光动力疗法对慢性牙周炎辅助治疗的临床及微生物评价

The clinical effects and changes of bacterium load of the patients with chronic periodontitis treated by photodynamic therapy as a coadjuvant to scaling and root planing

目的:评价光动力疗法(PDT)作为龈下刮治(SRP)的辅助手段对慢性牙周炎的临床及微生物疗效。方法:将30名中重度慢性牙周炎患者随机分为2组(n=15),分别以SRP及SRP+PDT进行牙周基础治疗,评价治疗后3、6个月临床附着水平(CAL),探诊深度(PD)以及(探诊出血)(BOP+)百分比的变化。采用实时定量PCR法评价两组患者治疗前后牙周菌群的变化差异。结果:与治疗前相比较,在3个月随访期,两组患者CAL和PD均明显改善(P<0.05),但组间改变量差异不显著。治疗后6个月,与治疗前相比,SRP+PDT组患者CAL改善量较SRP组显著(P<0.01);而PD在两组间改善的量无明显差异(P>0.05)。治疗后6个月,SRP+PDT组A.a、F.n菌量减少明显(P<0.05)。2组治疗均对P.g和T.d.菌种抑制较为显著(P<0.05)。结论:光动力疗法作为SRP的辅助治疗对慢性牙周炎有一定疗效,且对A.a、F.n等牙周致病菌有明显的抑制作用。

Objective:To evaluate the clinical effects and changes of bacterium load of the patients with chronic periodontitis treated by photodynamic therapy(PDT)as a coadjuvant to scaling and root planing(SRP).Methods:30 patients with moderate or severe chronic periodontitis were randomly divided into 2 groups(n=15)and treated by SRP and SRP+PDT respectively.The changes in CAL,PD and the percentage of BOP+between the 2 groups were evaluated 3 and 6 months postoperatively.The gene expression levels of the main bacteria in gingival crevicular fluid(GCF)were determined using RT-PCR.Results:At 3-month follow-up,The changes of CAL in both groups were significantly improved compared with baselines(P<0.05).However,the clinical outcome changes between the 2 groups were not significant(P>0.05).At 6-month follow-up,the change of CAL in SRP+PDT group was more than that in SRP group compared with baselines(P<0.05).However,there was no difference in changes of PD between the 2 groups(P>0.05).At 6-month follow-up,the bacterium load of A.a,F.n in SRP+PDT group was reduced significantly(P<0.01).The amount of P.g and T.d.were reduced significantly in both groups(P<0.05).Conclusion:PDT as a coadjuvant to SRP has certain effects in the treatment of chronic periodontitis,and can reduce the bacterial burden of A.a and F.n.