不同根面处理方法对重度牙周炎患牙根面的影响

The influence of different treatments on the root surface of teeth with severe periodontitis

目的:比较4种根面处理方法对重度牙周炎患牙根面结构、牙龈卟啉单胞菌(Porphyromonas gingivalis,P.gingivalis)和牙周膜成纤维细胞(human periodontal ligament cells,h PDLCs)根面黏附、增殖的影响。方法:将因重度牙周炎拔除的100颗离体牙龈下刮治和根面平整(scaling and root planning,SRP)后制成根片,随机分为SRP组、派丽奥组、EDTA组和Nd:YAG组,进行相应处理。扫描电镜(scanning electron microscope,SEM)和原子力显微镜(atomic force microscope,AFM)观察根面形态和粗糙度。将P.gingivalis和h PDLCs分别接种于各组根片表面,Cell Counting Kit-8(CCK-8)法测定根面P.gingivalis和h PDLCs的吸光度值。结果:SEM显示SRP组表面玷污层较多,其余3组均去除玷污层;AFM显示派丽奥组根面粗糙度最小,Nd:YAG组最粗糙;P.gingivalis接种于根面4 h和1 d时,派丽奥组和Nd:YAG组黏附量最少;h PDLCs接种于根面后,派丽奥组和Nd:YAG组增殖最明显。结论:刮治结合派丽奥、刮治结合Nd:YAG激光处理利于h PDLCs根面黏附和增殖,明显减少P.gingivalis在根面的早期定植。

Objective：This study aimed to evaluate the treatment of four different methods on root surfaces of teeth affected by severe periodontal disease,adhesion and proliferation of Porphyromonas gingivalis（P. gingivalis）and human periodontal ligament cells（h PDLCs）on root surfaces. Methods：Severe periodontal affected teeth（n=100）were extracted and treated with scaling and root planning（SRP）,and root slices were prepared. These slices were randomly divided into four groups：SRP group,Periocline group,EDTA group and Nd：YAG group. Scanning electron microscopy（SEM）and atom force microscope（AFM）were used to determine the morphology and the roughness of the root slices. The proliferation of P. gingivalis and h PDLCs was evaluated by cell count kit-8（CCK-8）. Results：The obvious smear layer was observed in SRP group,whereas it was almost removed in other three groups. The roughness of the root surface of Periocline group was the lowest while the Nd：YAG group was the highest. After 4 hours and 1 day,the amount of P. gingivalis adhered to the root surfaces of Periocline group and Nd：YAG group was significantly less than that to other groups. The attachment of h PDLCs to the root surfaces showed a time dependent manner,and the number of attached cells was higher in Periocline group and Nd：YAG group. Conclusion：SRP combined with Periocline or Nd：YAG laser is more conducive to the attachment and proliferation of h PDLCs,and decrease the adhesion of P. gingivalis at the early stage.