辅助掺钕钇铝石榴石激光治疗2型糖尿病牙周炎：一项随机对照试验。
完整摘要 · 中文译文
目的：确定在常规非手术牙周治疗基础上加用辅助性掺钕钇铝石榴石激光治疗，是否比单独常规非手术牙周治疗在牙周炎合并2型糖尿病患者中带来更大的基线校正后6个月探诊深度改善。方法：本随机对照试验纳入120例牙周炎合并2型糖尿病患者。参与者按1：1比例随机分配至激光组（常规非手术牙周治疗加辅助性掺钕钇铝石榴石激光治疗，n = 60）或对照组（单独常规非手术牙周治疗，n = 60）。常规非手术牙周治疗包括龈上洁治和根面平整，并给予标准化的家庭口腔卫生指导和强化。在基线和6个月时评估牙周和血糖结局。主要结局是6个月平均探诊深度的组间差异，使用协方差分析对基线探诊深度进行校正。次要结局包括临床附着水平、探诊出血阳性位点、牙龈退缩、糖化血红蛋白和空腹血糖水平的基线校正后组间差异。结果：除平均牙龈退缩存在轻度差异外，两组基线特征总体相当。根据主要分析，激光组基线校正后6个月平均探诊深度显著低于对照组（校正 校正差异为-0.70 mm（95%置信区间，-0.84至-0.56），p < 0.001）。基线校正后的差异在临床附着水平（-0.67 mm；95%置信区间，-0.79至-0.55）、探诊出血阳性位点（-11.3个百分点；95%置信区间，-13.9至-8.7）、糖化血红蛋白（-0.26%；95%置信区间，-0.34至-0.17）和空腹血糖水平（-0.62 mmol/L；95%置信区间，-0.81至-0.44）方面也支持激光组（均p < 0.001）。基线校正后，激光组的牙龈退缩略高（+0.09 mm；95%置信区间，0.03至0.14；p = 0.004）。未记录到与治疗相关的严重不良事件。结论辅助性掺钕钇铝石榴石激光治疗在牙周临床结局的短期改善方面优于单纯传统非手术牙周治疗。二次糖代谢结局也观察到有利变化；然而，应谨慎解读这些结果，因为糖代谢变量为次要终点，且随访时间仅限于6个月。研究注册号researchregistry12005。
完整摘要 · 英文原文
ObjectiveTo determine whether adjunctive neodymium-doped yttrium aluminum garnet laser therapy added to conventional nonsurgical periodontal therapy provides greater improvement in baseline-adjusted 6-month probing depth than conventional nonsurgical periodontal therapy alone in patients with periodontitis and type 2 diabetes mellitus.MethodsThis randomized controlled trial included 120 patients with periodontitis and type 2 diabetes mellitus. Participants were randomly assigned in a 1:1 ratio to the laser group (conventional nonsurgical periodontal therapy plus adjunctive neodymium-doped yttrium aluminum garnet laser therapy, n = 60) or the control group (conventional nonsurgical periodontal therapy alone, n = 60). Conventional nonsurgical periodontal therapy comprised scaling and root planing with standardized home oral-hygiene instruction and reinforcement. Periodontal and glycemic outcomes were assessed at baseline and 6 months. The primary outcome was the between-group difference in the 6-month mean probing depth, adjusted for baseline probing depth using analysis of covariance. Secondary outcomes included baseline-adjusted between-group differences in clinical attachment level, bleeding on probing-positive sites, gingival recession, glycosylated hemoglobin, and fasting plasma glucose level.ResultsBaseline characteristics were generally comparable between groups, except a modest difference in mean gingival recession. Based on the primary analysis, the baseline-adjusted 6-month mean probing depth was significantly lower in the laser group than in the control group (adjusted difference, -0.70 mm (95% confidence interval, -0.84 to -0.56) p < 0.001). Baseline-adjusted differences also favored the laser group for clinical attachment level (-0.67 mm; 95% confidence interval, -0.79 to -0.55), bleeding on probing-positive sites (-11.3 percentage points; 95% confidence interval, -13.9 to -8.7), glycosylated hemoglobin (-0.26%; 95% confidence interval, -0.34 to -0.17), and fasting plasma glucose level (-0.62 mmol/L; 95% confidence interval, -0.81 to -0.44) (all p < 0.001). Gingival recession was slightly higher in the laser group after baseline adjustment (+0.09 mm; 95% confidence interval, 0.03 to 0.14; p = 0.004). No serious treatment-related adverse events were recorded.ConclusionsAdjunctive neodymium-doped yttrium aluminum garnet laser therapy was associated with greater short-term improvement in periodontal clinical outcomes than conventional nonsurgical periodontal therapy alone. Favorable changes in secondary glycemic outcomes were also observed; however, these results should be interpreted cautiously because cautiously because glycemic variables were secondary endpoints, and the follow-up duration was limited to 6 months.Research registration numberresearchregistry12005.