根面处置牙周炎患牙根面牙骨质后内毒素水平的变化  

Changes of cementum endotoxin levels in different teeth with periodontitis treated with root conditioning

作　　者：付昌盛 刘荣森 罗芸 欧龙 李颖超 张贤华 田磊 杜岩 

机构地区：[1]解放军医学院.解放军总医院口腔科,北京100853 [2]老年病医学研究所细胞生物研究室,北京100853

出　　处：《上海口腔医学》2017年第2期175-179,共5页Shanghai Journal of Stomatology

摘　　要：目的 :观察不同方法处置牙周炎患牙根面牙骨质后内毒素水平的变化。方法 :选择临床上因正畸拔除的健康前磨牙6例,重度牙周炎拔除的后牙36例。每颗牙取釉-牙骨质界下2 mm牙根,制成2片4 mm×4 mm×1 mm的牙骨质片,对每个牙周炎患牙进行编号。健康牙作为阴性对照组,36颗牙周炎患牙中,每颗牙的1个牙片不进行根面处理,作为牙周炎组。其余36片牙周炎牙片随机平均分成6组:龈下刮治及根面平整(scaling and root planning,SRP)组、SRP+抗菌肽A组、SRP+抗菌肽B组、SRP+EDTA组、SRP+Nd:YAG激光组和SRP+Er:YAG激光组。用显色基质鲎试剂检测每个牙片的内毒素浓度。按照编号,记录每颗牙的内毒素浓度,计算每组每个牙周炎患牙治疗前、后内毒素浓度的变化。采用SPSS17.0软件包对数据进行统计学分析。结果:与牙周炎组相比,各治疗组内毒素浓度有不同程度降低,均有显著差异(P<0.01)。与SRP组相比,SRP+抗菌肽A组、SRP+抗菌肽B组、SRP+Er:YAG激光组内毒素浓度显著下降(P<0.01),SRP+EDTA组、SRP+Nd:YAG激光组之间无显著差异(P>0.05)。结论:不同方法处理牙周炎患牙根面均可降低内毒素含量,抗菌肽A+SRP处理牙周炎根面可能更为有效。PURPOSE： To observe the changes of endotoxin levels after different teeth with pefiodontitis were treated with different methods. METHODS： Six healthy premolars extracted for orthodontic reasons and 36 posterior teeth extracted due to severe periodontitis were selected. Each tooth was processed from two 4 mm×4 mm×1 mm cementum pieces 2 mm under the cementum-enamel junction, each tooth with periodontitis was numbered. Healthy teeth served as negative control group, one of the two tablets from each tooth with periodontitis was selected in the periodontitis group, which was not treated with root surface treatment. The remaining 36 teeth with periodontitis were randomly divided into 6 groups： SRP group, SRP ＋ antimicrobial peptide A group , SRP ＋ antimierobial peptide B group, SRP ＋ EDTA group, SRP ＋ Er：YAG laser group and SRP ＋ Nd：YAG laser group. Endotoxin concentration in each tooth was determined by chromogenic substrate limulus reagent. The endotoxin concentration in each tooth was recorded according to the serial number, and the changes of endotoxin concentration were calculated before and after treatment. SPSS17.0 software package was used to analyze the data. RESULTS： Compared with the teeth with periodontitis, endotoxin concentration decreased to varying degrees, there were significant differences in each treatment group （P〈0.01）. Compared with SRP group, endotoxin levels in SRP ＋ antimicrobial peptide A group, SRP ＋ antimicrobial peptide B group, SRP ＋ Er：YAG laser group were significantly decreased （P〈0.01）. No significant difference decreased was from between SRP ＋ EDTA group and SRP ＋ Nd：YAG laser group （P〉0.05）. CONCLUSIONS： Treatment of teeth with periodontitis using different methods can decrease the level of endotoxin, and the treatment of periodontitis root surface with antimierobial peptide A ＋ SRP may be more effective.

关 键 词：牙周炎 内毒素 牙骨质 根面处理 

分 类 号：R781.42[医药卫生—口腔医学]