替硝唑片联合超声波龈下刮治及根面平整治疗慢性牙周炎  

Tinidazole tablets combined with ultrasound subgingival scaling and root planing for chronic periodontitis

作　　者：武志贤 曹伟靖[1] 田莹[1] 高朵朵 WU Zhi-xian;CAO Wei-jing;TIAN Ying;GAO Duo-duo(Department of Oral Medicine,Yan'an University Affiliated Hospital,Yan'an,Shaanxi 716000,China)

机构地区：[1]延安大学附属医院口腔内科

出　　处：《中国临床研究》2019年第10期1400-1403,共4页Chinese Journal of Clinical Research

基　　金：国家自然科学基金青年科学基金项目(81700986)~~

摘　　要：目的探讨替硝唑片联合超声波龈下刮治及根面平整对慢性牙周炎患者的临床疗效及对龈沟液可溶性细胞间黏附分子-1(sICAM-1)、单核细胞趋化蛋白-1(MCP-1)水平的影响。方法选取2016年10月至2018年1月收治的86例慢性牙周炎患者,随机数字表法分为对照组(n=43)与研究组(n=43)。对照组采取超声波龈下刮治联合根面平整,研究组于对照组基础上采取替硝唑片,均治疗4周。统计两组临床疗效、治疗前后牙周状况[菌斑指数(PLI)、牙周袋探诊深度(PD)、牙齿松动度(TM)、龈沟出血指数(SBI)]、龈沟液sICAM-1、MCP-1、核因子κB受体活化子配体(RANKL)、骨保护素(OPG)水平,并随访3~6个月,统计两组疾病复发率。结果(1)研究组总有效率(93.02%)高于对照组(76.74%)(P<0.05);(2)治疗后两组PLI、TM、PD、SBI较治疗前减小,且研究组小于对照组(P均<0.01);(3)治疗后两组龈沟液sICAM-1、MCP-1水平较治疗前减低,且研究组低于对照组(P均<0.01);(4)治疗后两组RANKL水平较治疗前降低、OPG水平较治疗前增高,且研究组RANKL水平低于对照组、OPG水平高于对照组(P均<0.01);(5)治疗后3个月研究组疾病复发率(2.33%)与对照组(11.63%)比较无统计学差异(P>0.05),治疗后6个月研究组疾病复发率(4.65%)低于对照组(20.93%)(P<0.05)。结论联合超声波龈下刮治、根面平整及替硝唑片治疗慢性牙周炎,可有效减少龈沟液sICAM-1、MCP-1水平,调节RANKL、OPG含量,改善患者牙周状况,提高疾病整体疗效,且利于降低疾病复发风险,对改善预后效果具有积极意义。Objective To investigate the clinical effects of tinidazole tablets combined with ultrasound subgingival scaling and root planing on chronic periodontitis and on the levels of soluble intercellular adhesion molecule-1 ( sICAM-1 ) and monocyte chemoattractant protein-1 ( MCP-1 ) in gingival crevicular fluid. Methods Eighty-six patients with chronic periodontitis treated from October 2016 to January 2018 were enrolled and randomly divided into control group and study group (n = 43 , each). Ultrasonic subgingival scaling combined with root planing was performed in control group, and tinidazole tablets were added in study group based on the treatment in control group. The treatment lasted for 4 weeks in both groups. The clinical efficacy, the periodontal status before and after treatment [ plaque index ( PLI), periodontal pocket probing depth ( PD),tooth looseness ( TM), gingival sulcus bleeding index ( SBI)], levels of sICAM-1 , MCP-1 , receptor activator NF kB ligand ( RANKL) and osteoprotegerin ( OPG) were observed, and the recurrence rates were counted during 3 to 6 months follow-up in two groups. Results The total effective rate in study group was statistically higher than that in control group (93. 02% vs 76. 74%,P < 0. 05 ). After treatment, PLI, TM, PD and SBI decreased in two groups and were statistically less in study group than those in control group ( all P < 0. 01 );the levels of sICAM-1 and MCP-1 in gingival crevicular fluid were lower than those before treatment in two groups and was lower in study group than those in control group (all P <0. 01 );compared with before treatment, the level of RANKL decreased, and the level of OPG increased in both groups;compared with control group, RANKL level decreased, and OPG level increased in study group ( all P < 0. 01 ). At 3 months after treatment, there was no significant difference in the recurrence rate of disease between study group and control group ( 2. 33% vs 11. 63%,P> 0. 05). At 6 months after treatment, the recurrence rate of disease in study group wa

关 键 词：替硝唑片 超声波龈下刮治 根面平整 慢性牙周炎 炎性因子 

分 类 号：R781.42[医药卫生—口腔医学]