摘要
目的探讨掺钕钇铝石榴石(Nd:YAG)激光联合掺铒钇铝石榴石(Er:YAG)激光辅助龈下刮治根面平整术(SRP)治疗牙周炎的临床疗效及预后影响因素。方法采用前瞻性研究的方法,选择2018年8月至2020年8月河北省胸科医院就诊的牙周炎患者66例,按随机数字表法分为试验组和对照组各33例,对照组采用SRP治疗,试验组在SRP的基础上,接受Er:YAG激光刮治联合根面平整,并使用Nd:YAG激光照射牙周袋。分别在治疗前、治疗后4和12周检查两组患者牙周临床指标和龈沟液细胞因子水平变化。依据患者治疗后12周牙周袋探诊深度(PD)情况将患牙分为PD<3 mm组和PD≥3 mm组,对比分析两组患牙临床资料,并采用Logistic回归分析影响牙周炎患者激光治疗预后的危险因素。结果治疗后4、12周,两组患者PD、临床附着丧失(CAL)、龈沟出血指数(SBI)及牙菌斑指数(PLI)均较治疗前显著降低(P<0.05),且试验组PD、CAL、SBI及PLI均明显低于对照组[治疗后4周:(3.36±0.21)mm比(3.91±0.39)mm、(4.14±0.67)mm比(4.75±0.73)mm、(1.83±0.20)分比(2.58±0.17)分、(1.29±0.24)分比(1.61±0.52)分;治疗后12周:(3.04±0.28)mm比(3.66±0.54)mm、(3.91±0.47)mm比(4.68±0.66)mm、(0.88±0.06)分比(1.35±0.14)分、(1.05±0.31)分比(1.57±0.56)分],差异均有统计学意义(P<0.05)。激光治疗后12周,试验组患者龈沟液中白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-8(MMP-8)、白细胞介素-8(IL-8)均较对照组显著降低[(2.95±0.19)μg/L比(4.32±0.84)μg/L、(2.63±0.82)μg/L比(3.58±0.51)μg/L、(12.42±1.19)μg/L比(13.26±0.68)μg/L、(4.15±1.12)ng/L比(5.36±0.42)ng/L、(2.65±0.08)ng/L比(4.12±0.19)ng/L],差异均有统计学意义(P<0.05),转化生长因子-β(TGF-β)水平较对照组显著增加[(51.35±8.95)ng/L比(44.90±5.84)ng/L],且组间比较差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,牙周临床指标PD、SBI、PLI�
Objective To investigate the clinical efficacy and prognostic factors of Neodymium doped:Yttrium Aluminum Garnet(Nd:YAG)laser combined with Erbium:Yttrium Aluminum Garnet(Er:YAG)laser assisted subgingival scaling root planing(SRP)in the treatment of periodontitis.Methods A prospective research method was adopted.A total of 66 patients with periodontitis treated in Hebei Chest Hospital from August 2018 to August 2020 were selected and divided into experimental group and control group according to the random number table method,with 33 cases in each group.The control group was treated with SRP,and the experimental group received Er:YAG laser curettage combined with root surface leveling on the basis of SRP,and irradiated the periodontal pocket with Nd:YAG laser.The changes of periodontal clinical indicators and cytokine levels in gingival crevicular fluid were examined before treatment,4 weeks and 12 weeks after treatment.The patients were divided into PD<3 mm group and PD≥3 mm group according to the probing depth(PD)of periodontal pocket after 12 weeks of treatment,the clinical data of the two groups were compared and analyzed,and the Logistic regression analysis was performed to analyze the risk factors affecting the prognosis of patients with periodontitis after laser treatment.Results After 4 and 12 weeks of treatment,the PD,clinical attachment loss(CAL),sulcus bleeding index(SBI)and plaque index(PLI)of the two groups were significantly lower than those before treatment(P<0.05),and the PD,CAL,SBI and PLI in experimental group were significantly lower than those in control group,after 4 weeks of treatment:(3.36±0.21)mm vs.(3.91±0.39)mm,(4.14±0.67)mm vs.(4.75±0.73)mm,(1.83±0.20)scores vs.(2.58±0.17)scores,(1.29±0.24)scores vs.(1.61±0.52)scores;after 12 weeks of treatment:(3.04±0.28)mm vs.(3.66±0.54)mm,(3.91±0.47)mm vs.(4.68±0.66)mm,(0.88±0.06)scores vs.(1.35±0.14)scores,(1.05±0.31)scores vs.(1.57±0.56)scores,the differences were statistically significant(P<0.05).After 12 weeks of treatment,the l
作者
杨婷
郭涛
许音
张雨
张鹏飞
Yang Ting;Guo Tao;Xu Yin;Zhang Yu;Zhang Pengfei(Department of Stomatology,Hebei provincial Chest Hospital,Hebei Provincial Key Lung Disease Laboratory,Hebei Tuberculosis Control Institute,Hebei Lung Cancer Prevention Center,Hebei 050048,China)
出处
《中国医师进修杂志》
2023年第5期415-421,共7页
Chinese Journal of Postgraduates of Medicine
基金
2018年度河北省医学科学研究重点课题计划(20180673)。
