| Objective:At present,most probiotics used clinically are Lactobacillus,Bifidobacterium and Streptococcus,among which Lactobacillus reuteri is the most common.Probiotics have been shown to improve clinical indicators in patients with periodontitis.The treatment of peri-implant diseases(PID)is similar to periodontitis by controlling the formation of biofilms to reduce inflammation.At present,it is controversy whether the application of probiotics can contribute to the treatment of peri-implant diseases.Therefore,this study aims to evaluate the clinical efficacy value of probiotics in the treatment of peri-implant diseases.Materials and methods:As of February 2023,electronic databases including China Knowledge Infrastructure(CKNI),China Biomedical Literature Service System(CBM),VIP,Wanfang Data Knowledge Service Platform,PubMed,The Cochrane Library,Web of Science,and Scopus were searched without time and language limitations.Research screening and data extraction are conducted independently by two reviewers.The inclusion and exclusion criteria for this systematic review were determined based on the principles of participants,interventions,comparisons,outcomes,and research design(PICOS).The quality evaluation of randomized controlled trials(RCTs)and non randomized controlled trials(nRCTs)included in the study was evaluated based on the bias risk tool of Cochrane Collaboration and MINORS evaluation items,and corresponding clinical indicators were extracted.probing depth(PD),bleedind on probing(BOP),and sulcus bleeding index(BI)and plaque index(PLI)are used as outcome indicators.The description of continuous variables is the statistical difference between clinical indicators and baseline at 1 month,3 months,and 6 months of follow-up,and the extracted data is analyzed using Stata 17.0 software.The weighted mean differences(WMD)and 95%confidence intervals(CI)combined effects are calculated,and the heterogeneity included in the study is analyzed through Cochrane Q test and I2 Evaluate values and explore sources of heterogeneity using sensitivity analysis.Results:This study included a total of 13 case-control trials,including 12 RCTs and 1 nRCT.The results of the meta-analysis show that:1.The reduction in PD was not statistically significant at 1 month of follow-up[WMD=0.39,95%CI(-0.35,1.14),P=0.30],3 months of follow-up[WMD=0.18,95%CI(-0.19,0.54),P=0.345],and 6 months of follow-up[WMD=0.331,95%CI(-0.026,0.688),P=0.069].Compared with the control group,probiotics had no advantage in improving PID in terms of PD reduction.2.The reduction in BOP was statistically significant at 3 months of follow-up[WMD=5.722,95%CI(1.413,10.031),P=0.009],but not at 6 months[WMD=5.917mm,95%CI(-0.596,12.431),P=0.075].Compared with the control group,probiotics had an advantage in improving PID in reducing BOP at 3 months of follow-up,while there was no advantage at 6 months of follow-up.3.The decrease in BI was not statistically significant at 1 month of follow-up[WMD=0.072,95%CI(-0.422,0.565),P=0.776],and at 3 months of follow-up[WMD=0.589,95%CI(-0.045,1.223),P=0.069].However,at 6 months of follow-up[WMD=0.348,95%CI(0.087,0.608),P=0.009],probiotics showed no advantage in improving PID in BI reduction compared to the control group,At a follow-up of 6 months,there is an advantage.4.The reduction in PLI was not statistically significant at 1 month of follow-up[WMD=0.698,95%CI(-0.925,2.320),P=0.399],at 3 months of follow-up[WMD=0.247,95%CI(-0.285,0.779),P=0.362],and at 6 months of follow-up[WMD=0.354mm,95%CI(-0.282,0.991),P=0.275].Compared with the control group,probiotics showed no advantage in improving PID in reducing PLI at 1,3,and 6 months of follow-up.Conclusion:The therapeutic effect of probiotics on PID is limited compared to the control group.At a follow-up of 3 months,there was a significant improvement in BOP,and at a follow-up of 6 months,there was a significant improvement in BI.However,there was no advantage in improving PD,PLI,and other aspects compared to the control group at 1,3,and 6 months.. |
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