光动力疗法辅助治疗Ⅲ期、Ⅳ期牙周炎的临床效果评价  

Effectiveness of adjunctive photodynamic therapy in the treatment of stageⅢandⅣperiodontitis

作　　者：范雅丹 束蓉[1] 程岚[1] 葛琳华[1] FAN Ya-dan;SHU Rong;CHENG Lan;GE Lin-hua(Department of Periodontology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院牙周病科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海200011

出　　处：《上海口腔医学》2022年第5期501-506,共6页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(81600863)。

摘　　要：目的:探讨光动力疗法(photodynamic therapy,PDT)辅助龈下刮治术(subgingival scaling and root planning,SRP)在Ⅲ、Ⅳ期牙周炎治疗中的临床效果。方法:根据2018年牙周病新分类,选择Ⅲ期和Ⅳ期牙周炎患者,经龈上洁治1周后,记录牙周探诊深度(probing depth,PD)、牙龈指数(gingival index,GI)和探诊出血(bleeding on probing,BOP)为基线。将患者分为3组,SRP组进行SRP治疗;PDT1组在SRP后即刻对口内所有PD≥5 mm的位点进行PDT;PDT2组在SRP+PDT后6周,对原位点再进行1次PDT。基线治疗后3、6个月复查,比较PD、GI和BOP阳性率的变化。采用SPSS 22.0软件包对数据进行统计学分析。结果:共纳入30例患者、1289个位点。SRP组、PDT1组和PDT2组各10例患者,位点数分别为476个(36.9%)、384个(29.8%)和429个(33.3%)。3组治疗后3个月、6个月复查时,PD、GI、BOP阳性率较基线均显著降低(P<0.05);6个月与3个月的复查结果无显著差异。PD≥5 mm的位点,PDT1组和PDT2组可以显著降低患牙的GI和BOP阳性率(P<0.05);PD≥7 mm时,PDT2组PD显著降低(P<0.05)。结论:对于Ⅲ、Ⅳ期牙周炎,PDT辅助SRP治疗可以获得比单纯SRP更好的临床效果。PURPOSE:To explore the clinical effect of subgingival scaling and root planning(SRP)with adjunctive photodynamic therapy(PDT)in the treatment of stageⅢandⅣperiodontitis.METHODS:According to 2018 Classification of Periodontitis,patients diagnosed as stageⅢandⅣperiodontitis were recruited.One week after supragingival scaling,probing depth(PD),bleeding on probing(BOP)and gingival index(GI)were recorded as the baseline.All patients were divided into 3 groups,SRP group received whole mouth SRP treatment;PDT1 group:PDT at all sites with PD≥5 mm immediately after SRP;PDT2 group received another PDT at the test sites 6 weeks after full mouth SRP+PDT.PD,GI and the positive rates of BOP were compared 3 months and 6 months after treatment.SPSS 22.0 software package was used for data analysis.RESULTS:Thirty patients and 1289 test sites were included in this trial.There were 10 patients in group SRP,PDT1 and PDT2,and the number of tests sites were 476,36.9%,384,29.8%and 42933.3%,respectively.The PD,GI and the positive rates of BOP in the three groups were reduced at 3-months and 6-months of follow-up(P<0.05),there was no significant difference between 3-months and 6-months of follow-up.At the site of PD≥5 mm,group PDT1 and PDT2 could significantly reduce GI and the positive rates of BOP at the test sites(P<0.05).When PD≥7 mm,significant PD reduction was observed in group PDT2(P<0.05).CONCLUSIONS:In the treatment of stageⅢandⅣperiodontitis,PDT assisted with SRP therapy can achieve better clinical effect than SRP alone.

关 键 词：光动力疗法 龈下刮治术 晚期牙周炎 

分 类 号：R781.4[医药卫生—口腔医学]