低能量激光对牙种植术后种植体周围感染防治及骨吸收影响的研究  

Effect of Low Level Laser on Prevention and Treatment of Peri-Implant Infection and Bone Resorption after Dental Implantation

作　　者：倪文庆[1] 倪瑞阳 戈伟[1] 李亚群[2] NI Wenqing;NI Ruiyang;GE Wei;LI Yaqun(Department of Stomatology,Taizhou Hospital of Traditional Chinese Medicine,Taizhou 225300,China;Department of Pediatrics,Taizhou Hospital of Traditional Chinese Medicine,Taizhou 225300,China)

机构地区：[1]泰州市中医院口腔科,泰州市225300 [2]泰州市中医院儿科,泰州市225300

出　　处：《中国激光医学杂志》2023年第4期181-186,238,共7页Chinese Journal of Laser Medicine & Surgery

基　　金：江苏省中医药科技计划(YB202278)。

摘　　要：目的探究低能量激光对牙种植术后种植体周围感染的防治和对骨吸收的影响。方法口腔牙种植修复患者93例,按随机数字表分为对照组(n=46)和观察组(n=47),两组患者均接受种植体修复,观察组患者联合低能量激光干预,波长860 nm,治疗功率为80 mW,光斑面积为0.28 cm^(2),功率密度286 mW/cm^(2),照射时间14 s,能量密度4 J/cm^(2);对照组患者不进行任何干预。检测两组患者种植后2周种植体周围牙龈探诊出血(bleeding on probing,BOP),菌斑指数(plaque index,PLI),龈沟液白细胞、中性粒细胞数量及肿瘤坏死因子(tumor necrosis factor,TNF)-α、白细胞介素(interleukin,IL)-6水平;比较种植后即刻、种植后1、6个月骨吸收水平改变,以及种植前、种植后1个月龈沟液核因子Β受体激活蛋白配体(receptor activator of nuclear factorκB ligand,RANKL)、骨保护素(osteoprotegerin,OPG)水平改变。结果两组患者种植前牙龈BOP、PLI,龈沟液白细胞、中性粒细胞数量、TNF-α及IL-6水平比较,差异均无统计学意义(P>0.05);观察组患者种植后2周牙龈BOP、PLI,龈沟液白细胞、中性粒细胞数量及TNF-α、IL-6水平显著低于对照组(P<0.05)。观察组患者种植后1、6个月骨吸收水平显著低于对照组;种植后1个月,两组龈沟液OPG水平比较,差异无统计学意义(P>0.05),但两组种植后1个月龈沟液RANKL表达水平均显著高于种植前(P<0.05),且观察组患者龈沟液RANKL水平显著低于对照组(P<0.05)。结论牙种植术后给予低能量激光干预有助于抑制种植体周围感染、提高骨吸收,值得临床推广。Objective To explore the effect of low level laser on prevention and treatment of peri-implant infection and bone resorption after dental implantation.Methods Totally 93 patients with dental implant restoration were divided randomly into a control group(n=46)and an observation group(n=47).Upon implant restoration,the patients in the observation group were given low-intensity laser intervention,for which the treating power was 80 mW,spot area 0.28 cm2,power density 286 mW/cm2,irradiation time 14 s,and energy density 4 J/cm^(2).The patients in the control group were given no intervention.The bleeding on probing(BOP),plaque index(PLI)around the implant and white blood cell number,neutrophil number,tumor necrosis factor(TNF-α)level and interleukin(IL-6)level in gingival sulcus fluid were detected 2 weeks after the implantation for both groups.The levels of bone resorption 1 and 6 months after the implantation,and the levels of receptor activator of nuclear factorκB ligand(RANKL)and osteoprotegerin(OPG)in gingival crevicular fluid before and 1 month after the implantation were compared.Results There was no significant difference in gingival BOP,PLI,number of leukocytes and neutrophils in gingival crevicular fluid or levels of TNF-αand IL-6 between the observation group and control group before the implantation(P>0.05).Two weeks after the implantation,the gingival BOP and PLI,the number of white blood cells and neutrophils in gingival crevicular fluid and the levels of TNF-αand IL-6 in the observation group were significantly lower than those in the control group.The bone resorption level of the observation group was significantly lower than that of the control group 1 and 6 months after the implantation.For both groups,there was no significant change in the level of OPG in gingival crevicular fluid 1 month after the implantation(P>0.05),but the expression level of RANKL in gingival crevicular fluid was significantly higher than that before the implantation.Moreover,the level of RANKL in gingival crevicular fluid w

关 键 词：低能量激光 牙种植术 种植体 感染 骨吸收 

分 类 号：R454.2[医药卫生—治疗学] R782.12[医药卫生—临床医学]