| Objective:Evidence-based medicine method is used to systematically assess the efficacy of laser adjunctive to mucogingival surgery for gingival recession defect.In this context,the application of laser in conjunction with periodontal surgery for treatment of gingival recession is evaluated.Methods:Chinese and English databases were searched such as Wan Fang,Pubmed,CNKI,Embase,CBM,Web of science and Cochrane,our finding the literatures of Randomized Controlled Trial to compare laser associated with mucogingival surgery with mucogingival surgery alone in treatment of gingival recession as of September 30 th 2018.All the data and clinical issues were based on the principle of PICO(Patient?Interference?Comparison and Outcome).According to the fixed searching protocol.Searching words were adjusted according to the database mode in order to reduce the missed detection rate.All the literatures searched for were in Chinese and English.Screening data was performed according to including and excluding criteria designed in advance.In case of unconsensus,two investigators came to an agreement through discussion on mutual consulation.If there was also a disagreement verdict was performed by another one to eliminate the divergence.The quality of the literatures was evaluated,wihich was based on Cochrane Handbook for Systematic Review of Interventions and the required data is extracted from them.The Review manager 5.3 data analysis software provided by the Cochrane collaboration network is applied to Meta analyzed.Issue bias was detected and assessed by funnel plot to make the objective assessment for the final conclusion.Result:A total 7 RCTs about 122 patients and 269 teeth were included,including 136 teeth in the laser treatment group and 133 teeth in control group.Meta-analysis result showed that the parameter of WKT(WMD=0.72,95%CI:0.41~1.04,P<0.00001),PD after 1 year follow-up(WMD=-0.18,95%CI:-0.33~-0.02,P=0.03),total PD(WMD=-0.12,95%CI:-0.23~-0.01,P=0.04),CAL after 1 year follow-up(WMD=-0.61,95%CI:-0.84~-0.39,P<0.00001)had statistic significance(P<0.05),the laser associated with flap graft group had better indicators than the flap graft alone group.But two groups showed in parameters such as CRC(RR=1.37,95%CI:0.95~1.97,P=0.09),RES(WMD=0.94,95%CI:-0.53~2.41,P=0.21),PD after 6 months followup(WMD=-0.06,95%CI:-0.23~-0.10,P=0.45),GRD(WMD=-0.23,95%CI:-0.55~0.10,P=0.17),CAL after 6 months follow-up(WMD=-0.22,95%CI:-0.85~0.42,P=0.50),GRW(WMD=0.02,95%CI:-0.97~1.02,P=0.96)no statistic significance.(P>0.05).Conclusions:In treatment for gingival recession compared with mucogingival surgery wideused in dentistry,laser associated with flap graft has the safty,at the same time shows the effects in the parameters such as WKT?PD and CAL.But the parameters such as CRC?RES?GRD and GRW shows no difference between two groups.Although there is sparse evidence from long-term follow-up,there is also similar predictive effect between two approaches.More cases with laser application in conjunction with mucogingival surgery are needed to assess the clinical effect of laser for treatment with gingival recession. |
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