明,对于种植体周围炎,PBMT+MD在改善PPD方面表现出最高效果(SUCRA=75.3%),SA+MD在改善CAL方面表现出最高的效果(SUCRA=87.4%，SMD=2.20，95%CI：0.38至4.02)和MBL(SUCRA=99.9%，SMD=3.92，95%CI。2.90to4.93),与单独的MD相比。对于种植体周围粘膜炎，益生菌+MD在改善PPD(SUCRA=100%)和PLI(SUCRA=83.2%)方面表现出最高效果，SA+MD在改善BoP方面效果最高(SUCRA=88.1%,SMD=0.77，95%CI：0.27至1.28)，与单独的MD相比。尽管我们的研究在种植体周围疾病的治疗中确立了排名，决定仍应参考最新的治疗指南。仍然需要更多高质量的研究来提供确凿的证据，特别是需要进行有关多种治疗方案之间直接比较的研究。
