■评估二极管激光辅助牙周皮瓣手术治疗慢性牙周炎的临床效果和术后疼痛管理,并为该程序的临床使用提供循证医学理由。
■在这项研究中,使用计算机结合人工检索检索从数据库建立到2023年9月发表的有关二极管激光辅助牙周瓣手术治疗慢性牙周炎的文章.检索的数据库包括中国学术期刊全文数据库(CNKI),中国生物医学文献数据库(CBM),中国科技期刊数据库(VIP),万方数据库,PubMed,WebofScience,科克伦图书馆,Embase,还有Scopus.两名研究人员独立进行筛选和研究选择,按照纳入和排除标准提取基本信息和所需数据。采用RevmanV5.4软件对纳入文献进行Meta分析。
■分析了13篇文章。荟萃分析表明,使用二极管激光可有效减少术后3和6个月的患者探查袋深度(PPD)(3个月:MD=-0.46,95%CI=[-0.89,-0.03],P=0.04;6个月:MD=-0.35,95%CI=[-0.63,-0.06],P=0.02),能够有效提高3个月临床依恋水平(CAL)(MD=-0.36,95%CI=[-0.66,-0.06],P=0.02),并且能够促进伤口愈合并减轻患者术后早期疼痛(MD=0.67,95%CI=[0.01,1.32],P=0.05;MD=-1.67,95%CI=[-2.23,-1.00],P<0。001),而对于牙龈指数(GI),使用二极管激光器没有明显的效果。
■现有证据表明,使用二极管激光器辅助器件可有效降低PPD,改进CAL,促进伤口愈合,与单纯应用皮瓣相比,减少了患者术后早期疼痛;然而,对于GI,二极管激光器没有显示任何改进。
■牙周膜瓣手术未能消除软组织壁的微生物,可能导致重新殖民,再感染,以及伴随的副作用,如疼痛和肿胀。二极管激光器的使用降低了PPD,改进了CAL,减轻术后早期疼痛。
UNASSIGNED: To assess the diode laser-assisted periodontal flap surgery\'s clinical effectiveness and postoperative pain management in treating chronic periodontitis, and to offer evidence-based medical justification for the procedure\'s clinical use.
UNASSIGNED: In this study, a computer combined with manual search was used to search for articles on diode laser-assisted periodontal flap surgery for the treatment of chronic periodontitis published from the establishment of the database to September 2023. The databases searched included China Academic Journal Full Text Database (CNKI), China Biomedical Literature Database (CBM), Chinese Science and Technology Journal Database (VIP), Wanfang Database, PubMed, Web of science, Cochrane Library, Embase, and Scopus. Two researchers independently performed the screening and study selection, following the inclusion and exclusion standards to extract basic information and required data. Meta-analysis of the included literature was performed using Revman V5.4 software.
UNASSIGNED: Thirteen articles were analyzed. Meta-analysis showed that the use of the diode laser was effective in reducing patients\' probing pocket depth (PPD) at 3 and 6 months postoperatively (3 months: MD = -0.46, 95 % CI = [-0.89, -0.03], P = 0.04; 6 months: MD = -0.35, 95 % CI = [-0.63, -0.06], P = 0.02), was able to effectively improve 3 month clinical attachment level (CAL) (MD = -0.36, 95 % CI = [-0.66, -0.06], P = 0.02), and was able to promote wound healing and reduce patients\' early postoperative pain (MD = 0.67, 95 % CI = [0.01, 1.32], P = 0.05; MD = -1.67, 95 % CI = [-2.23, -1.00], and P < 0. 001), while for gingival index (GI), the use of diode laser did not have a significant effect.
UNASSIGNED: The available evidence suggests that the use of a diode laser adjunct is effective in reducing PPD, improving CAL, promoting wound healing, and reducing early postoperative pain in patients compared with flap application alone; however, for GI, diode lasers did not show any improvements.
UNASSIGNED: Periodontal flap surgery fails to eliminate microorganisms from the soft tissue wall, potentially leading to recolonization, reinfection, and accompanying side effects such as pain and swelling. The use of a diode laser reduces PPD, improves CAL, and relieves early postoperative pain.