上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

光化合技术辅助治疗慢性牙周炎的临床效果

胡淑澄，束蓉，宋忠臣，孙梦君，王依玮   

  1. 上海交通大学 医学院附属第九人民医院牙周病科，上海市口腔医学重点实验室，上海 200011
  • 出版日期:2017-05-28 发布日期:2017-05-31
  • 通讯作者: 束蓉，电子信箱：shurong123@hotmail.com。
  • 作者简介:胡淑澄（1990—），女，住院医师，硕士；电子信箱：ovel_yeol@hotmail.com。
  • 基金资助:

    国家自然科学基金（81271156）；上海市科学技术委员会项目（13411951300）

Clinical effects of photo-activated disinfection as an adjunctive therapy for the treatment of chronic periodontitis

HU Shu-cheng, SHU Rong, SONG Zhong-chen, SUN Meng-jun, WANG Yi-wei   

  1. Department of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai key Laboratory of Stomatology Shanghai 200011, China
  • Online:2017-05-28 Published:2017-05-31
  • Supported by:

    National Natural Science Foundation of China，81271156；Project of Science and Technology Commission of Shanghai Municipality, 13411951300

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摘要：

目的 ·观察光化合技术（PAD）辅助牙周传统非手术疗法治疗慢性牙周炎的临床效果。方法 ·随机纳入11例慢性牙周炎患者，共118个位点，采用自身对照分口设计，将双侧同名牙的探诊深度（PD）≥ 5 mm的位点随机分为A组（n=59）和B组（n=59），分别给予龈下刮治和根面平整（SRP）及PAD辅助SRP（SRP+PAD）治疗。在基线和治疗后第6、12周时，对各检测位点的牙周临床指标、炎症指标及牙周致病菌进行检测。结果 · SRP或SRP+PAD治疗均能显著改善牙周炎症状况；治疗后第12周，B组探诊出血（BOP）阳性率显著低于A组（37.3% vs 57.6%，P=0.042）。SRP或SRP+PAD治疗均能有效降低龈沟液中基质金属蛋白酶-8（MMP-8）和白介素-1β（IL-1β）水平；治疗后第6、12周时，B组龈沟液中IL-1β水平均显著低于A组[（17.99±14.26）pg/mL vs（32.64±30.69）pg/mL，P=0.007；（11.37±10.25）pg/mL vs（23.85±15.55）pg/mL，P=0.000]。治疗后2组龈下菌斑中牙龈卟啉单胞菌和具核梭杆菌占总菌比例均呈现下降趋势。结论 · PAD辅助治疗慢性牙周炎可以更好地改善牙龈出血，控制牙周炎症；PAD可作为牙周传统治疗方法的一种有发展潜力的辅助治疗手段。

关键词: 光化合技术；慢性牙周炎；牙周临床指标；基质金属蛋白酶8；白介素1&beta, ；牙周致病菌

Abstract:

Objective · To investigate the clinical effects of photo-activated disinfection (PAD)-assisted non-surgical therapy on the treatment of chronic periodontitis. Methods · Eleven patients with chronic periodontitis (totally 118 selected sites) were randomly enrolled. A split-mouth self-control method was adopted. Selected sites with the probing depth (PD) of bilateral homonymous teeth ≥ 5 mm were randomly assigned to the group A (receiving scaling and root planning, SRP) and the group B (receiving SRP+ PAD). Periodontal clinical indexes, inflammation indexes, and periodontal pathogens at selected sites were examined at baseline and 6 and 12 weeks after treatment. Results · Both SRP alone and SRP+PAD improved the periodontal inflammation significantly. The positive rate of bleeding on probing (BOP) 12 weeks after treatment was remarkably lower in the group B than in the group A (37.3% vs 57.6%, P=0.042). Both SRP and SRP+PAD effectively decreased matrix metalloproteinase-8 (MMP-8) and interleukin-1β (IL-1β) levels in gingival crevicular fluid. The IL-1β levels 6 and 12 weeks after treatment were significantly lower in the group B than in the group A [(17.99±14.26) pg/mL vs (32.64±30.69) pg/mL, P=0.007; (11.37±10.25) pg/mL vs (23.85±15.55) pg/mL, P=0.000]. Both treatments decreased the ratio of P. gingivalis and F. nucleatum in total bacteria. Conclusion · PAD can serve as a potential adjunctive therapy to conventional SRP in the treatment of chronic periodontitis with better improvement of bleeding gums and control of periodontal inflammation.

Key words: photo-activated disinfection, chronic periodontitis, periodontal index, matrix metalloproteinase-8, interleukin-1β, periodontal pathogens