机械性邻面菌斑控制措施对牙周非手术治疗效果影响的系统评价

doi:10.7518/gjkq.2021107

摘要/Abstract

摘要：

目的评估常见的机械性邻面菌斑控制措施对牙周炎患者邻面菌斑控制的效果,为临床口腔医生选择对患者合适的邻面菌斑控制措施提供有效的循证医学证据。方法计算机检索Pubmed、EMbase、Cochrane、Web of Science、CNKI、CBM、万方数据库中发表1980年3月至2020年4月的文章,对符合纳入标准的文献进行系统评价并进行可能的定量分析。结果最终纳入13项研究。分析提示：与牙线组比较,牙间隙刷组对菌斑指数有显著改善效应（P<0.000 01）。结论对于牙周炎患者使用邻面菌斑控制措施能去除更多的牙菌斑,作为刷牙的辅助手段,使用牙间隙刷比使用牙线能去除更多的牙菌斑。

关键词: 牙周炎, 牙菌斑, 机械性邻面菌斑控制, 系统评价

Abstract:

Objective Numerous studies have been conducted on plaque control measures in the interdental space, including on dental floss, interdental brush, toothpicks, and dental water jet. The knowledge and skills of dentists should be upgraded to provide patients with excellent plaque control measures. This systematic review evaluated the effectiveness of mechanical plaque control measures on adjacent plaque control of patients with periodontitis and discussed effective evidence-based dental interventions so dentists can apply appropriate adjacent plaque control measures for their patients. Methods Articles published in PubMed, EMbase, Cochrane, Web of Science, CNKI, CBM, and Wanfang database were searched from March 1980 to April 2020. Articles that involved mechanical adjacent plaque control in patients with periodontitis were included in this study. Participants and interventions: patients who were diagnosed with periodontal disease and who were administered with adjacent plaque control measures during periodontal treatment were selected. The articles that met the inclusion criteria were systematically evaluated. Possible quantitative analyses were performed. Results Thirteen studies were finally included for the analysis. Results showed that compared with dental floss, interdental brush significantly improved plaque index (P<0.000 01). The sample size was small, and the range of publication time was broad. Conclusion The use of adjacent plaque control measures for patients with periodontitis can remove more dental plaques. As an auxiliary means of brushing the teeth, interdental brushes can remove more plaques than flossing alone.

Key words: periodontitis, plaque, mechanical interdental cleaning, systematic review

中图分类号:

R781.4

黄晓慧,祁本婷,杨洁,刘玉,孙卫斌. 机械性邻面菌斑控制措施对牙周非手术治疗效果影响的系统评价[J]. 国际口腔医学杂志, 2021, 48(6): 656-663.

Huang Xiaohui,Qi Benting,Yang Jie,Liu Yu,Sun Weibin. Effects of mechanical adjacent surface plaque control measures on periodontal nonsurgical treatment: a systematic review[J]. Int J Stomatol, 2021, 48(6): 656-663.

图/表 5

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纳入的临床研究的基本特征"

文献	研究类型	观察周期	菌斑控制措施	测量指标	结论
Gjermo 1970^[7]	RCT 平行对照	基线 1月	牙线牙间隙刷	Silness & Loë PLI	在宽的牙间隙区,牙间隙刷更适合去除邻面菌斑
Jackson 2006^[8]	RCT 平行对照	基线 6周 3月	牙线牙间隙刷	Silness & Loë PLI、PD、RIPL、EIBI、BOP	通过齿间清洁,尤其是使用齿间刷可以改善牙周情况
章彦彦 2010^[9]	RCT 平行对照	基线 3月 6月 9月	牙线牙间隙刷	PLI、PD、BI、AL	各组复查时,PLI、BOP、PD均较基线明显改善,但9个月后指数有所反弹
金爱琼 2011^[10]	RCT 平行对照	基线 6周	牙线牙间隙刷	Silness & Loë PLI、PD、RIPL、EIBI、BOP	使用牙间隙刷,慢性牙周炎患者获益明显,体现为牙周体征改善、炎症减轻
周铨 2014^[11]	RCT 平行对照	基线 6周 3月 6月	牙间隙刷冲牙器	Turesky修正Quigley-Hein评分、PD、GI	冲牙器和牙间隙刷,作为牙刷的有效辅助工具,对于中重度牙周病患者的牙周维护期均具有良好的控制菌斑作用
Goyal 2016^[12]	RCT 平行对照	基线 2周	牙间隙刷冲牙器	Navy,Rustogi修正、BOP	冲牙器比牙间隙刷更有效地减少两周内的牙龈出血
谢乐 2017^[13]	RCT 平行对照	基线 1月 3月	仅牙刷牙线冲牙器仅冲牙器	GI、Turesky修正Quigley-Hein评分	冲牙器配合刷牙比单纯刷牙在1个月及3个月后能更有效的清除牙菌斑,减少牙龈出血
袁丹 2018^[14]	RCT 平行对照	基线 1月 3月	牙线冲牙器	Turesky修正Quigley-Hein评分、BOP	刷牙联合压力喷雾式冲牙器可有效减少牙菌斑附着,降低并发症
张宇辰 2019^[15]	RCT 平行对照	基线 1月 3月	牙线冲牙器	PLI、GI 牙龈出血发生率	冲牙器应用于牙周病临床治疗效果明显,能有效减少牙菌斑,降低牙龈出血等并发症发生率
Kiger 1991^[16]	RCT 交叉对照	基线 1月	仅牙刷牙线牙间隙刷	Turesky修正Quigley-Hein评分、Wolffe指数、GI	牙间隙刷与牙刷连用比单用牙刷或牙刷与牙线连用能更有效去除邻面菌斑
Christou 1998^[17]	RCT Split mouth	基线 6周	牙线牙间隙刷	Volpe修正Quigley-Hein评分、PD、BOP	使用牙间隙刷更能有效地去除牙菌斑并显著降低PD
Rösing 2006^[18]	RCT Split mouth	基线单次使用	仅牙刷牙线牙间隙刷	Silness & Loë PLI	对于牙周维护期受试者而言,牙间隙刷比牙线更能有效去除牙间龈上菌斑
李中琴 2009^[19]	RCT split-mouth	基线单次使用	牙线牙间隙刷	Turesky修正Quigley-Hein评分	使用牙间隙刷可以更有效地控制因牙间乳头退缩而暴露的较大牙间隙处的菌斑

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