貝氏網絡統合分析之應用：一次性全口牙根表面整平術對慢性牙周炎之療效

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貝氏網絡統合分析之應用：一次性全口牙根表面整平術對慢性牙周炎之療效

Application of Bayesian network meta-analysis to full-mouth disinfection for the treatment of chronic periodontitis

呂雅媛 , Masters　　Advisor：杜裕康　　

繁體中文

慢性牙周炎；象限分次全口牙根表面整平術；一次性全口牙根表面整平術；統合分析；網絡統合分析； Chronic periodontitis ； Quadrant scaling and root planning ； Full-mouth scaling and root planning ； Pairwise meta-analysis ； Network meta-analysis

Abstract │ Reference (36) │ Altmetrics

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Background 
Bayesian network meta-analysis has gained widespread popularity in the synthesis of clinical evidence in the recent years. Traditional meta-analysis is limited to pairwise- comparisons, and when more than two treatments to be compared, multiple pairwise comparisons have to be undertaken. However, some direct comparisons among pairs of treatments may not have been conducted, or only very few studies have undertaken direct comparisons. Bayesian network meta-analysis overcomes the limitations of traditional meta-analysis by combining both direct and indirect comparisons of multiple treatments, giving rise consistent estimates of relative effectiveness of multiple treatments.  
Objectives
Quadrant scaling and root planning (Q-SRP) and full-mouth scaling and root planning (FM-SRP) are two common non-surgical treatments for chronic periodontitis. Both have also been used in conjunction with other supplemented materials, such as antimicrobials and mouth rinse. The aim of this study was to conduct Bayesian network meta-analysis of randomized control trials for comparisons of treatment effects of Q-SRP, FM-SRP and their combination therapies.
Source of Data
A systematic literature search was conducted, on electronic database Medline, Pubmed , Cochrane CENTRAL and Embase with no time and language restriction up to May 2015. Treatment outcomes were changes in probing pocket depth (PPD) and changes in clinical attachment level (CAL).
Results
A total of 18 studies were included in Bayesian network meta-analysis. We only found small differences among Q-SRP, FM-SRP and their combination therapies and these differences were neither statistically nor clinically significant. In terms of treatment ranking, full-mouth scaling in conjunction with chlorhexidine and fluoride (FM-SRP+CHX+F) had the best performance on PPD reduction, while full-mouth scaling supplement to chlorhexidine Varnish (FM-SRP+CHX Varnish) achieved the greatest CAL reduction at 3 months than other treatments. Full-mouth scaling in conjunction with chlorhexidine (FM-SRP+CHX) had greater CAL reduction at 6 months than other treatments.
Conclusions
This study did not find substantial differences in benefits of different non-surgical treatment strategies for chronic periodontitis, although are similar. FM-SRP+CHX+F have the best performance on PPD; FM-SRP+CHX Varnish and FM-SRP+CHX have the best performance on CAL.

Reference ( 36 ) 〈TOP〉

1. Farman, M. and R.I. Joshi, Full-mouth treatment versus quadrant root surface debridement in the treatment of chronic periodontitis: a systematic review. Br Dent J, 2008. 205(9): p. E18; discussion 496-7.
2. Eberhard, J., et al., Full-mouth disinfection for the treatment of adult chronic periodontitis (Review). The Cochrane Collaboration, 2012.
3. Lang, N.P., et al., A systematic review of the effects of full-mouth debridement with and without antiseptics in patients with chronic periodontitis. J Clin Periodontol, 2008. 35(8 Suppl): p. 8-21.
4. 國泰綜合醫院. 衛教資訊-牙周病的預防與治療. http://www.cgh.org.tw/tw/content/depart/5000/article.html.
5. Higgins, J.P.T. and A. Whitehead, Borrowing strength from external trails in a meta-analysis. Stat Med, 1996. 15: p. 2733-2749.

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