光动力疗法与二极管激光辅助治疗牙周病疗效的临床随机对照研究

Comparison of outcomes between photodynamic therapy and diode laser as aided treatment for periodontal disease

目的比较光动力疗法(photodynamic therapy,PDT)与二极管激光(diode laser,DL)辅助传统非手术方法即洁治、龈下刮治和根面平整术(scaling and root planing,SRP)治疗慢性牙周炎的临床效果。方法 60例慢性牙周炎患者的双侧下颌2颗前磨牙(PD≥5 mm)共120颗随机入A、B、C三组治疗。A组为对照组,仅接受SRP,B组为SRP后辅助2次PDT,C组为SRP后辅助2次DL,两次辅助治疗之间间隔1周。治疗前、基础治疗后2周、辅助治疗完成后2周、12周检测PD、CAL、BI,ELISA试验检测龈沟液中IL-1β、bFGF的含量。结果治疗后牙周炎症状好转,A、B、C三组牙位点PD、CAL和BI治疗后与基线相比有显著统计学差异(P<0.01),辅助治疗后2周B、C组BI较A组显著好转(P<0.05)。治疗后三组龈沟液中碱性成纤维细胞生长因子(bFGF)浓度含量与基线比均显著增加(P<0.05),IL-1β总含量下降(P<0.05),但组间无统计学差异。结论对于前磨牙区慢性牙周炎的治疗,二极管激光或光动力疗法辅助SRP较单纯SRP可以更快改善牙龈出血状况。

Objective To compare the clinical effects in the treatment of chronic periodontitis with scaling and root plaing(SRP)assisted by photodynamic therapy(PDT)and diode laser DL).Methods A balanced in complete block design(BIBD)trial was conducted in 60 patients with chronic periodontitis.One hundred and twenty bilateral area premolar teeth(PD≥5 mm)were chosen randomly into three groups A,B,C,standing for therapy for periodontal disease namely SRP,SRP with twice auxiliary photodynamic therapy and SRP with twice auxiliary diode laser.The amounts of IL-1β,bFGF in gingival crevicular fluid were measured by ELISA.Periodontal parameters of PD,CAL,BI,as well as gingival crevicular fluid humoral factor amounts were evaluated at baseline,2 weeks after SRP,2 weeks and 12 weeks after conducting PDT or DL.Results All groups showed significant improvement in PD,CAL and BI after treatment(P<0.01);BI reduced increasingly in group B and C after 2 weeks of conducting PDT/DL(P<0.05);bFGF levels in GCF increased significantly after the treatment(P<0.05).However the levels of IL-1βdecreased significantly(P<0.05).No significant differences were found among groups.Conclusion SRP with PDT and DL may decrease the presence of bleeding better in the treatment of chronic periodontitis in premolar teeth.