光动力疗法与半导体激光辅助治疗重度牙周炎的疗效比较  

Comparison of the effects between photodynamic therapy and diode laser on severe chronic periodontitis

作　　者：罗玉[1] LUO Yu(Department of Periodontics,the Affilianted Stomatological Hospital of Nanchang University,Jiangxi Provincial Key Labboratory of Oral Biomedicine,Nanchang 330006,China)

机构地区：[1]南昌大学附属口腔医院牙周病科,江西省口腔生物医学重点实验室,330006

出　　处：《中国实用医药》2024年第7期12-17,共6页China Practical Medicine

基　　金：江西省卫健委科技计划项目(项目编号:20203406)。

摘　　要：目的比较光动力疗法(PDT)与半导体激光(DL)辅助龈下刮治和根面平整术(SRP)治疗重度牙周炎的临床疗效。方法筛选成年重度牙周炎患者30例作为研究对象,采用自身对照试验,每位受试者选3个象限,每个象限各选取1颗探诊深度(PD)≥7 mm且病损情况相似的磨牙作为指数牙,共90颗,共355个位点,3颗磨牙被随机分为SRP组(单独SRP治疗,118个位点)、DL组(SRP治疗后1周进行DL辅助治疗,122个位点)、PDT组(SRP治疗后1周进行PDT辅助治疗,115个位点)。比较三组治疗前后的PD、临床附着水平(CAL)、探诊出血(BOP)阳性位点、牙周致病菌[牙龈卟啉单胞菌(P.g)、伴放线共生杆菌(A.a)、福赛斯坦纳菌(T.f)]菌量。结果治疗前SRP组、DL组、PDT组的PD分别为(7.87±0.82)、(7.97±0.72)、(7.93±0.83)mm,治疗后6周PD分别为(5.43±1.25)、(5.17±0.79)、(5.13±0.90)mm,治疗后12周PD分别为(5.07±1.05)、(4.77±0.78)、(4.73±0.83)mm;治疗前SRP组、DL组、PDT组的CAL分别为(8.37±0.49)、(8.43±0.57)、(8.40±0.62)mm,治疗后6周CAL分别为(6.17±0.75)、(5.78±0.62)、(5.73±0.64)mm,治疗后12周CAL分别为(5.83±0.61)、(5.52±0.56)、(5.47±0.57)mm。治疗前,三组PD、CAL水平比较,均无统计学差异(P>0.05)。治疗后6、12周,三组PD、CAL水平较治疗前有所改善,且DL组、PDT组的CAL均优于SRP组(P<0.05);治疗后12周,三组PD、CAL较治疗后6周略降低,但差异不具有统计学意义(P>0.05)。治疗后6周SRP组、DL组、PDT组BOP阳性位点占比分别为78.0%、67.2%、65.2%,治疗后12周,SRP组、DL组、PDT组BOP阳性位点占比分别为77.1%、62.3%、59.1%,均低于治疗前的94.1%、93.4%、94.8%,且治疗后12周DL组、PDT组BOP阳性位点占比持续下降,低于SRP组(P<0.05);但治疗后12周DL组与PDT组BOP阳性位点占比比较,差异不显著(P>0.05)。治疗后6、12周三组P.g、A.a、T.f菌量均低于治疗前,治疗后6周DL组、PDT组的P.g、A.a、T.f菌量均低于SRP组,治疗后12周DL组、PDObjective To compare the clinical effect of photodynamic therapy(PDT)and diode laser(DL)adjuvant to scaling and root planing(SRP)in the treatment of severe chronic periodontitis.Methods 30 adult patients with severe periodontal disease were selected as study subjects.A self-controlled trial was conducted.3 quadrants were selected for each subject,and 1 molar with probing depth(PD)≥7 mm and similar lesions in each quadrant was selected as the index tooth,with a total of 90 teeth and 355 loci.3 molar teeth were randomly classified into the SRP group(SRP treatment alone,118 loci),the DL group(DL adjuvant therapy after 1 week of SRP treatment,122 loci),and the PDT group(PDT adjuvant therapy after 1 week of SRP treatment,115 loci).The PD,clinical adhesion level(CAL),positive site of bleeding on probing(BOP)and number of periodontal pathogens[porphyromonas gingivalis(P.g),actinobacillus actinomycetemcomitans(A.a)and tannerella forsythensis(T.f.)]were compared before and after treatment among the three groups.Results Before treatment,PD in SRP group,DL group and PDT group were(7.87±0.82),(7.97±0.72)and(7.93±0.83)mm;at 6 weeks after treatment,PD were(5.43±1.25),(5.17±0.79)and(5.13±0.90)mm;at 12 weeks after treatment,PD were(5.07±1.05),(4.77±0.78)and(4.73±0.83)mm.Before treatment,CAL of SRP group,DL group and PDT group were(8.37±0.49),(8.43±0.57)and(8.40±0.62)mm;at 6 weeks after treatment,CAL were(6.17±0.75),(5.78±0.62)and(5.73±0.64)mm;at 12 weeks after treatment,CAL were(5.83±0.61),(5.52±0.56)and(5.47±0.57)mm.Before treatment,there were no significant differences in PD and CAL levels among the three groups(P>0.05).At 6 and 12 weeks after treatment,the levels of PD and CAL in three groups were improved compared with those before treatment,and CAL in DL group and PDT group were better than that in SRP group(P<0.05).At 12 weeks after treatment,PD and CAL in the three groups were slightly lower than those at 6 weeks after treatment,but the difference was not statistically significant(P>0.05).At 6 weeks af

关 键 词：慢性牙周炎 光动力疗法 半导体激光 龈下刮治术及根面平整术 

分 类 号：R781.42[医药卫生—口腔医学]