Nd:YAP激光联合牙髓血运重建术治疗年轻恒牙合并根尖周炎的疗效  

Joint Effect of Nd:YAP Laser and Pulp Revascularization on Periapical Periodontitis

作　　者：董潇[1] 曲行舟[2] DONG Xiao;QU Xing-zhou(Department of Oral and Maxillofacial Surgery,Huxi Hospital Affiliated to Jining Medical College,Shan County 274300,China;Department of Oral and Maxillofacial Head and Neck Oncology,the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University)

机构地区：[1]山东省济宁医学院附属湖西医院口腔颌面外科,单县274300 [2]上海交通大学附属第九人民医院口腔颌面头颈肿瘤科

出　　处：《中国激光医学杂志》2021年第4期192-197,共6页Chinese Journal of Laser Medicine & Surgery

基　　金：上海交通大学医工交叉研究基金(YG2017MS02)。

摘　　要：目的观察Nd∶YAP激光结合牙髓血运重建术治疗根尖周炎的疗效及其对龈沟液中相关生长因子表达量的影响。方法选择2016年1月至2017年12月,恒牙合并根尖周炎患者120例,按消毒方法不同分为对照组和激光组,每组患者60例,对照组以三联抗生素糊剂方式封药消毒;激光组以Nd∶YAP激光照射消毒。两组患者采用不同消毒方法后,均行牙髓血运重建术,术后2年随访,比较两组治疗前后临床疗效、不良反应发生率、牙根管壁厚度及牙冠根比,并计算治疗后两组患牙的骨质样组织沉积率。术后6个月,比较两组血管内皮生长因子(vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)表达量。结果激光组患者的总有效率(93.3%)略高于对照组(91.7%);激光组患者治疗不良反应发生率(10.0%)略低于对照组(13.0%),差异无统计学意义(P>0.05)。两组患者治疗前牙冠根比、牙根管壁厚度差异均无统计学意义(P>0.05),术后2年两组患者的牙冠根比、牙根管壁,与治疗前比较均显著增厚(P<0.05);但激光组各观察指标与对照组比较,差异无统计学(P>0.05)。术后6个月,两组患者治疗后的VEGF、bFGF含量均显著高于治疗前(P<0.05),但两组间差异无统计学差异(P>0.05)。结论Nd∶YAP激光联合牙髓血运重建术可能通过影响牙组织中相关生长因子,促进牙根的继续发育,对治疗年轻恒牙合并根尖周病变安全有效。Objective To study the joint effect of Nd:YAP laser and pulp revascularization on periapical periodontitis and expression of growth factors in gingival crevicular fluid.Methods Totally 120 patients with permanent and periapical periodontitis treated from Jan.2016 to Dec.2017 were selected and divided into the control group and laser group by disinfection methods,with 60 cases in each group,Firstly the patients in the control group were sterilized with triple antibiotic paste and those in the laser group with Nd:YAP laser irradiation.Then all of them were given pulp revascularization.After 2 years’of follow-up,the clinical efficacy,incidence of adverse reactions,root canal wall thickness and crown root ratio were compared between the two groups,and the bone like tissue deposition rate of the two groups were calculated.The expressions of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)of the two groups were compared 6 months after the operation.Results The total effective rate of the laser group(93.3%)was slightly higher than that of the control group(91.7%).The incidence of adverse reactions in the laser group(10.0%)was slightly lower than that in the control group(13.0%),but the difference was not statistically significant(P>0.05).The ratio of crown to root and the thickness of root canal wall were taken as the indexes to ensure that the indexes of the two groups were at the same level before the treatment(P>0.05).After 2 years’follow-up,the cementoid tissue deposition rate was measured and calculated again.It was found that the root canal wall of the two groups significantly thickened and the crown root ratio significantly increased(P<0.05).However,compared with the control group,all the indexes in the laser group were higher,but the difference was not statistically significant(P>0.05).After 6 months’follow-up,the levels of VEGF and bFGF in both groups were significantly higher than those before the treatment(P<0.05),but there was no significant difference between the two gr

关 键 词：激光 牙髓血运重建术 年轻恒牙 根尖周病变 生长因子 

分 类 号：R312[医药卫生—基础医学] R781.34