Nd:YAG和Er:YAG双激光辅助治疗老年牙周合并牙髓病变患者的疗效及对牙周状态、炎性因子的影响  

Curative effect of Nd:YAG and Er:YAG dual-laser assisted treatment on elderly patients with periodontal disease and pulp disease and its influence on periodontal status and inflammatory factors

作　　者：赵云 李海燕 黄婷 Zhao Yun;Li Hai-yan;Huang Ting(Department of Stomatology,Shangcai Chongyang Hospital,Zhumadian 463800,Henan,China;Department of Stomatology,Zhengzhou First People's Hospital,Zhengzhou 450000,China)

机构地区：[1]上蔡重阳医院口腔科,河南驻马店463800 [2]郑州第一人民医院口腔科,河南郑州450000

出　　处：《四川生理科学杂志》2023年第12期2365-2369,共5页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨掺钕钇铝石榴石(Neodymium doped:yttrium aluminum garnet,Nd:YAG)激光和掺铒钇铝石榴石(Erbium doped:yttrium aluminum garnet,Er:YAG)激光辅助治疗老年牙周合并牙髓病变患者的疗效,及对患者牙周状态、炎性因子的影响。方法:选取2019年4月至2022年1月我院收治的152例老年牙周合并牙髓病变患者作为研究对象。根据治疗方案不同,分为常规组和激光组,各76例。常规组采用Vitapex糊剂填充根管和米诺环素填充牙周袋治疗;激光组在常规组治疗的基础上采用Nd:YAG激光处理根管和Er:YAG激光处理牙周袋。治疗6m后,比较两组治疗总有效率、牙周状态、血清炎性因子、程序性细胞死亡受体1(Programmed cell death-1,PD-1)、程序性细胞死亡配体(Programmed cell death-ligand 1,PD-L1)水平及不良反应。结果:治疗6 m后,激光组总有效率明显高于常规组(P<0.05);激光组临床附着水平(Clinical attachment level,CAL)、垂直探诊深度(Vertical probing depth,VPD)明显短于常规组,牙龈出血指数(Sulcus bleeding index,SBI)、菌斑指数(Plaque index,PLI)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、基质金属蛋白酶(Metal matrix proease,MMP)-2、MMP-9、白细胞介素-17(Interleukin-17,IL-17)、PD-1(CD4+)、PD-L1(CD4+)、PD-1(CD8+)、PD-L1(CD8+)水平低于常规组(P<0.05)。治疗期间,激光组不良反应发生率明显低于常规组(P<0.05)。结论:Nd:YAG和Er:YAG双激光辅助治疗老年牙周合并牙髓病变可显著提升疗效,能改善患者牙周状态,减轻炎性反应,抑制PD-1、PD-L1表达。Objective:To investigate the efficacy of neodymium doped:yttrium aluminum garnet(Nd:YAG)laser and erbium doped:yttrium aluminum garnet(Er:YAG)laser in the treatment of elderly patients with periodontal disease and pulp disease,and the effect on periodontal status and inflammatory factors.Methods:A total of 152 elderly patients with periodontal and pulpal lesions admitted to our hospital from April 2019 to January 2022 were selected.According to different treatment schemes,they were randomly divided into conventional group and laser group with 76 cases each.The conventional group was treated with Vitapex paste filling root canal and minocycline filling periodontal pocket;the laser group was treated with Nd:YAG laser and Er:YAG laser on the basis of the conventional treatment.After 6 months of treatment,the total effective rate,periodontal status,serum inflammatory factors,programmed cell death receptor 1(PD-1),programmed cell death ligand 1(PD-L1)levels and adverse reactions were compared between conventional group and laser group.Results:After 6 months of treatment,the total effective rate of the laser group was higher than that of the conventional group(P<0.05).Clinical attachment level(CAL)and vertical probing depth(VPD)in laser group were shorter than those in conventional group,sulcus bleeding index(SBI),plaque index(PLI)and tumor necrosis factor-α(TNF-α),the levels of matrix metalloproteinase(MMP)-2,MMP-9,interleukin-17(IL-17),PD-1(CD4+),PD-L1(CD4+),PD-1(CD8+)and PD-L1(CD8+)were lower than those in the conventional group(P<0.05);during the treatment,the incidence of adverse reactions in the laser group was lower than that in the conventional group(P<0.05).Conclusion:Nd:YAG and Er:YAG dual-laser can significantly improve the curative effect of elderly patients with periodontal and pulpal lesions,improve the periodontal status of patients,reduce inflammatory reaction,and inhibit the expression of PD-1 and PD-L1.

关 键 词：牙周病变 牙髓病变 Nd:YAG激光 ER:YAG激光 

分 类 号：R781.42[医药卫生—口腔医学]