超声系统治疗与牙周翻瓣术的短期疗效比较

Comparison of clinical effects in ultrasonic system and periodontal flap surgery in a short time

目的比较Vector超声系统治疗和牙周翻瓣术治疗慢性牙周炎的1年临床疗效。方法选取牙周基础治疗3个月后,30例慢性牙周炎患者,其口内的单根牙及多根牙都存在牙周探诊深度5~7 mm的位点,随机分为3组各10例患者,Vector超声系统治疗组进行Vector超声治疗、牙周翻瓣术组进行改良Widman翻瓣术、常规龈下刮治和根面平整组进行龈下刮治和根面平整术,记录治疗结束1 d后的疼痛程度,并在治疗前,治疗后3、6、12个月,采用Florida探针系统检查记录探诊出血（BOP）、探诊深度（PD）、牙龈退缩（GR）、临床附着丧失（CAL）,并比较分析。结果 3组治疗后1 d的疼痛程度评价,Vector超声系统治疗组最低2.2,牙周翻瓣术组最高为6.4,组间差异具有统计学意义（P〈0.05）。对于单根牙,3组在治疗后的3、6、12个月PD、GR、BOP与治疗前比较都有显著改善（P〈0.01）;治疗后的第12个月,Vector超声系统治疗组和牙周翻瓣术组PD改善相同,且该组的GR和CAL低于牙周翻瓣术组和常规龈下刮治和根面平整组。对于多根牙,治疗后3、6个月,3组PD较治疗前有改善,GR较治疗前明显增加（P〈0.01）,翻瓣术组和Vector超声系统治疗组的CAL值较治疗前减少（P〈0.05）;治疗后12个月只有翻瓣术组的PD、CAL值较治疗前减少（P〈0.05）,3组的GR较治疗前明显增加（P〈0.01）;3组的BOP阳性率在治疗后的3、6、12个月,翻瓣术组与治疗前比较显著下降（P〈0.01）,另两组则在治疗后的12个月与治疗前差异无统计学意义（P〉0.05）。结论对于基础治疗后3个月,仍存在5~7 mm牙周袋位点的单根牙,采用Vector超声系统进行治疗的患者,1年后的疗效优于牙周翻瓣术;而对于多根牙,Vector超声系统治疗的效果不及牙周翻瓣手术的效果。

Objective This study aims to compare the clinical effects of therapy with vector ultrasonic system and periodontal flap surgery in patients with chronic periodontitis in a short time. Methods A total of 30 patients with chronic periodontitis were selected. The patients had deep pockets from 5 mm to 7 mm in both single-rooted teeth and multi- rooted teeth at 3 months after initial therapy. All patients were randomly divided into three groups. Each group had 10 patients. The patients were treated with vector ultrasonic system, periodontal flap surgery, and scaling and root planning, respectively. Patients were asked to report their perceived pain after 1 day of treatment by using a visual analog scale. The clinical parameters of bleeding on probing（BOP）, probing depth（PD）, gingival recession（GR）, and clinical attachment loss（CAL） were recorded by Florida electronic probe at baseline, 3 months, 6 months, and 1 year. Differences were analyzed by SPSS 11.5. Results The three groups had differences in pain perception 1 day after the treatment. The vector ultrasonic system treatment group had the least pain reported, and the periodontal flap surgery group had the worst pain reported. For the study of the single-rooted teeth, the three groups had differences in PD, GR, and BOP after treatment in 3, 6, and 12 months compared with the baseline（P〈0.01）. After 1 year, the vector ultrasonic system treatment groupand periodontal flap surgery group showed similar improvement in PD; however, the former had the lowest GR and CAL. For multi-rooted teeth, the three groups improved in PD at 3 and 6 months after treatment. CALdecreased in the vector ultrasonic system treatment group and the periodontal flap surgery group. CAL and PD decreased in the periodontal flap surgery group（P〈0.05） 12 months after treatment. GR increased in three groups at 3, 6, and 12 months after treatment （P〈0.01）. In addition, 3, 6, and 12 months after treatment, the BOP positive rate decreased in the periodontal flap surgery group （P〈0.01）. The other two groups had no difference 12 months after treatment（P〉0.05）. Conclusion The vector ultrasonic system achieved better curative effect on single-rooted teeth than periodontal flap surgery 1 year after treatment. In multi-rooted teeth, the effect of the periodontal flap surgery was the most stable, whereas the other two treatments were unstable.