不同修复材料联合牙周治疗对牙周炎患者的近远期美容效果及牙周状况和龈沟液MMP的影响  

Effects of Different Restorative Materials Combined with Periodontal Therapy on the Short-term and Long-term Cosmetic Effect,Periodontal Status and MMP in Gingival Crevicular Fluid of Patients with Periodontitis

作　　者：李静 蔡世新 LI Jing;CAI Shi-xin(Department of Orthodontics and Prosthodontics,Hengshui People's Hospital,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院口腔正畸修复科,河北衡水053000

出　　处：《中国美容医学》2021年第1期128-132,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:研究不同修复材料(光固化复合树脂、Geramage聚合瓷、全瓷贴面)联合牙周治疗对牙周炎患者的近远期美容效果及对牙周状况、龈沟液基质金属蛋白酶(Matrix metalloproteinase,MMP)的影响。方法:选取2015年2月-2016年6月笔者科室收治的150例慢性牙周炎患者为研究对象,根据随机数字表法分为A、B、C组,每组50例。三组患者均进行牙周基础治疗,同时分别使用全瓷贴面、Geramage聚合瓷及光固化复合树脂材料修复。比较三组患者使用不同修复材料后的近远期美容效果,以及对牙周状况[包括牙龈指数(GI)、龈沟出血指数(SBI)、菌斑指数(PLI)、牙齿松动度(MD)以及牙周袋深度(PD)]、龈沟液MMP的影响,并统计并发症及复发情况。结果:三组患者近远期疗效差异显著,其中A组1年有效率(96.00%)、3年优秀率(96.67%)显著高于B组(84.00%、82.00%)、C组(80.00%、76.00%),1年复发率(2.00%)显著低于B组(12.00%)、C组(18.00%),差异具有统计学意义(P<0.05)。三组患者治疗后牙周状况指标(SBI、GI、PLI、PD、MD)以及龈沟液MMP-4、MMP-5水平均显著降低,且各组差异显著(P<0.05),其中A组患者各指标显著高于B组、C组,C组各指标显著低于A组、B组。经治疗后VAS评分显著降低,直至治疗后第8周处于最低水平,且治疗后A组患者各时间点VAS评分显著低于B、C组(P<0.05)。主要并发症为疼痛、牙龈肿胀、感染及咬合不适,三组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论:全瓷贴面治疗牙周炎的疗效优于光固化复合树脂、Geramage聚合瓷,可有效改善患者牙周状况和降低龈沟液MMP水平,从而提高近远期疗效和降低复发率。Objective To study the effects of different restorative materials(light curing composite resin;geramage polymerized porcelain;all ceramic veneer)combined with periodontal therapy on the short-term and long-term cosmetic effect,periodontal status and MMP in gingival crevicular fluid of patients with periodontitis.Methods 150 patients with chronic periodontitis admitted to our hospital from February 2015 to June 2016 were selected as the study objects.According to the random number table method,they were divided into groups A,B and C,50 cases/group.All the patients in the three groups were treated with periodontal basic treatment,and were repaired with all ceramic veneer,germange polymerized porcelain and light curing composite resin respectively.The short-term and long-term cosmetic effects of the three groups were compared,and the periodontal status(including GI,SBI,PLI,MD and PD)and MMP in gingival crevicular fluid were compared,and the complications and recurrence were counted.Results The short-term and long-term effects of the three groups were significantly different.The one-year effective rate(96.00%)in group A,the three-year excellent rate(96.67%)of group A were significantly higher than those of group B(84.00%,82.00%),group C(80.00%,76.00%),one-year recurrence rate(2.00%)was significantly lower than those of group B(12.00%)and group C(18.00%),the difference was statistically significant(P<0.05).After treatment,the periodontal index(SBI,GI,PLI,PD,MD)and MMP-4,MMP-5 levels of gingival crevicular fluid in the three groups were significantly reduced,and the differences between the groups were significant(P<0.05).The indexes of group A were significantly higher than that in group B and C and the group C were significantly lower than group A and B.After treatment,VAS score decreased significantly until the 8th week after treatment,and the VAS score of group A was significantly lower than that of group B and C(P<0.05).The main complications were pain,gingival swelling,infection and malaise of occlusion.There was

关 键 词：光固化复合树脂 Geramage聚合瓷 全瓷贴面 牙周炎 基质金属蛋白酶 

分 类 号：R781.42[医药卫生—口腔医学]