牙周病患者隐形矫治器治疗前后龈沟液中炎性因子水平变化的Meta分析

台银霞, 张晗, 余磊, 朱宪春

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吉林大学学报(医学版) ›› 2025, Vol. 51 ›› Issue (1) : 182-190. DOI: 10.13481/j.1671-587X.20250122
临床研究

牙周病患者隐形矫治器治疗前后龈沟液中炎性因子水平变化的Meta分析

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Changes in levels of inflammatory factors in gingival crevicular fluid of patients with periodontal disease before and after invisible appliance:A Meta-analysis

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摘要

目的 分析评价错牙合畸形伴牙周病患者佩戴隐形矫治器前后龈沟液中炎症因子水平的变化,为临床实践提供参考。 方法 检索PubMed、Embase、Cochrane Library、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方和维普等数据库中隐形矫治器与固定矫治器对比治疗牙周病患者的相关文献,检索时间为1997年1月-2023年11月。由2名研究者独立完成筛选文献、提取数据和质量评价等过程,采用Review Manager 5.4统计软件分析矫治器佩戴前及佩戴6个月后患者龈沟液中炎症因子水平的变化,包括肿瘤坏死因子α(TNF-α)、C-反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞介素1β(IL-1β)和白细胞介素2(IL-2)。 结果 共纳入6个随机对照试验,总样本量为601例,结局指标按固定矫治器种类进行亚组分析。Meta分析,隐形矫治器组患者治疗后龈沟液中TNF-α[均值差(MD)=-1.32,95%CI:-1.87~-0.77,P<0.001]、IL-6(MD=-0.78,95%CI:-1.22~-0.35,P<0.001)、CRP(MD=-1.03,95%CI:-1.30~-0.76,P<0.001)和IL-1β(MD=-1.45,95%CI:-2.21~-0.70,P<0.001)水平变化明显低于固定矫治器组;IL-2水平变化明显高于固定矫治器组(MD=0.74,95%CI:0.61~0.87,P<0.001)。 结论 与固定矫治器比较,采用隐形矫治器治疗可以较好地控制牙周病患者龈沟液中炎性因子水平,有益于牙周病患者的牙周健康维护。

Abstract

Objective To analyze the changes in the levels of inflammatory factors in gingival crevicular fluid of the patients with periodontal disease underwent invisible appliance, and to provide the reference for clinical practice. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure(CNKI), Chinese Biology Medicine(CBM), Wanfang and VIP Databases were used for literature collection about the treatment using invisible appliance and fixed appliance for periodontal disease. The retrieval time was limited from January 1997 to November 2023. Two researchers independently screened the literatures and extracted data based on the inclusion and exclusion criteria,and conducted quality evaluation. Review Manager 5.4 software was used to analyze the changes in the levels of inflammatory cytokines including tumor necrosis factor-α(TNF-α),C-reaction protein(CRP), interleukin-6(IL-6),interleukin-1β(IL-1β) and interleukin-2(IL-2) before and 6 months after appliance placement. Results Six randomized controlled trials were included in this study with a total sample size of 601 cases. Subgroup analysis was conducted based on the type of brackets. The results of Meta-analysis showed that compared with fixed appliance group,the changes in the levels of TNF-α(MD=-1.32, 95%CI:-1.87--0.77,P<0.001),IL-6(MD=-0.78, 95%CI:-1.22--0.35, P<0.001),CRP(MD=-1.03, 95%CI:-1.30--0.76, P<0.001) and IL-1β (MD=-1.45, 95%CI:-2.21--0.70, P<0.001) in invisible appliance group were significantly decreased, while the change in IL-2 level(MD=0.74,95%CI:0.61-0.87, P<0.001) was significantly increased. Conclusion Compared with fixed appliance, the invisible appliance can better control the levels of inflammatory factors in gingival crevicular fluid of the patients with periodontal disease,which is beneficial to the periodontal tissue health of these patients.

关键词

牙周病 / 隐形矫治器 / 固定矫治器 / Meta分析 / 炎症因子

Key words

Periodontal disease / Invisible appliance / Fixed appliance / Meta-analysis / Inflammatory factors

中图分类号

R783.5

引用本文

导出引用
台银霞 , 张晗 , 余磊 , . 牙周病患者隐形矫治器治疗前后龈沟液中炎性因子水平变化的Meta分析. 吉林大学学报(医学版). 2025, 51(1): 182-190 https://doi.org/10.13481/j.1671-587X.20250122
Yinxia TAI, Han ZHANG, Lei YU, et al. Changes in levels of inflammatory factors in gingival crevicular fluid of patients with periodontal disease before and after invisible appliance:A Meta-analysis[J]. Journal of Jilin University(Medicine Edition). 2025, 51(1): 182-190 https://doi.org/10.13481/j.1671-587X.20250122

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作者贡献声明

台银霞参与研究构思与设计、研究实施、统计学分析及论文撰写,张晗参与文献筛选、资料提取、偏倚风险评估及图表绘制,余磊参与文献筛选、资料提取及偏倚风险评估,朱宪春参与课题指导、论文审阅与修改。

基金

吉林省科技厅自然科学基金项目(YDZJ202201ZYTS057)

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©《吉林大学学报(医学版)》编辑部,开放获取遵循CC BY-NC-ND协议。

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