光动力疗法辅助龈下刮治及根面平整术治疗慢性牙周炎的临床疗效及对龈沟液中VEGF-D、S100A12、ICAM-1表达水平的影响  

Clinical effect of photodynamic therapy assisted subgingival scaling and scaling and root planing in the treatment of chronic periodontitis and its influence on the expression levels of VEGF-D,S100A12 and ICAM-1 in gingival crevicular fluid

作　　者：陈星宇 陈芳 童钰鑫 高瑞 张琳琳 刘芬 白晓帆 安莹 CHEN Xingyu;CHEN Fang;TONG Yuxin;GAO Rui;ZHANG Linlin;LIU Fen;BAI Xiaofan;AN Ying(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi International Joint Research Center for Oral Diseases,Department of Periodontology,School of Stomatology,Air Force Medical University,Xi'an 710032,China;Department of Pediatric Dentistry,Hospital of Stomatology,Xi'an Jiaotong University,Xi'an 710003,China)

机构地区：[1]口颌系统重建与再生全国重点试验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病国际联合研究中心,空军军医大学口腔医院牙周病科,陕西西安710032 [2]西安交通大学口腔医院儿童牙颌疾病诊疗专科,陕西西安710003

出　　处：《空军军医大学学报》2024年第10期1129-1134,共6页Journal of Air Force Medical University

基　　金：国家自然科学基金(82101049)。

摘　　要：目的探讨光动力疗法(PDT)辅助龈下刮治和根面平整术(SRP)治疗慢性牙周炎的临床疗效及对龈沟液(GCF)中血管内皮生长因子-D(VEGF-D)、S100钙结合蛋白A12(S100A12)、细胞间黏附分子-1(ICAM-1)表达水平的影响。方法选取2023年9月至2024年4月于空军军医大学口腔医院牙周病科收治的24例慢性牙周炎患者作为研究对象,采用自身对照试验,每位受试者4个象限,每个象限各选取至少1颗探诊深度(PD)≥6 mm且病损情况相似的同名牙,共104颗患牙,将双侧患牙随机分为对照组(n=52)与试验组(n=52),对照组仅采取单纯SRP治疗,试验组在对照组的基础上辅助PDT,测量并比较两组患牙治疗前(T0)、治疗后1个月(T1)和3个月(T2)的牙周PD、牙龈出血指数(BI)及菌斑指数(PLI)以及治疗前后GCF中VEGF-D、S100A12、ICAM-1的表达水平。结果相较于T0,两组患牙的PD、BI、PLI在T1、T2均有不同程度的降低(P<0.001),试验组患牙的临床指标降低幅度更显著(P<0.001)。对照组中的T1与T2,PLI在统计学上无统计学差异。两组患牙GCF中VEGF-D(P=0.023)、S100A12(P=0.020)、ICAM-1(P=0.010)含量明显低于T0,试验组患牙降低幅度相较于对照组更显著(P<0.01)。结论PDT作为SRP治疗慢性牙周炎的辅助手段,可有效降低PD、BI、PLI等牙周临床指标,并显著降低GCF中VEGF-D、S100A12、ICAM-1的含量,从而减轻牙周炎症反应,改善患者的牙周健康状况。Objective To investigate the clinical efficacy of photodynamic therapy(PDT)assisted subgingival scaling and scaling and root planing(SRP)in the treatment of chronic periodontitis and its effect on the expression levels of vascular endothelial growth factor-D(VEGF-D),S100 calcium-binding protein A12(S100A12),and intercellular adhesion molecule-1(ICAM-1)in gingival crevicular fluid(GCF).Methods A total of 24 patients with chronic periodontitis treated in Department of Periodontology,School of Stomatology,Air Force Medical University from September 2023 to April 2024 were selected as the research objects.A self-controlled trial was conducted,with each subject having 4 quadrants.For each quadrant,at least one tooth with a probing depth(PD)≥6 mm and similar disease severity was selected as the index tooth.In total,104 affected teeth were included.The teeth were randomly divided into control group(n=52)and experimental group(n=52).The control group was treated with SRP alone,while the experimental group received PDT in addition to the standard treatment.Periodontal PD,bleeding index(BI),and plaque index(PLI)were measured and compared at baseline(T0),1 month(T1),and 3 months(T2)after treatment between the two groups.Meanwhile,the expression levels of VEGF-D,S100A12 and ICAM-1 in GCF were tested before and after treatment.Results At T1 and T2,both groups exhibited significant reductions in PD,BI,and PLI compared to T0(P<0.001),with greater improvements in the experimental group(P<0.001).No significant difference in PLI was observed between T1 and T2 in the control group.Both groups showed a significant decrease in VEGF-D(P=0.023),S100A12(P=0.020),and ICAM-1(P=0.010)in GCF compared to baseline,with a more pronounced reduction in the experimental group(P<0.01).Conclusion PDT,as an adjunct to SRP in the treatment of chronic periodontitis,can effectively reduce the periodontal clinical indicators such as PD,BI and PLI,and significantly reduce the contents of VEGF-D,S100A12 and ICAM-1 in GCF,thus alleviating the periodontal

关 键 词：光动力疗法 根面平整术 慢性牙周炎 血管内皮生长因子 钙结合蛋白 细胞间黏附分子 

分 类 号：R781[医药卫生—口腔医学]