水激光辅助牙髓牙周治疗的有效性和安全性：一项回顾性对照研究
Effectiveness and safety of water laser-assisted endodontic-periodontal therapy: A retrospective controlled study.
摘要(中文译文)
目的：牙髓-牙周联合病变的治疗具有挑战性，因为单纯采用传统根管治疗及龈下刮治和根面平整往往难以实现彻底清创。本研究旨在评估辅助水激光治疗在改善牙髓-牙周结局方面的有效性和安全性。方法：本单中心回顾性对照研究纳入634颗患牙，随访时间为12±3个月，其中295颗接受辅助水激光治疗，339颗按传统非激光方案治疗。采用倾向性评分重叠权重法平衡基线特征，加权后所有标准化差异均<0.10。主要终点为牙髓-牙周复合成功率。次要终点包括探诊深度和临床附着水平的变化、探诊出血阴性率以及术后7天内急性加重情况。安全性采用Miettinen-Nurminen非劣效性检验评估，风险差异界值为5%。结果：水激光组的复合成功率高于对照组（风险比=1.22，95%置信区间：1.10至1.36；风险差异=13.88个百分点，95%置信区间：6.97至20.34；=0.003）。水激光组的影像学愈合情况也更为有利。此外，水激光组在探诊深度（β=-0.39 mm，95%置信区间：-0.56至-0.22；=0.001）和临床附着水平（β=-0.28 mm，95%置信区间：-0.44至-0.12；=0.001）方面的改善更大，探诊出血阴性率更高（风险比=1.20，95%置信区间：1.07至1.34；=0.003），急性加重更少（风险比=0.52，95%置信区间：0.30至0.88；=0.016）。总体不良事件符合非劣效性标准。基线探诊深度≥6 mm的患牙获益更为明显。结论：辅助水激光治疗与改善短期至中期牙髓-牙周结局、增强牙周状况及降低术后早期加重风险相关，且不损害安全性。对于存在深牙周袋的患牙，其获益似乎尤为显著。
Abstract
ObjectiveCombined endodontic-periodontal lesions are challenging to manage because complete debridement is often difficult to achieve with conventional root canal therapy and scaling and root planing alone. This study aimed to assess the effectiveness and safety of adjunctive water laser therapy in improving pulp-periodontal outcomes.MethodsThis single-center retrospective controlled study included 634 teeth with 12 ± 3 months of follow-up, including 295 treated with adjunctive water laser treatment and 339 treated according to a conventional nonlaser regimen. Propensity score overlap weighting was used to balance baseline characteristics, with all standardized differences <0.10 after weighting. The primary endpoint was pulp-periodontal composite success. Secondary endpoints included changes in probing depth and clinical attachment level, bleeding on probing negativity, and acute exacerbation within 7 postoperative days. Safety was assessed using a Miettinen-Nurminen noninferiority test with a 5% risk-difference margin.ResultsThe water laser group showed a higher composite success rate than the control group (risk ratio = 1.22, 95% confidence interval: 1.10 to 1.36; risk difference = 13.88 percentage points, 95% confidence interval: 6.97 to 20.34; = 0.003). Radiographic healing was also more favorable in the water laser group. Additionally, the water laser group demonstrated greater improvement in probing depth (β = -0.39 mm, 95% confidence interval: -0.56 to -0.22; = 0.001) and clinical attachment level (β = -0.28 mm, 95% confidence interval: -0.44 to -0.12; = 0.001), a higher bleeding on probing-negative rate (risk ratio = 1.20, 95% confidence interval: 1.07 to 1.34; = 0.003), and fewer acute exacerbations (risk ratio = 0.52, 95% confidence interval: 0.30 to 0.88; = 0.016). Overall adverse events met the noninferiority criterion. Greater benefit was observed in teeth with baseline probing depth ≥6 mm.ConclusionsAdjunctive water laser therapy was associated with improved short- to mid-term pulp-periodontal outcomes, enhanced periodontal status, and a lower risk of early postoperative exacerbations without compromising safety. The benefits appeared particularly pronounced in teeth presenting with deep periodontal pockets.
如何引用
AMA
Jing Li, Chunyan Chen, Donghui Wu, Fengqing Tan, Juan Liu. Effectiveness and safety of water laser-assisted endodontic-periodontal therapy: A retrospective controlled study.. The Journal of international medical research. 2026; doi:10.1177/03000605261469426.
APA
Jing Li, Chunyan Chen, Donghui Wu, Fengqing Tan, Juan Liu (2026). Effectiveness and safety of water laser-assisted endodontic-periodontal therapy: A retrospective controlled study.. The Journal of international medical research. https://doi.org/10.1177/03000605261469426
GB/T 7714
Jing Li, Chunyan Chen, Donghui Wu, Fengqing Tan, Juan Liu. Effectiveness and safety of water laser-assisted endodontic-periodontal therapy: A retrospective controlled study.[J]. The Journal of international medical research, 2026 doi:10.1177/03000605261469426.
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