牙周机械治疗对牙周病患者龈沟液中碱性磷酸酶水平的影响

Effect of periodontal mechanical therapy on alkaline phosphatase in gingival crevicular fluid of the patients with periodontal diseases

目的研究牙周机械治疗对牙周病患者龈沟液(gingival crevicular fluid,GCF)中碱性磷酸酶(alkaline phosphatase,ALP)活性的影响。方法选择2017年9月-2018年12月在新疆医科大学附属口腔医院牙周科就诊的65例牙周病患者为研究对象,所有研究对象在治疗前和牙周机械治疗2个月后接受全口牙周状况检查,包括:全口菌斑指数(plaque index,PLI),出血指数(bleeding index,BI),探诊深度(probing depth,PD),根据治疗前患者牙周临床指标分为牙龈炎组(20例)、侵袭性牙周炎组(aggressive periodontitis,AgP,18例)和慢性牙周炎组(chronic periodontitis,CP,27例)。采用滤纸条法收集3组患者治疗前和牙周机械治疗2个月后最深牙周袋的GCF标本,采用对硝基苯酚测定法测定GCF中的ALP活性,比较牙周机械治疗前后3组患者龈沟液中ALP活性变化,分析龈沟液中ALP活性与牙周临床指标的相关性。结果与治疗前比较,3组患者GCF取样点牙周临床指标PLI、PD、BI均降低,差异有统计学意义(P<0.01)。与治疗前比较,牙周机械治疗2个月后牙龈炎组、CP组和AgP组患者GCF中ALP活性均降低,差异有统计学意义(P<0.05)。牙龈炎组、CP组、AgP组患者GCF中ALP活性与探诊深度(probing depth,PD)呈正相关,r分别为0.996、0.904、0.968,ALP活性与出血指数(bleeding index,BI)无相关性。结论牙周机械治疗能够降低牙周病患者GCF中ALP的活性。

Objective To study the effect of periodontal mechanical therapy on alkaline phosphatase(ALP)activity in gingival crevicular fluid(GCF)of patients with periodontal disease.Methods From September 2017to December 2018,sixty-five patients with periodontal disease in the Department of Periodontal and Mucosal Disease,the First Affiliated Hospital of Xinjiang Medical University were selected as the subjects.All the subjects were undergone periodontal examination before treatment and 2months after periodontal mechanical therapy,including plaque index(PLI),bleeding index(BI)and probing depth(PD).According to the periodontal clinical indicators of patients before the treatment,they were divided into gingivitis group(20cases),aggressive periodontitis group(18cases),and chronic periodontitis group(27cases).GCF specimens of the deepest periodontal pockets in the three groups were collected by filter strip method before and after 2months of periodontal mechanical treatment.The ALP activity in GCF was measured by p-nitrophenol assay.The changes of ALP activity in GCF of the three groups before and after periodontal mechanical treatment were compared,and the correlation between the ALP activity in GCF and periodontal clinical indicators was analyzed.Results Compared with before the treatment,the periodontal clinical indicators:PLI,PD and BI of GCF sampling points in the three groups were significantly lower(P<0.01).Compared with before the treatment,the ALP activity in GCF of gingivitis group,CP group and AgP group decreased significantly after 2months of periodontal mechanical therapy(P<0.05).The ALP activity in GCF of the gingivitis group,CP group and AgP group was positively correlated with probing depth(PD),and the R value were 0.996,0.904and 0.968respectively.There was no correlation between the ALP activity and BI.Conclusion The periodontal mechanical therapy can reduce the activity of ALP in GCF of patients with periodontal disease.