单纯牙周翻瓣术和牙周翻瓣术前行牙周非手术治疗对重度牙周炎的疗效比较

Comparative study of effect of periodontal flap surgery and caling and root planning before periodontal flap surgery on severe periodontitis

目的比较单纯牙周翻瓣术和牙周翻瓣术前行牙周非手术治疗两种方法治疗重度牙周炎的疗效。方法本临床试验共纳入了28例重度牙周炎患者,随机分入实验组和对照组(每组14例)。对照组患者直接行改良的牙周翻瓣术;实验组患者接受牙周非手术治疗后行改良的牙周翻瓣术。纳入时及纳入后3、6个月检查并记录所有受试者的牙周探诊出血(bleeding on probing,BOP)、牙周探诊深度(pocket probing depth,PPD)、临床附着水平(clinical attachment lose,CAL)及牙槽骨水平(level of bone,LOB)。采用t检验及χ~2检验对结果进行比较分析。结果与纳入时相比,经过牙周治疗后,两组患者的BOP、PPD、CAL均有显著改善;两组对比,纳入时无明显差异;6个月后进行复查时,实验组的牙周探诊深度的降低显著高于对照组[(4.0±0.23)mm vs(4.9±0.13)mm,P<0.01],临床附着水平的改善也优于对照组[(5.6±0.30)mm vs(5.5±0.29)mm,P<0.01]。结论牙周翻瓣术前对重度牙周炎患者行牙周非手术治疗可以在一定程度上提高牙周手术治疗的效果。

Objective To compare the curative effects of periodontal flap surgery alone and periodontal flap surgery combined with periodontal non-surgery treatment for patients with chronic severe periodontitis. Methods Twenty-eight patients participated in this clinical trial and they were randomly allocated into the control group and the test group. The control group was treated with Modified Widman Flap surgery directly while the test group received scaling and root planning before the same surgery. Bleeding on probing（ BOP）,pocket probing depth（ PPD）,clinical attachment loss（ CAL） and level of bone（ LOB） were examined and recorded at baseline and 3,6 months later. We used t-test and chi-square test to evaluate the difference between the two groups. Results Both therapeutic methods were conducive to patients,for the measurement indicators improved significantly compared with baseline. 6 months after enrollment,the change of PPD [（ 4. 0 ± 0. 23） mm vs（ 4. 9 ± 0. 13） mm,P〈0. 01] reduction and CAL[（ 5. 6 ± 0. 30） mm vs（ 5. 5 ± 0. 29） mm,P〈0. 01]gain that had occurred in the test group was more obvious than that of the control group,although there was no significant difference between the two groups at baseline. Conclusions Implementation of scaling and root planning before surgery may bring about better results than surgery alone.