脉冲CO_2激光切除整形术与手术切龈治疗牙龈增生病变的前瞻性研究

Perspective Comparison Study on Pulsing CO_2 Laser Irradiation and Gingivectomy for Gingival Hyperplastic Lesions

目的 探讨脉冲CO2 激光手术在牙龈增生性病变治疗中的应用价值。方法 对 72例牙龈增生性病变患者分别行脉冲CO2 激光牙龈整形与传统手术切龈治疗 ,采用临床定量指标手术时间、术中出血量、创面愈合时间、创面感染率和牙龈指数 (GI)、龈沟出血指数 (SBI)评定及临床疗效观察 ;分别于术前、术后即时、1、2、3、4周及 1年追踪观察。结果 脉冲CO2 激光切除牙龈增生性病变较传统手术节省手术时间约 1倍 ,术中平均减少6 6 .6 %的失血量 ,术后创面愈合快 ;创面感染率明显低于手术组 ;GI、SBI较术前均有明显下降 ,且激光组较手术组更能有效控制牙龈炎症 ,两组治疗牙龈增生性病变近期与远期临床疗效可靠 (分别为 10 0 %、91.9%、85 .7% )。结论 脉冲CO2 激光不失为一种值得临床推广的安全。

Purpose To investigate the applied value of the pulsed CO 2 laser in the treatment of gingival hyperplastic lesions. Methods 72 cases of patients with gingival hyperplastic lesions were divided into two groups.One group was treated with the pulsed CO 2 laser,while the other with traditional surgical gingivectomy.To used clinical quantum index:Operative time,Operative hemorrhage volume,Surface of wound healing time,Wound infection rate and GI,SBI and Clinical effects was observed.Respectively exercise recorded data and clinical follow up observed before operation,0,7,14,21,28 days and 1 year after the treatments.Then we made assessment and statistic process using the data abouve. Results Using pulsed CO 2 laser in the treatment of gingival hyperplastic lesions can save half time as traditional operation ( P <0.01) .During the operation,the average capacity of blood loss can be decreased 66.6%( P <0.01);The curing time was shorter( P <0.01);and the infected rate of the wound surface was much lower (adjusted X test, P <0.05).GI,SBI index were all lower obviously comparing pre operation( P <0.01),but there was significant difference between two groups in GI index post operation( P <0.05);Two groups can all get valuable effects no mater in near future or in long term observation. Conclusions Pulsing CO 2 laser is a safe,effective and ideal laser when treating periodontal disease.It gives a new therapy to clinical treatment of gingival hyperplastic lesions.