局部应用派丽奥与牙康比较治疗成人慢性牙周炎的Meta分析_《中国循证医学杂志》

作者：

李思敏 ,  郭良微 , 丁玲

哈尔滨医科大学附属口腔医院牙周病科（哈尔滨 150001）;

关键词：

米诺环素甲硝唑牙周炎系统评价 Meta分析随机对照试验

DOI：

10.7507/1672-2531.20130038

视频：

导出 下载 收藏 扫码 引用

摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价局部应用派丽奥（2%盐酸米诺环素软膏）与牙康（甲硝唑棒）比较治疗成人慢性牙周炎的临床疗效。
方法　计算机检索PubMed、The Cochrane Library、EMbase、CNKI、CBM和WanFang Data数据库，查找派丽奥与牙康比较治疗慢性牙周炎的随机对照试验（RCT），并追溯纳入文献的参考文献，文献检索时限均从建库至2012年7月。由2名评价员按照纳入和排除标准独立进行文献筛选、资料提取和评价纳入研究的方法学质量后，采用RevMan 5.0软件进行Meta分析。
结果　最终纳入7个RCT，737例受试者。Meta分析结果显示：治疗后两组在探诊深度［MD=0.26，95%CI（–0.35，0.87），P=0.40］、临床附着水平［MD=–0.10，95%CI（–0.75，0.54），P=0.75］、龈沟出血指数［MD=0.12，95%CI（–0.30，0.53），P=0.59］和菌斑指数［MD=0.07，95%CI（–0.09，0.22），P=0.41］的改变方面，差异均无统计学意义。
结论　现有研究证据表明，在牙周基础治疗后，局部应用派丽奥和牙康治疗慢性牙周炎的疗效无显著差异。但由于纳入研究的方法学质量均欠佳，且样本量有限，因此本系统评价结论尚需开展更多设计严谨的高质量、大样本RCT进一步验证，并尽可能延长随访时间以观察长期疗效。

引用本文： 李思敏,郭良微,丁玲. 局部应用派丽奥与牙康比较治疗成人慢性牙周炎的Meta分析. 中国循证医学杂志, 2013, 13(2): 224-230. doi: 10.7507/1672-2531.20130038 复制

1.	Miani PK, do Nascimento C, Sato S, et al. In vivo evaluation of a metronidazole-containing gel for the adjuvant treatment of chronic periodontitis: preliminary results. Eur J Clin Microbiol Infect Dis, 2012, 31(7): 1611-1618.
2.	Ribeiro Edel P, Bittencourt S, Zanin IC, et al. Full-mouth ultrasonic debridement associated with amoxicillin and metronidazole in the treatment of severe chronic periodontitis. J Periodontol, 2009, 80(8):1254-1264.
3.	Sedlacek MJ, Walker C. Antibiotic resistence in an in vitro subgingival biofilm model. Oral Microbiol Immunol, 2007, 22(5): 333-339.
4.	Zandbergen D, Slot DE, Cobb CM, et al. The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontal, 2012, 83(5): 1-29.
5.	Bogren A, Teles RP, Torresyap G, et al. Locally delivered doxycycline during supportive periodontal therapy: a 3-year study. J Periodontal, 2008, 79(5): 827-835.
6.	Paolantonio M, D’ Ercole S, Pilloni A, et al. Clinical, microbiologic, and biochemical effects of subgingival administration of a Xanthan-based chlorhexidine gel in the treatment of periodontitis: a randomized multicenter trial. J Periodontol, 2009, 80(9): 1479-1492.
7.	Singh S, Roy S, Chumber SK. Evaluation of two local drug delivery systems as adjuncts to mechanotherapy as compared to mechanotherapy alone in management of chronic periodontitis: A clinical, microbiological, and molecular study. J Indian Soc Periodontol, 2009, 13(3): 126-132.
8.	Colombo AP, Bennet S, Cotton SL, et al. Impact of periodontal therapy on the subgingival microbiota of severe periodontitis: comparison between good responders and individuals with refractory periodontitis using the human oral microbe identification microarray. J Periodontol, 2012, 83(10): 1279-1287.
9.	Rizzo A, Paolillo R, Guida L, et al. Effect of metronidazole and modulation of cytokine production on human periodontal ligament cells. Int Immunopharmacol, 2010, 10(7): 744-750.
10.	Reise M, Wyrwa R, Müller U, et al. Release of metronidazole from electrospun poly (L-lactide-co-D/L-lactide) fibers for local periodontitis treatment. Dental Mater, 2012, 28(2): 179-188.
11.	Bruschi ML, Jones DS, Panzeri H, et al. Semisolid systems containing propolis for the treatment of periodontal disease: in vitro release kinetics, syringeability, rheological, textural, and mucoadhesive properties. J Pharm Sci, 2007, 96(8): 2074-2089.
12.	Sato S, Fonseca MJ, Ciampo JO, et al. Metronidazole-containing gel for the treatment of periodontitis: an in vivo evaluation. Braz Oral Res, 2008, 22(2): 145-150.
13.	Tiwari G, Tiwari R, Rai AK. Studies on development of controlled delivery of combination drug(s) to periodontal pocket. Indian J Dent Res, 2010, 21(1): 72-83.
14.	欧阳翔英. 牙周病的药物治疗. 见: 曹采方, 主编. 临床牙周病学. 第1版. 北京: 北京大学医学出版社, 2006: 280.
15.	孙颖, 吴亚菲. 米诺环素在牙周治疗中的应用. 牙体牙髓牙周病学杂志, 2003, 13(11): 659-661.
16.	Yilmaz S, Kut B, Gursoy H, et al. Er: YAG laser versus systemic metronidazole as an adjunct to nonsurgical periodontal therapy: a clinical and microbiological study. Photomed Laser Surg, 2012, 30(6): 325-330.
17.	Silva MP, Feres M, Sirotto TA, et al. Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol, 2011, 38(9): 828-837.
18.	傅晓幼, 李国峰. 三种药物对牙周炎的临床疗效研究. 南方医科大学学报, 2010, 30(3): 611-613.
19.	张俊羽. 盐酸米诺环素软膏和甲硝唑棒治疗慢性牙周病58例的疗效比较. 广西医学, 2008, 30(2): 238-239.
20.	李绮文. 米诺环素辅助治疗慢性牙周炎疗效观察. 中国现代药物应用, 2008, 2(23): 67.
21.	梅雪. 盐酸米诺环素软膏、甲硝唑、碘甘油对牙周炎的效果观察. 中国卫生产业, 2012, (6): 54-55.
22.	胡燕. 盐酸米诺环素局部治疗慢性牙周炎的临床效果评价. 中国医药指南, 2011, 9(15): 228-230.
23.	邹红. 盐酸米诺环素软膏、甲硝唑、碘甘油对牙周炎的临床效果观察. 中国医药导报, 2011, 8(19): 67-68.
24.	陈家欢, 陈金萍, 张楠. 盐酸米诺环素软膏治疗中重度慢性牙周炎临床疗效评价. 广州医药, 2010, 41(2): 32-34.
25.	韩宁, 杨圣辉. 牙周病缓释治疗的进展. 北京口腔医学, 2000, 8(2): 98-107.
26.	罗杰, 肖晓蓉, 刘琴, 等. 派丽奥局部应用治疗牙周炎的疗效评价. 西部医学, 2008, 20(5): 1057-1059.
27.	李湘明. 甲硝唑联合盐酸米诺环素治疗牙周炎的临床观察. 中国现代医生, 2010, 48(21): 56-57.
28.	王聃, 邓嘉胤. 牙周局部缓释型制剂的研究现状及应用进展. 中国组织工程研究与临床康复. 2010, 14(8): 1437-1441.
29.	吴昊, 牛薇. 派丽奥与牙康局部治疗牙周炎效果的Meta分析. 口腔医学研究, 2012, 28(6): 563-569.

1. Miani PK, do Nascimento C, Sato S, et al. In vivo evaluation of a metronidazole-containing gel for the adjuvant treatment of chronic periodontitis: preliminary results. Eur J Clin Microbiol Infect Dis, 2012, 31(7): 1611-1618.
2. Ribeiro Edel P, Bittencourt S, Zanin IC, et al. Full-mouth ultrasonic debridement associated with amoxicillin and metronidazole in the treatment of severe chronic periodontitis. J Periodontol, 2009, 80(8):1254-1264.
3. Sedlacek MJ, Walker C. Antibiotic resistence in an in vitro subgingival biofilm model. Oral Microbiol Immunol, 2007, 22(5): 333-339.
4. Zandbergen D, Slot DE, Cobb CM, et al. The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontal, 2012, 83(5): 1-29.
5. Bogren A, Teles RP, Torresyap G, et al. Locally delivered doxycycline during supportive periodontal therapy: a 3-year study. J Periodontal, 2008, 79(5): 827-835.
6. Paolantonio M, D’ Ercole S, Pilloni A, et al. Clinical, microbiologic, and biochemical effects of subgingival administration of a Xanthan-based chlorhexidine gel in the treatment of periodontitis: a randomized multicenter trial. J Periodontol, 2009, 80(9): 1479-1492.
7. Singh S, Roy S, Chumber SK. Evaluation of two local drug delivery systems as adjuncts to mechanotherapy as compared to mechanotherapy alone in management of chronic periodontitis: A clinical, microbiological, and molecular study. J Indian Soc Periodontol, 2009, 13(3): 126-132.
8. Colombo AP, Bennet S, Cotton SL, et al. Impact of periodontal therapy on the subgingival microbiota of severe periodontitis: comparison between good responders and individuals with refractory periodontitis using the human oral microbe identification microarray. J Periodontol, 2012, 83(10): 1279-1287.
9. Rizzo A, Paolillo R, Guida L, et al. Effect of metronidazole and modulation of cytokine production on human periodontal ligament cells. Int Immunopharmacol, 2010, 10(7): 744-750.
10. Reise M, Wyrwa R, Müller U, et al. Release of metronidazole from electrospun poly (L-lactide-co-D/L-lactide) fibers for local periodontitis treatment. Dental Mater, 2012, 28(2): 179-188.
11. Bruschi ML, Jones DS, Panzeri H, et al. Semisolid systems containing propolis for the treatment of periodontal disease: in vitro release kinetics, syringeability, rheological, textural, and mucoadhesive properties. J Pharm Sci, 2007, 96(8): 2074-2089.
12. Sato S, Fonseca MJ, Ciampo JO, et al. Metronidazole-containing gel for the treatment of periodontitis: an in vivo evaluation. Braz Oral Res, 2008, 22(2): 145-150.
13. Tiwari G, Tiwari R, Rai AK. Studies on development of controlled delivery of combination drug(s) to periodontal pocket. Indian J Dent Res, 2010, 21(1): 72-83.
14. 欧阳翔英. 牙周病的药物治疗. 见: 曹采方, 主编. 临床牙周病学. 第1版. 北京: 北京大学医学出版社, 2006: 280.
15. 孙颖, 吴亚菲. 米诺环素在牙周治疗中的应用. 牙体牙髓牙周病学杂志, 2003, 13(11): 659-661.
16. Yilmaz S, Kut B, Gursoy H, et al. Er: YAG laser versus systemic metronidazole as an adjunct to nonsurgical periodontal therapy: a clinical and microbiological study. Photomed Laser Surg, 2012, 30(6): 325-330.
17. Silva MP, Feres M, Sirotto TA, et al. Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol, 2011, 38(9): 828-837.
18. 傅晓幼, 李国峰. 三种药物对牙周炎的临床疗效研究. 南方医科大学学报, 2010, 30(3): 611-613.
19. 张俊羽. 盐酸米诺环素软膏和甲硝唑棒治疗慢性牙周病58例的疗效比较. 广西医学, 2008, 30(2): 238-239.
20. 李绮文. 米诺环素辅助治疗慢性牙周炎疗效观察. 中国现代药物应用, 2008, 2(23): 67.
21. 梅雪. 盐酸米诺环素软膏、甲硝唑、碘甘油对牙周炎的效果观察. 中国卫生产业, 2012, (6): 54-55.
22. 胡燕. 盐酸米诺环素局部治疗慢性牙周炎的临床效果评价. 中国医药指南, 2011, 9(15): 228-230.
23. 邹红. 盐酸米诺环素软膏、甲硝唑、碘甘油对牙周炎的临床效果观察. 中国医药导报, 2011, 8(19): 67-68.
24. 陈家欢, 陈金萍, 张楠. 盐酸米诺环素软膏治疗中重度慢性牙周炎临床疗效评价. 广州医药, 2010, 41(2): 32-34.
25. 韩宁, 杨圣辉. 牙周病缓释治疗的进展. 北京口腔医学, 2000, 8(2): 98-107.
26. 罗杰, 肖晓蓉, 刘琴, 等. 派丽奥局部应用治疗牙周炎的疗效评价. 西部医学, 2008, 20(5): 1057-1059.
27. 李湘明. 甲硝唑联合盐酸米诺环素治疗牙周炎的临床观察. 中国现代医生, 2010, 48(21): 56-57.
28. 王聃, 邓嘉胤. 牙周局部缓释型制剂的研究现状及应用进展. 中国组织工程研究与临床康复. 2010, 14(8): 1437-1441.
29. 吴昊, 牛薇. 派丽奥与牙康局部治疗牙周炎效果的Meta分析. 口腔医学研究, 2012, 28(6): 563-569.

《中国循证医学杂志》

局部应用派丽奥与牙康比较治疗成人慢性牙周炎的Meta分析

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

《中国循证医学杂志》

局部应用派丽奥与牙康比较治疗成人慢性牙周炎的Meta分析

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

摘要全文图表视频参考文献施引文献补充材料