上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (4): 378-.doi: 10.3969/j.issn.1674-8115.2019.04.008

• 论著·临床研究 • 上一篇    下一篇

Er,Cr:YSGG激光辅助龈下刮治对重度牙周炎患者的短期 临床疗效

王雅萍，林智恺，束蓉   

  1. 上海交通大学医学院附属第九人民医院 ·口腔医学院牙周病科，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，上海市口腔医学研究所，上海 200011
  • 出版日期:2019-04-28 发布日期:2019-05-23
  • 通讯作者: 束蓉，电子信箱：shurong123@hotmail.com。
  • 作者简介:王雅萍（1992—），女，硕士生；电子信箱： wangyapingkim@163.com。
  • 基金资助:
    国家自然科学基金 (81570977)；上海市卫生和计划生育委员会科研课题 (20174Y0012)

Short-term clinical efficacy observation of adjunctive Er,Cr:YSGG laser application following subgingival scaling in patients with severe periodontitis

WANG Ya-ping, LIN Zhi-kai, SHU Rong   

  1. Department of Periodontology, Shanghai Ninth People′s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology; Shanghai 200011, China
  • Online:2019-04-28 Published:2019-05-23
  • Supported by:
    National Natural Science Foundation of China, 81570977; Scientific Research Project of Shanghai Municipal Commission of Health and Family Planning, 20174Y0012)。

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摘要： 目的 ·观察 Er,Cr:YSGG激光辅助龈下刮治对重度牙周炎患者的短期临床疗效。方法 ·纳入 46例重度牙周炎患者，龈上洁治后 2周行基线检查，并将患者随机分为试验组和对照组，每组 23例。超声龈下刮治后，分别采用 Er,Cr:YSGG激光和手工龈下刮治器对患者探诊深度（ probing depth，PD）≥ 5 mm的位点行牙周袋内清创。比较 2组患者在基线、治疗后 6周和治疗后 3个月的菌斑指数（ plaque index，PLI）、PD、临床附着水平（ clinical attachment level，CAL）和探诊出血（ bleeding on probing，BOP）阳性率的变化，并采用视觉模拟评分（ visual analogue scale, VAS）比较患者在治疗过程中的主观疼痛程度。结果 · PD ≥ 5 mm的位点，组内比较结果显示， 2组患者于治疗后 6周和治疗后 3个月的 PLI、PD、CAL以及 BOP阳性率均较基线时明显降低，且差异具有统计学意义（均 P0.000）。5 mm ≤PD ≤ 6 mm的位点，与对照组相比，试验组患者治疗后 6周的 CAL有所下降，且差异具有统计学意义（P0.036）。PD ≥ 7 mm的位点，与对照组相比，试验组患者治疗后 6周和治疗后 3个月的 PD均显著降低 (P0.002，P0.039)，患者的治疗后 6周 PD与其基线时水平间的下降程度也较为明显 (P0.015)，且试验组患者治疗后 6周的 CAL也较低 (P0.011)。在治疗过程中，试验组患者的 VAS较对照组有所下降（ P0.005）。结论 · Er,Cr:YSGG激光辅助龈下刮治可达到与传统手工龈下刮治器相似的短期临床疗效，对于深牙周袋的 PD降低和 CAL获得等疗效更为明显，且患者体验更为舒适。 Er,Cr:YSGG激光辅助龈下刮治可作为牙周非手术治疗的一种有效方法。

关键词: Er,Cr:YSGG激光, 龈下刮治, 重度牙周炎

Abstract:

Objective · To observe the short-term clinical efficacy of adjunctive Er,Cr:YSGG laser application following subgingival scaling in patients with severe periodontitis. Methods · In this parallel control design clinical trial, 46 patients with severe periodontitis were selected. Baseline examination was performed 2 weeks after supragingival scaling. Then the patients were randomly divided into the test group and the control group, with 23 cases in each group. After ultrasonic subgingival scaling, sites with probing depth (PD) ≥5 mm of patients in two groups received subgingival debridement with Er,Cr:YSGG laser and hand curettes, receptively. The changes in plaque index (PLI), PD, clinical attachment level (CAL), the percentage of bleeding on probing (BOP) positive sites, and the degree of subjective pain during treatment with visual analogue scale（VAS）were compared between two groups at baseline, 6 weeks after treatment, and 3 months after treatment. Results · For sites with PD ≥5 mm, PLI, PD, CAL, and the percentage of BOP positive sites significantly reduced for both groups at 6 weeks and 3 months after treatment compared with baseline (all P0.000). For sites with 5 mm ≤PD ≤6 mm, the CAL of the test group was significantly lower compared with the control group at 6 weeks after treatment (P0.036). For sites with PD≥7 mm, the PDs of the test group were significantly lower compared with the control group at 6 weeks and 3 months after treatment (P0.002, P0.039). The PD reduction between baseline and 6 weeks after treatment was greater in the test group compared with the control group (P0.015). The CAL of the test group was lower compared with the control group at 6 weeks after treatment (P0.011). The VAS of the test group was significantly lower than that of the control group (P0.005). Conclusion · Adjunctive Er,Cr:YSGG laser application following subgingival scaling can achieve similar short-term clinical efficacy compared with traditional hand curettes. Er,Cr:YSGG laser may be beneficial particularly on the reduction of PD and regain of CAL in deep pockets on a short-term basis, which can make the patients more comfortable. Subgingival scaling with adjunctive Er,Cr:YSGG laser application can be an effective way for the non-surgical periodontal therapy. [Key words]Er,Cr:YSGG laser; subgingival scaling; severe periodontitis

Key words: Er,Cr:YSGG laser, subgingival scaling, severe periodontitis

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