激光联合药物修复牙周-牙髓联合病变的对比研究

Comparative study of laser and drug in treatment of combined periodontal-endodontic lesions

目的比较激光、药物、激光与药物联合应用修复牙周-牙髓联合病变的有效性。方法选取西南医科大学附属口腔医院160例牙周牙髓联合病变患者。随机分为基础治疗组、激光治疗组、药物治疗组及激光与药物联合治疗组(以下简称联合治疗组)4组,4组均接受根管治疗和牙周系统治疗。基础治疗组只接受根管和牙周系统治疗;激光治疗组辅助半导体激光治疗;药物治疗组辅助盐酸米诺环素软膏治疗;联合治疗组辅助激光联合盐酸米诺环素软膏治疗。观察各组治疗前与治疗后牙周袋深度、改良出血指数、临床附着水平、牙齿松动度、菌斑指数及牙龈指数等牙周-牙髓临床指标的变化,比较4组的治疗总有效率。结果 4组治疗后6个月,牙周袋深度、改良出血指数、临床附着水平、牙齿松动度、菌斑指数及牙龈指数均低于治疗前(P<0.05);治疗后联合治疗组牙周袋深度、改良出血指数、临床附着水平、牙齿松动度、菌斑指数及牙龈指数均低于其他3组,激光治疗组和药物治疗组各指标均低于基础治疗组(P<0.05);联合治疗组治疗总有效率高于基础治疗组(P<0.05)。结论激光联合药物修复牙周-牙髓联合病变效果优于激光或药物辅助治疗,值得推广应用。

Objective To compare the effectiveness of the laser,drug and laser combined with drug in the repair of combined periodontal-endodontic lesions.Methods A total of 160 cases of combined periodontal-endodontic lesions were randomly divided into basic treatment group,laser treatment group,drug treatment group and combined treatment group.Patients in the basic treatment group were only treated with standard treatment (root canal and systemic periodontal treatment).Patients in the laser treatment group received additional semiconductor laser therapy.Patients in the drug treatment group were treated with additional Minocycline Hydrochloride Ointment.Patients in the combined treatment group were treated additionally with laser combined with Minocycline Hydrochloride Ointment.Changes of periodontal pocket depth,bleeding index,clinical attachment level,tooth mobility,plaque index and gingival index were observed before and after treatment.The total efficiency of the four groups was compared.Results The depth of periodontal pocket,improved bleeding index,clinical attachment level after 6 months of treatment were all lower than those before treatment in the four groups (P<0.01).The periodontal pocket depth,modified bleeding index,clinical attachment level,tooth mobility,plaque index and gingival index in the combined treatment group after treatment were lower than those in the other three groups (P<0.01).The indexes of the laser treatment group and the drug treatment group were significantly lower than those in the basic treatment group (P<0.01).The total effective rate of treatment in the combined treatment group was higher than that of the basic treatment group (P<0.05).Conclusions The effect of laser combined with drugs in the treatment of combined periodontalendodontic lesions is better than that of only laser or drug assisted treatment,which is worth popularizing.