系统性牙周治疗影响重度慢性牙周炎松动牙转归的临床研究

Clinical study of systemic periodontal treatment on the impact of severe chronic periodontitis on loose teeth

目的:探讨系统性牙周治疗重度慢性牙周炎松动牙的临床疗效.方法:选取2015年3月~2018年6月于海南省人民医院就诊的重度慢性牙周炎患者62例(376颗牙),按照治疗方式的不同分成两组,再按牙齿的松动程度进行分度(Ⅰ~Ⅲ度).对照组30例,松动牙180颗(Ⅰ度110颗,Ⅱ度46颗,Ⅲ度24颗),给予牙周基础治疗;实验组32例,松动牙196颗(Ⅰ度112颗,Ⅱ度52颗,Ⅲ度32颗),进行系统性牙周治疗.比较两组治疗前与治疗后4个月的炎症指标(CRP、TNF-α、IL-33),牙周探诊深度(probing depth,PD)、牙周探诊出血(bleeding of probe,BOP)、牙齿松动度(tooth mobility,TM)改善情况与不良反应发生情况.结果:两组牙周指标与炎性指标治疗后较治疗前有显著改善,且实验组各指标改善效果明显优于对照组(P<0.01);实验组TM改善率明显优于对照组(P<0.01);不良反应发生率实验组低于对照组(P<0.05).结论:系统性牙周治疗较单纯的牙周基础治疗,炎症及牙周各项指标显著降低,TM改善率升高,不良反应发生率降低,更有利于改善重度慢性牙周炎患者的牙齿松动情况.

Objective: To investigate the clinical effect of systemic periodontal therapy on loose teeth in patients with severe chronic periodontitis. Methods: Totally 62 patients ( 376 teeth) with severe chronic periodontitis who were treated in Hainan Provincial People's Hospital from March 2015 to June 2018 were selected as subjects, according to the different methods of treatment were divided into two groups, then indexing according to the degree of looseness of the teeth (Ⅰ-Ⅲ degrees ).Control group with 30 cases that 180 loose teeth(Ⅰ degrees 110,Ⅱdegrees 46,Ⅲ degrees 24)were given a simple periodontal basic treatment, and experimental group with 32 cases that 196 loose teeth (Ⅰ degrees 112,Ⅱ degrees 52,Ⅲ degrees 32) were given systematic periodontal treatment. Inflammatory indicators ( CRP, TNF-α, IL-33), probing depth ( PD), bleeding of probe( BOP),tooth mobility(TM) improvement and adverse reactions were compared between the two groups before and 4 months after treatment. Results:The periodontal index and inflammatory index of the two groups were significantly improved after treatment, and the improvement effect of each index in the experimental group was significantly higher than that of the control group( P<0. 01). The improvement rate TM in the experimental group was significantly better than that in the control group( P< 0. 01 ). The incidence of adverse reactions was lower in the experimental group than in the control group, and the difference was statistically significant ( P< 0. 05). Conclusion: Systemic periodontal therapy can significantly reduce the incidence of inflammation and periodontal indicators, and reduce the incidence of adverse reactions, which is more conducive to improving the teeth loosening in patients with severe chronic periodontitis than simple supragingival scaling therapy.