清热消炎固齿缓释剂联合龈下喷砂治疗种植体周围炎的临床疗效评价

Evaluation on clinical efficacy of Qingre Xiaoyan Guchi Sustained Release Preparation combined with subgingival sandblasting in treatment of peri-implantitis

目的:探讨中药清热消炎固齿缓释剂联合龈下喷砂治疗种植体周围炎的临床疗效,阐明其治疗种植体周围炎的作用机制。方法:选择72例种植体周围炎患者并按照就诊顺序分为对照组和中药组,每组36例。2组患者均由第一位医生进行牙周基础治疗,对照组患者进行龈上洁治及龈下喷砂治疗,中药组患者进行龈上洁治、龈下刮治及龈下喷砂治疗;由第二位医生对2组患者种植体牙周袋进行冲洗和置放药物,中药组使用0.9%氯化钠注射液冲洗后将中药清热消炎固齿缓释剂留置种植体周围袋,对照组使用3%过氧化氢+0.9%氯化钠注射液对受试牙位种植体周围袋进行冲洗;第三位医生分别于治疗前、治疗1个疗程(4周为1个疗程)后记录2组患者受试牙位牙周指数[改良菌斑指数(mPLI)、牙周袋深度(PPD)和改良龈沟出血指数(mSBI)],检测2组患者种植体龈沟液(PISF)质量和PISF中白细胞介素1β(IL-1β)水平。结果:治疗前2组患者受试牙位的PPD、mSBI、mPLI、PISF质量和PISF中IL-1β水平比较差异无统计学意义(P>0.05)。与治疗前比较,2组患者在不同治疗方式干预后,mPLI、PPD和mSBI均降低(P<0.05)。与对照组比较,中药组患者治疗后mSBI、mPLI和PPD明显降低(P<0.05),PISF质量和PISF中IL-1β水平明显降低(P<0.05)。结论:与传统机械治疗联合过氧化氢及生理盐水冲洗比较,采用中药清热消炎固齿缓释剂联合龈下喷砂治疗种植体周围炎,患者PPD、mSBI和mPLI明显降低,PISF质量和PISF中IL-1β水平明显下降,临床症状得到改善,临床疗效更佳。

Objective:To explore the clinical efficacy of Qingre Xiaoyan Guchi Sustained Release Preparation combined with subgingival sandblasting in the treatment of peri-implantitis,and to clarify its mechanism in the treatment of peri-implantitis.Methods:Seventy-two patients with peri-implantitis were selected and divided into control group and Chinese medicine group according to the time of consultation(n=36).Both groups of patients were treated with basic periodontal treatment by the first doctor;the patients in control group received supragingival scaling treatment and subgingival sandblasting,and the patients in Chinese medicine group received supragingival treatment,subgingival curettage,and subgingival sandblasting.The implant periodontal pockets of the patients in two groups were rinsed and placed with drugs by the second doctor.The patients in Chinese medicine group were rinsed with 0.9%sodium chloride injection and received Qingre Xiaoyan Guchi Sustained Release Preparation in the pockets around the implants;and 3%hydrogen peroxide+0.9%sodium chloride injection was used to rinse the pockets around the implants in control group.The periodontal indexes,including modified plaque index(mPLI),periodontal probing depth(PPD),modified sulcular bleeding index(mSBI)of the patients’teeth in two groups were recorded before treatment and after 1 course of treatment(4 weeks as a course of treatment)by the third doctor,and the implant gingival crevicular fluid(PISF)quality and the interleukin-1β(IL-1β)levels in PISF of the patients in two groups were detected.Results:There were no significant differences in the PPD,mSBI,mPLI,PISF,and IL-1βin PISF of the patients between two groups before treatment(P>0.05).Compared with before treatment,after intervention of different treatment methods,the mPLI,PPD,and mSBI of the patients in two groups were decreased(P<0.05).Compared with control group.the mSBI,mPLI,and PPD of the patients in Chinese medicine group after treatment were significantly reduced(P<0.05),and the PISF quality and the IL-1βlevels in PISF were also significantly reduced(P<0.05).Conclusion:Compared with traditional mechanical therapy combined with hydrogen peroxide and saline irrigation,the use of Qingre Xiaoyan Guchi Sustained Release Preparation combined with subgingival sandblasting is more effective in treating peri-implantitis,which can significantly reduce PPD,mSBI,mPLI,PISF quality and IL-1βlevel,and the clinical symptoms are alleviated after treatment.