光活化消毒在龈下刮治及根面平整术中的应用

Application of photo-activated disinfection in subgingival scaling and root planing

目的:观察光活化消毒(PAD)辅助龈下刮治及根面平整术(SRP)治疗慢性牙周炎的疗效。方法:将40例慢性牙周炎患者随机分为4组:单纯SRP治疗组(A组)、SRP术前用PAD治疗组(B组)、SRP术前和术后同时用PAD治疗组(C组)、SRP术后用PAD治疗组(D组)。分别于基线(T1)、治疗后6周(T2)和12周(T3)检测各组探诊深度(PD)、临床附着丧失(CAL)、探诊出血指数(BOP)的变化;然后从每例患者中各随机选取两个PD≥5 mm的位点进行取样,并用Real-Time PCR及ELISA法分别检测龈下菌斑中Pg相对于总菌的含量及龈沟液中TNF-α、IL-1α的含量。结果:T2、T3时,4组的临床各指标、Pg相对于总菌的含量以及龈沟液中TNF-α、IL-1α的含量均较其T1时显著降低(P<0.05);A组BOP阳性位点多于B、C、D组(P<0.05);B、C、D组Pg相对于总菌的含量均低于A组,C组低于B、D组(P<0.05);B、C、D组龈沟液中TNF-α的含量均显著低于A组(P<0.05)。T3时,B、C、D组龈沟液中IL-1α的含量显著低于A组(P<0.05),B、C、D各组间相比均无显著差异(P>0.05)。结论:PAD辅助SRP治疗慢性牙周炎时,可有效杀灭其牙周袋内的Pg,并可降低龈沟液中TNF-α、IL-1α的含量。

AIM： To observe the effects of photo-activated disinfection（ PAD） in auxiliary treatment of chronic periodontitis. METHODS： 40 patients with chronic periodontitis were randomly divided into 4 groups and received the following treatment： scaling and root planning（ SRP,Group A）; SRP plus pre-PAD（ Group B）,SRP plus pre-and post-PAD（ Group C）,SRP plus post-PAD（ Group D）. The changes of PD,BOP and CAL were observed at baseline,6 w and 12 w after treatment. 2 loci（ PD≥5mm） were selected from each patient and the changes of Porphyromonas Gingivalis（ Pg） content relative to total bacteria in subgingival plaque were detected by real- time PCR.TNF-α and IL-1α content in gingival crevicular fluid were measured by ELISA. RESULTS： Clinical parameters,Pg content,TNF-α and IL-1α levels in all 4 groups decreased at 6 w and 12 w after treatment（ P 0. 05）. The clinical parameters,Pg content,TNF-α and IL-1α levels in group B,C and D were lower than those in group A（ P 0. 05）.Whereas,no significant difference was found among group B,C and D（ P 0. 05）. CONCLUSION： PAD is an effective auxiliary treatment method for chronic periodontitis.