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.

Key words: Periodontal disease, Invisible appliance, Fixed appliance, Meta-analysis, Inflammatory factors