重度广泛型侵袭性牙周炎患者非手术治疗的临床疗效观察

Clinical effects of non-surgical treatment on severe generalized aggressive periodontitis

目的观察重度广泛型侵袭性牙周炎（generalized aggressive periodontitis，GAg／））患者牙周非手术治疗后临床指标的变化，并评价其治疗效果。方法19例GAgP患者在洁治后1个月内完成刮治和根面平整，每2个月进行1次牙周维护，纵向观察6个月。在基线和维护期各时间点记录全1：1探诊深度（probing depth，PD）、探诊出血（bleeding on probing，BOP）、附着丧失（attachment loss，AL）和牙齿松动度，磨牙记录根分叉病变的程度，其中7例患者在基线和治疗后6个月进行白细胞计数、中性粒细胞百分比和甘油三酯的检测。结果在基线时患者的平均PD为（5．1±2．1）mm，BOP阳性位点占98．0％，AL（3．9±1．9）mm。治疗后6个月平均PD为（3．0±1．1）mm，BOP阳性位点减少至11．9％，AL（3．2±1．2）mm，其中重度位点治疗后PD减少[（4．0±1．6）mm]大于中度位点[（2．2±0．9）mm，P〈0．001]，切牙治疗后PD减少大于磨牙，中性粒细胞百分比治疗后6个月[（55．4±9．3）％]较治疗前[（65．7±9．9）％]明显减少（P〈0．05）。结论GAgP患者经牙周非手术治疗和定期牙周维护能取得良好的治疗效果，磨牙可能需要进一步的刮治和根面平整或手术治疗。

Objective To investigate the clinical results of non-surgical periodontal treatment of generalized aggressive periodontitis in a Chinese population. Methods Nineteen patients aged （24. 5 ± 4. 1 ） years with generalized aggressive periodontitis were included in this prospective study. All subjects received scaling and root planing and were clinically monitored every 2 months for 6 months. The clinical parameters, including probing depth（ PD）, bleeding on probing（ BOP）, attachment loss（AL） and mobility, furcation involvement of molars were recorded at baseline, 2, 4 and 6 months after treatment. White blood cells, neutrophil percentage, triglyceride of 7 patients were detected at baseline and 6 months after treatment. Results At baseline, the mean PD of patients was （5. 1± 2. 1 ） ram, the percentage of BOP positive sites was 98.0% and mean AL was （3.9 ± 1.9 ） ram. At 6 months after treatment, the mean pocket depth reduction was 2.0 mm, the percentage of BOP positive sites reduced to 11.9% and 0. 6 mm attachment level was gained. Incisors showed greater PD reduction than molars, the baseline PD had predictive effect on PD reduction, deep sites showed greater PD reduction than shallow sites. There was a statistically significant decrease of neutrophil percentage at 6 months after treatment [ （65.7 ± 9. 9） % vs. （55.4 ± 9. 3 ）%, P 〈 0. 05 ] . Conclusions Non-surgical treatment is effective for the generalized aggressive periodontitis and every 2 months SPT is necessary for maintenance. Further surgical treatment or repeated SRP is recommended for molars.