氯己定龈下冲洗辅助超声龈下刮治对老年人慢性牙周炎的疗效  

Therapeutic efficacy of chlorhexidine subgingival irrigation as an adjunct to ultrasonic subgingival scaling in the treatment of the elderly with chronic periodontitis

作　　者：周程晨 罗旭[1] Zhou Chengchen;Luo Xu(The Second Clinical Division of Peking University School of Stomatology,Beijing 10010l,China)

机构地区：[1]北京大学口腔医院第二门诊部,北京100101

出　　处：《中华老年医学杂志》2024年第11期1451-1455,共5页Chinese Journal of Geriatrics

摘　　要：目的评估氯己定龈下冲洗辅助超声龈下刮治对老年人中重度慢性牙周炎的临床治疗效果。方法 22例患有中重度慢性牙周炎的老年患者, 随机把口内两侧的牙齿分为试验侧和对照侧, 试验侧在进行超声龈下刮治时, 用0.02%氯己定替代蒸馏水从超声工作尖中喷出;对照侧常规进行超声龈下刮治。分别记录基线、刮治后6周和3个月的菌斑指数(PLI)、探针深度(PD)、临床附着水平(CAL)、牙龈出血指数(BI)和探诊后出血百分比(BOP)。结果治疗后6周和3个月, 试验侧和对照侧的PD均较基线显著减少(均P<0.05), 但两侧的改变幅度基本相同, 差异无统计学意义(P=0.591、0.106)。试验侧和对照侧的CAL在6周和3个月时与基线比较差异均有统计学意义(均P<0.05), 试验侧的变化幅度要比对照侧略大, 但差异未达到统计学意义(P=0.758、0.909)。BI在6周和3个月时, 试验侧和对照侧与基线比较差异均有统计学意义(均P<0.05), 且在6周和3个月时试验侧和对照侧组比较差异也均有统计学意义(P=0.003、0.015), 试验侧牙龈出血情况的改善程度要显著优于对照侧。类似的, BOP在6周和3个月时, 两侧均有一定的改善, 与基线比较差异有统计学意义(均P<0.05), 且试验侧的改善幅度要显著优于对照侧(P=0.005、0.019)。PLI在6周和3个月时, 与基线比较差异均有统计学意义(均P<0.05), 但两侧比较差异均无统计学意义(均P>0.05)。结论使用超声洁牙机联合氯己定进行龈下刮治和根面平整可以显著改善老年慢性牙周炎患者的牙周袋深度和牙龈出血情况, 且与传统治疗方式相比, 超声洁牙机联合氯己定的治疗效果更好, 易被老年人接受。Objective To evaluate the clinical efficacy of subgingival irrigation with chlorhexidine as an adjunct to ultrasonic subgingival scaling for the treatment of moderate to severe chronic periodontitis in elderly patients.MethodsTwenty-two elderly patients diagnosed with moderate to severe chronic periodontitis were randomly assigned to test and control groups based on mouth side.In the test group,O.02%chlorhexidine was used in place of distilled water for irrigation during ultrasonic scaling,while the control group received routine ultrasonic subgingival scaling.The plaque index(PLI),probing depth(PD),clinical attachment level(CAL),gingival bleeding index(BI),and percentage of bleeding on probing(BOP)were recorded at baseline,6 weeks post-treatment,and 3 months post-treatment.Results At 6 weeks and 3 months post-treatment,both the test and control sides exhibited a significant reduction in PD from baseline(both P<0.05).However,the magnitude of change was comparable between the two sides,with no statistically significant difference observed(P=0.591,0.106).Both sides also demonstrated statistically significant differences in CAL at 6 weeks and 3 months compared to baseline(both P<0.05).Although the change in the test side was slightly greater than that in the control side,this difference was not statistically significant(P=0.758,0.909).Regarding BI,both sides showed a significant difference from baseline at both 6 weeks and 3 months(both P<o.05),with statistically significant differences between the test and control groups(P=0.003,0.015),indicating a significantly better improvement in gingival bleeding on the test side.Similarly,both sides demonstrated improvement in BOP at 6 weeks and 3 months,with the test side showing a significantly better improvement than the control side(P=0.005,0.019).The PLI also showed statistically significant differences compared to baseline at 6 weeks and 3 months(both P<0.05);however,there was no statistically significant difference between the two sides(both P>0.05).Conclusions The use

关 键 词：牙周炎 氯己定 牙龈下刮治术 

分 类 号：R781.42[医药卫生—口腔医学]