牙周牙髓联合治疗对重度牙周炎患者牙周组织基质金属蛋白酶表达及预后的影响分析

Effect of combined periodontal endodontic treatment on the expression of matrix metalloproteinase and prognosis in periodontal tissues of patients with severe periodontitis

目的分析牙周牙髓联合治疗对重度牙周炎患者牙周组织基质金属蛋白酶(matrix metalloproteinase,MMP)表达及预后的影响,探讨其临床应用价值。方法选取本院2014年2月至2016年2月收治的180例重度牙周炎患者为研究对象。按照随机数表法将入选患者分为观察组和对照组,每组各90例。观察组患者给予牙周牙髓联合治疗,对照组患者给予单纯牙周治疗。对比两组患者预后及牙周组织MMP变化,分析牙周牙髓联合治疗重度牙周炎的效果与机制。结果观察组患者临床治疗总有效率显著高于对照组(χ~2=6.527,P<0.05);两组患者治疗后均未发生不良反应。末次复诊时,两组患者探诊深度、附着丧失、菌斑指数、龈沟出血指数、松动度较治疗前均显著下降(P<0.05),且观察组患者上述牙周相关临床指标均显著低于对照组(P<0.05)。末次复诊时,两组患者牙周组织MMP-1、MMP-8表达水平均显著低于治疗前(P<0.05),观察组患者牙周组织MMP-1、MMP-8表达水平均显著低于对照组(P<0.05)。治疗前和末次复诊时,两组患者MMP-13和TIMP-1表达水平均未见显著变化(P>0.05)。结论牙周牙髓联合治疗能够有效降低重度牙周炎患者牙周组织MMP-1和MMP-8表达水平,从而在保证治疗安全性的前提下有效提高临床疗效,值得推广应用。

Objective To analyze the effect of combined periodontal endodontic treatment on the expression of matrix metalloproteinase(MMP)and prognosis in periodontal tissues of patients with severe periodontitis,and to explore its clinical application value.Method In our hospital from February2014to February2016,180cases of severe periodontitis patients were randomly divided into observation group and control group,90cases in each group.Observation group patients were given combined periodontal endodontic treatment,and control group patients were given simple periodontal treatment.Compared the prognosis of the two groups and the changes of periodontal tissue MMP,and analyzed the effect and mechanism of combined periodontal endodontic treatment of severe periodontitis.Result The total efficiency of observation group was significant higher than control group(χ2=6.527,P<0.05),there was no occurrence of adverse reactions of the two groups of patients after treatment.At the last visit,the probing depth,attachment loss,plaque index,sulcus bleeding index,mobility of the two groups of patients were significantly decreased than that before treatment(P<0.05),the periodontal related clinical indicators of observation group were significantly lower than thosein control group(P<0.05).At the last visit,the expression levels of MMP-1and MMP-8in periodontal tissues of the two groups were significantly lower than those before treatment(P<0.05),and the expression levels of MMP-1and MMP-8in periodontal tissues of observation group were significantly lower than those of control group(P<0.05).Before treatment and at the last visit,there were no significantly differences of the expression levels of MMP-13and TIMP-1between the two groups of patients(P>0.05).Conclusion Combined periodontal endodontic treatment scheme can effectively reduce the severe periodontitis patients undergoing periodontal tissue MMP-1,MMP-8expression levels,in order to effectively improve the clinical curative effect in treatment of security under the premise,it is worthy of popularization and application.