光动力疗法辅助非手术治疗对慢性牙周炎患者龈沟液MMP-8、TNF-α和TIMP-1水平的影响

Effect of photochemic therapy assisted non-surgical treatment on the level of MMP-8,TNF-α and TIMP-1 in gingival crevicular fluid in patients with chronic periodontitis

目的:探讨光动力疗法辅助非手术治疗对慢性牙周炎患者龈沟液基质金属蛋白酶(MMP)-8、肿瘤坏死因子-α(TNF-α)和基质金属蛋白酶组织抑制物(TIMP)-1水平的影响。方法:选择16例中、重度慢性牙周炎患者共104颗患牙,将两侧牙分为实验侧(54颗患牙)与对照侧(50颗患牙),对照侧仅采取基础治疗,实验侧在对照侧的基础上进行光动力疗法治疗。治疗前及治疗后3个月检测龈沟液MMP-8、TNF-α和TIMP-1水平以及牙周袋深度(PD)、出血指数(BI)、附着丧失(AL)、菌斑指数(PLI)。结果:治疗后,实验侧龈沟液MMP-8、TNF-α水平明显降低(P<0.05),TIMP-1水平明显升高(P<0.05);对照侧TNF-α水平明显降低(P<0.05),TIMP-1水平明显升高(P<0.05);实验侧MMP-8、TNF-α水平明显低于对照侧(P<0.05),TIMP-1水平明显高于对照侧(P<0.05);实验侧与对照侧PD、BI、AL及PLI均明显下降(P<0.05),实验侧明显低于对照侧(P<0.05);龈沟液MMP-8、TNF-α和TIMP-1水平变化与PD、BI、AL、PLI具有一定的相关性。结论:光动力疗法辅助非手术治疗能显著降低龈沟液MMP-8、TNF-α水平,提高TIMP-1水平,减轻牙周炎症反应,改善牙周状况。

Objective: To investigate the effects of photodynamic therapy combined with non-surgical treatment on the levels of matrix metalloproteinase-8 (MMP-8),tumor necrosis factor-α(TNF-α) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in gingiva groove liquid in patients with chronic periodontitis. Methods: A total of 104 teeth from 16 patients with moderate or severe chronic periodontitis were collected,and divided into experimental side (54 teeth) and control side (50 teeth).The control side teeth were given basic therapy,and the experimental side teeth were given photodynamic therapy on the basis of control side.The levels of MMP-8,TNF-α and TIMP-1 in gingival crevicular fluid,periodontal pocket depth (PD),bleeding index (BI),attachment loss (AL) and plaque index (PLI) were detected before and 3 months after treatment. Results: After treatment,the levels of MMP-8 and TNF-α in gingiva groove liquid in the experimental side decreased while the TIMP-1 level increased ( P <0.05).The levels of MMP-8 and TNF-α in the experimental side were significantly lower than those in the control side,and the level of TIMP-1 was significantly higher ( P <0.05).The PD,BI,AL and PLI in both sides were significantly decreased ( P <0.05),and the changes were more marked in the experimental side ( P <0.05).The MMP-8,TNF-α and TIMP-1 levels in gingiva groove liquid were correlated with PD,BI,AL and PLI. Conclusion: Photodynamic therapy combined with non-surgical treatment could significantly reduce the levels of MMP-8 and TNF-α in gingival crevicular fluid,increase the level of TIMP-1,relieve periodontal inflammation and improve periodontal status.