3种参数Er:YAG激光治疗早期种植体周围炎的临床疗效及细菌学分析

Clinical Efficacy and Bacteriological Analysis on Er:YAG Laser with Three Parameters in Treatment of Early Peri-implantitis

目的:评价不同能量参数的Er:YAG激光对早期种植体周围炎照射后的临床疗效及厌氧菌含量的变化。方法:纳入90例早期种植体周围炎患者,采用随机数字表法分A、B、C、D四组,记录基线值:菌斑指数(plaque index,PLI)、出血指数(bleeding index,BI)、探诊深度(probing depth,PD)、骨缺损深度(defect depth,DD)。A、B、C三组分别用40、60、80mj的Er:YAG激光进行照射;术中用视觉模拟评分法(visual analogue scale,VAS)记录患者疼痛程度;D组用盐酸米诺环素。临床治疗1次/周,治疗3次。比较第8周临床总疗效。收集治疗前、激光照射及D组洁刮治后各患牙龈沟液进行厌氧菌培养并对其含量进行分析。结果:各组第8周时临床总有效率未见明显差异(P>0.05),细菌含量变化(P<0.05)有统计学意义。结论:在安全范围内,第8周时不同能量参数的Er:YAG激光对早期种植体周围炎的临床总有效率差异不明显,但其微生物变化差异显著,且随着激光能量的增高其杀菌性越强。

Objective:To evaluate the clinical efficacy and anaerobic bacteria content of Er:YAG laser irradiation with different energy parameters on early peri-implantitis.Methods:90 patients with early peri-implantitis were included,who were randomly devided into four groups A,B,C,and D.Baseline values were recorded:plaque index(PLI),bleeding index(BI),probing depth(PD),and defect depth(DD).A,B and C groups were irradiated with Er:YAG laser at 40mj,60mj,and 80mj,respectively.The degree of pain was recorded by visual analogue scale(VAS)during operation.Group D was treated with minocycline hydrochloride.Clinical treatment was 1 time per week for 3 times.The total clinical efficacy after the 8 weeks were compared.Gingival crevicular fluid for each tooth was collected to culture and analyze the content of anaerobic bacteria before treatment,after laser irradiation,and after scaling.Results:There was no significant difference in the rate of total clinical effective after 8 weeks for each group(P>0.05),but the change of bacterial content for each group was statistically significant(P<0.05).Conclusion:Among the safety range,the rate of total clinical effective for Er:YAG laser with different energy parameters on early peri-implantitis was not obvious after 8 weeks.However,the microbial changes were significant,and as the laser energy increasing,the bactericidal property was stronger.