新型龈下超声工作尖与手工器械龈下刮治效果比较的随机对照研究  

Comparison of treatment effect between periodontal subgingival scaling with the special series of ultrasonic inserts and Gracey curette

作　　者：黄振[1] 于晓潜[1] 张立[1] 尚校[1] 朴牧子[1] 

机构地区：[1]北京大学口腔医学院·口腔医院牙周科,100081

出　　处：《中华口腔医学杂志》2012年第9期513-517,共5页Chinese Journal of Stomatology

摘　　要：目的比较新型龈下超声工作尖与手工刮治器进行牙周非手术治疗的临床效果，以期为临床应用提供参考。方法将30例中重度慢性牙周炎患者纳入研究，26例完成随访。采用单盲、随机（随机数字表法）、分口对照设计，比较新型龈下超声工作尖（超声组）和Gracey刮治器（手工组）进行龈下刮治的效果，临床评价菌斑指数（plaqueindex，PLI）、出血指数（bleedingindex，BI）、探诊深度（probingdepth，PD）、附着丧失（attachmentloss，AL），并记录治疗时间。采用视觉模拟评分法（visualanalogue scale，VAS）评价患者术中疼痛度和术后敏感度，比较两种方法治疗6周后各项临床指标的改善情况。两组间各项结果数据的比较采用Mann—WhitneyU检验，治疗前后组内各项指标的比较采用Wilcoxon符号秩检验，双侧检验水准为0．05。结果术前和术后6周PD、BI、PLI、AL在超声组和手工组内均显著降低；超声组术前中等深度牙周袋（PD为4—5mm）位点PD[M（Q25，Q75）]与术后6周PD[M（Q25，Q75）]分别为4．0（4．0，5．0）、3．0（3．0，3．0）mm，手工组分别为4．0（4．0，5．0）、3．0（3．0，3．0）mm，术后6周均显著低于术前（P〈0．001）；超声组术前深牙周袋位点（PD≥6mm）PD[M（Q25，Q75）]与术后6周PD[M（Q25，Q25）]分别为7．0（6．0，7．0）、5．0（4．0，7．0）mm，手工组分别为7．0（6．0，7．0）、5．0（4．0，6．0）mm，术后6周亦显著低于术前（P〈0．001）；术后6周根分叉区两组PD也均较术前显著降低（P〈0．001）。超声组每颗牙的治疗时间[（2．41±0．61）mird颗]显著低于手工组[（2．71±0．61）min／颗，P〈0．01]；超声组术中疼痛VAS值[M（Q25，Q75）]为5．0（3．0，6．7），显著低于手工组[5．9（4．9，8．0）]，P=0．001；超声组术后敏感度VAS值[M（Q25，Q75）]为4．0（1．8，6．0），也显著低于�Objective To compare the special series of ultrasonic inserts with Gracey curettes in the effectiveness and efficiency for non-surgical periodontal treatment. Methods A total of 30 patients with moderate to advanced chronic periodontal disease were treated with both ultrasonic inserts （ultrasonic group） and Gracey curettes（ Gracey group） according to a prospective, randomized, controlled, one-blind, ＂ split- mouth＂ design. Twenty-six cases were available for the whole follow-up period. Plaque index （PLI）, bleeding index（BI） , probing depth（PD）, attachment loss（AL） were evaluated before and 6 weeks after treatment. Treatment time was recorded. The severity of pain during treatment and teeth sensitivity after treatment were evaluated by the visual analogue scale （VAS）. Differences in clinical parameters were analyzed with the Wilcoxon signed ranks test and Mann and Whitney U-test. Results No significant differences in any of the clinical parameters were observed at baseline between the two groups. The mean value of PD, BI, PLI, AL decreased in both ultrasonic group and Gracey group. At moderately deep site （initial PD between 4 mm and 5 mm ）, PD [ M （Q25, Q75 ）] changed in the ultrasonic group from 4. 0 （4.0, 4. 5 ） mm to 3.0 （3.0,3.0） mm （ P 〈 0.001 ） and in the Gracey group from 4. 0 （4. 0,5.0） mm to 3.0 （3.0,3.0） mm（ P 〈 0. 001 ）. At deep sites （ initial PD 1〉6 mm） PD [ M（ Q25, Q75 ） ] changed in the ultrasonic group from 7.0 （ 6. 0,7. 0 ）mm to 5.0 （4. 0,7. 0 ）mm （ P 〈 0. 001 ） and in the Gracey group from 7.0 （6.0,7, 0） mm to 5.0 （4.0,6. 0） ram（ P 〈 0. 001 ）. In the furcation area, PD [ M（ Q25, Q75 ） ] changed from 5.0（4. 0,7.0） mm to 3.0（3.0,5.0） mm（P 〈 0. 001 ） in both Gracey group and ultrasonic group. However, the average time of active instrumentation was （2, 41 ± 0. 61 ） rain/tooth in the ultrasonic scaling and （2. 71 ± 0. 61 ） min/tooth in the Gracey curette（ P 〈 0. 00

关 键 词：超声疗法 牙周炎 牙龈下刮治术 疼痛测定 

分 类 号：R781.4[医药卫生—口腔医学]