目的:本系统综述旨在分析现有证据,以回答关于赤藓糖醇粉末空气抛光(EPAP)(i)在主动牙周治疗(APT)期间作为辅助治疗和(ii)在支持性牙周治疗(SPT)期间作为手/超声器械的替代方法的功效的两个重点问题。此外,微生物学结果和患者的舒适度/感知被评估为次要结果。
方法:PubMed,根据PRISMA指南,搜索了Cochrane和Medline在2021年2月之前发表的相关文章。搜索是由三名独立审稿人进行的,协议是由科恩的卡帕分数来衡量的。在1043篇文章中,选择了8项随机临床试验进行系统评价和定量综合.只有牙周参数,如临床依恋水平(CAL),探测袋深度(PPD)和探测时出血(BoP),显示出均匀性,因此,选择进行荟萃分析。
结果:在APT和SPT期间,使用EPAP后PPD和BoP评分的改善与手/超声仪器相当。在APT期间使用EPAP实现了显著的CAL增益(0.16mm,p<0.02)与终点的手/超声波仪器相比,而在SPT期间实现了非显著的CAL增益。在两种治疗方式之间的微生物学结果没有观察到差异。然而,EPAP造成的疼痛较少,患者的感知更好。
结论:赤藓糖醇粉末空气抛光可以代替SPT的手/超声仪器,当在APT期间使用EPAP作为辅助时,CAL增益显着提高。对于微生物结果,两种方法之间没有观察到显著差异;然而,与手/超声仪器相比,患者对EPAP的耐受性更好。
结论:赤藓糖醇粉末空气抛光可用作APT期间的辅助和SPT期间常规机械清创的替代方法。
OBJECTIVE: This systematic
review aimed to analyse available evidence to answer two focused questions about the efficacy of
erythritol powder air-polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient\'s comfort/perceptions were assessed as secondary outcomes.
METHODS: PubMed, Cochrane and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. The search was conducted by three independent reviewers, and the agreement was measured by Cohen\'s kappa score. Out of 1043 articles, eight randomized clinical trials were selected for systematic
review and quantitative synthesis. Only periodontal parameters, such as clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing (BoP), showed homogeneity and, thus, were selected for meta-analysis.
RESULTS: The improvement in PPD and BoP scores after using EPAP was comparable with hand/ultrasonic instrumentation during both APT and SPT. Significant CAL gain was achieved with EPAP during APT (0.16 mm, p < 0.02) compared with hand/ultrasonic instrumentation at the end point, whereas non-significant CAL gain was achieved during SPT. No differences were observed regarding microbiological outcomes between the two treatment modalities. However, EPAP inflicted less pain and was better perceived by the patients.
CONCLUSIONS: Erythritol powder air-polishing can substitute hand/ultrasonic instrumentation for SPT, and CAL gain is significantly improved when EPAP is used as an adjunct during APT. For microbiological outcomes, no significant differences were observed between the two approaches; however, EPAP was better tolerated by the patients than hand/ultrasonic instrumentation.
CONCLUSIONS: Erythritol powder air-polishing can be used as an adjunct during APT and as an alternative to conventional mechanical debridement during SPT.