光活化消毒辅助治疗慢性牙周炎的疗效  

Effect of Photo-activated Disinfection as An Adjunctive Therapy in the Treatment of Chronic Periodontitis

作　　者：钱为民 曹良菊[1] 蒋愉[1] 蒲丹 母凤婷 潘永圣 QIAN Weimin;CAO Liangju;JIANG Yu;PU Dan;MU Fengting;PAN Yongsheng(Dept.of Stomatology,The 1st People’s Hospital of Kunming,Kunming Yunnan 650224,China;Clinical Laboratory,The 1st People’s Hospital of Kunming,Kunming Yunnan 650224,China;Dept.of Science and Education,The 1st People’s Hospital of Kunming,Kunming Yunnan 650224,China)

机构地区：[1]昆明市第一人民医院口腔科,云南昆明650224 [2]昆明市第一人民医院检验科,云南昆明650224 [3]昆明市第一人民医院科教科,云南昆明650224

出　　处：《昆明医科大学学报》2024年第1期136-142,共7页Journal of Kunming Medical University

基　　金：昆明市科技计划基金资助项目(2019-1-S-25318000001512)。

摘　　要：目的评价光活化消毒(photo-activated disinfection,PAD)作为中重度慢性牙周炎辅助治疗的效果。方法选择PD≥5 mm的慢性牙周炎后牙(共计21例,218位点),以龈下刮治及根面平整术(scaling and root planing,SRP)治疗前为基线,在SRP后分4组进行辅助治疗。A组:盐酸米诺环素;B组:PAD;C组:PAD+盐酸米诺环素;D组:无辅助治疗。在基线、治疗后6周、治疗后12周分别记录患牙探诊深度(probing depth,PD)、探诊出血(bleeding on probing,BOP)及临床附着丧失(clinical attachment loss,CAL);同时用Real-time PCR检测3个辅助治疗组龈下菌斑中的牙龈卟啉单胞菌(porphyromonas gingivalis,Pg)和福赛坦氏菌(tannerella forsythia,Tf),观察2种牙周致病菌含量的变化情况。结果与基线比较,4个组牙周指标在治疗后6周、12周均有显著改善(P<0.001),且A、B、C 3个辅助治疗组控制效果均明显优于无辅助治疗的D组(P<0.001),C组对PD的改善效果优于A组(P<0.001);3个辅助治疗组Pg、Tf的量在6周、12周均有明显下降(P<0.001),组间差异无统计学意义(P>0.05)。结论作为SRP的辅助治疗,PAD能达到与盐酸米诺环素同等程度的临床疗效,PAD可替代盐酸米诺环素用于中重度慢性牙周炎。Objective To evaluate the effect of photo-activated disinfection(PAD)as a kind of adjuvant treatment on moderate to severe chronic periodontitis.Methods 21 patients with the chronic periodontitis(totally 218 selected sites)were randomly enrolled and divided into group A(minocycline hydrochloride),group B(PAD),group C(PAD+minocycline hydrochloride),and group D(no adjunctive therapy)for the adjunctive treatment after receiving the scaling and root planing(SRP).Periodontal indexs as probing depth(PD),bleeding on probing(BOP)and clinical attachment loss(CAL)were examined at the baseline,6 and 12 weeks after the treatment.Meanwhile,periodontal pathogens as Porphyromonas gingivalis(Pg)and Tannerella forsythia(Tf)from subgingival plaque of group A,B and C were detected by Real-time PCR.Results Compared with the baseline,the periodontal inflammations of all groups were improved signiffcantly at 6 and 12 weeks after the treatment(P<0.001),and group A,group B and group C were better than group D(P<0.001),group C was better than group A(P<0.001);Furthermore,the concentration of Pg and Tf was decreased significantly(P<0.001),and there was no difference among the three groups with adjunctive therapy.Conclussion As the adjunctive treatment of SRP,PAD could achieve the same and even better effect than minocycline hydrochloride ointment.

关 键 词：光活化消毒 盐酸米诺环素软膏 慢性牙周炎 牙周临床指标 牙周致病菌 

分 类 号：R781.4[医药卫生—口腔医学]