光动力疗法对慢性牙周炎患者龈沟液IL-1β和MMP-8含量的影响

Effect of photodynamic therapy on IL-1β and MMP-8 in gingival crevicular fluid of chronic periodontitis

目的:光动力疗法(photodynamic therapy,PDT)具有抗微生物作用,在牙周病等感染性疾病的治疗中受到关注。该实验通过检测治疗前、后患者龈沟液IL-1β和MMP-8的含量变化,评价PeriowaveTM光敏抑菌系统治疗慢性牙周炎的临床效果。方法:58例慢性牙周炎患者,随机分为A组[龈下刮治和根面平整(SRP)+1次PDT]、B组(SRP+2次PDT)和C组(SRP),PDT治疗选用PeriowaveTM光敏抑菌系统(675nm的二极管激光和0.01%亚甲蓝),治疗时以0.01%亚甲蓝作为光敏剂,二极管激光用140mW的功率照射60s。用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测治疗前、后龈沟液中IL-1β和MMP-8的含量。采用SAS6.12软件包进行统计学分析。结果:治疗后6周时,A、B、C3组龈沟液IL-1β和MMP-8的含量与治疗前的基线相比,均显著降低,但组间无显著差异;治疗后12周,A、B2组IL-1β及B组MMP-8含量变化与C组比较有显著差异(P<0.05)。结论:SRP和SRP与PDT联合治疗在控制炎症的同时,能有效降低患者龈沟液中IL-1β和MMP-8的含量,但控制炎症的效果维持时间更长。因此,PDT可作为治疗慢性牙周炎的一种新方法。

PURPOSE： Photodynamic therapy （PDT） is used in infectious disease for its antimicrobial effects. The aim of the study is to evaluate the effects of a diode laser-based photodynamic therapy on the treatment of chronic periodontitis. METHODS： Fifty eight patients with chronic periodontitis were divided into three groups. Group A was treated with scaling and root planing （SRP） plus photoactivated disinfection therapy for one time （Periowave^TM： a diode laser with a wavelength of 670nm and 0.01% methylene blue solution）. In group B, the patients were treated with SRP followed by photoactivated disinfection, and a second photoactivated disinfection treatment 6 weeks later. Group C was treated with SRP alone. The irradiation time was 60 seconds at a power output of 140mW. Gingival crevicular fluid （GCF） samples from these three groups of patients were obtained before periodontal treatment, 6 weeks and 12 weeks after treatment. GCF was collected using a paper strip, and enzyme-linked immunoabsorbent assay （ELISA） was performed to determine the cytokine （IL-1β and MMP-8） levels. The data were analyzed with SAS 6.12 software package. RESULTS： ELISA showed IL-1β and MMP-8 levels of all groups were decreased significantly at 6-week after treatment compared to pretreatment levels. No significant inter-group differences were noted. At 12-week after treatment, the decreases in IL-1β levels of group A and B and the decrease in MMP-8 level of group B were significantly higher than group C （P〈0.05）. CONCLUSIONS： Based on these findings, it appears that SRP and SRP with PDT are all effective for chronic periodontitis, but the effect of SRP with PDT may last longer. PDT therefore appears to be a useful adjunct to SRP for chronic periodontitis therapy.