透明质酸凝胶联合Nd:YAG激光对老年牙周炎患者牙根敏感的实验研究及临床疗效观察

Experimental Study and Clinical Observation of Hyaluronic Acid Gel Combined with Nd:YAG Laser on Sensitivity of Tooth Root of Elderly Patients with Periodontitis

目的:观察和评价透明质酸凝胶联合Nd:YAG激光对老年患者牙周基础治疗后牙根敏感并发症的疗效。方法:收集老年患者因慢性牙周炎拔除的完整无龋前磨牙24颗,随机分为4组,制备成牙根敏感标本分别用生理盐水、透明质酸凝胶、Nd:YAG激光、透明质酸凝胶联合Nd:YAG激光处理,扫描电镜下观察各样本牙本质小管封闭情况。临床观察60例牙周基础治疗后出现牙根敏感并发症的老年患者,随机分为3组,分别为透明质酸凝胶组(20例,66颗患牙)、Nd:YAG激光组(20例,81颗患牙)、联合组(20例,102颗患牙)。透明质酸凝胶组采用单独透明质酸凝胶涂擦敏感牙根,Nd:YAG激光组采用单独Nd:YAG激光照射敏感牙根,联合组先用透明质酸凝胶涂擦敏感牙根,再联合Nd:YAG激光照射。采用Schiff冷空气敏感指数评价,比较3组治疗的有效率。结果:扫描电镜结果显示透明质酸凝胶、Nd:YAG激光照射、透明质酸凝胶联合Nd:YAG激光照射均可封闭牙本质小管,透明质酸凝胶联合Nd:YAG激光效果最佳。临床观察结果显示透明质酸凝胶组、Nd:YAG激光组、联合组治疗有效率分别为69.70%、83.95%、93.13%。联合组治疗有效率显著优于透明质酸凝胶组及Nd:YAG激光组,结果具有统计学意义(P<0.05)。结论:透明质酸凝胶联合Nd:YAG激光对老年患者牙周基础治疗后牙根敏感并发症具有较好的临床效果。

Objective:To observe and evaluate the clinical effect of hyaluronic acid gel combined with Nd:YAG laser in the treatment of tooth root sensitivity complications after periodontal initial therapy in elderly patients.Methods:24 complete caries-free premolars of elderly patients due to chronic periodontitis were selected,and randomly divided into 4 groups.The tooth roots were treated by using normal saline,hyaluronic acid gel,Nd:YAG laser,and hyaluronic acid gel combined with Nd:YAG laser,respectively.The morphology of all 24 specimens was observed under scanning electron microscope.60 elderly patients with tooth root sensitivity complications after periodontal initial therapy were randomly divided into 3 groups,which were hyaluronic acid gel group(20 cases,66 teeth),Nd:YAG laser group(20 cases,81 teeth),and the combined group(20 cases,102 teeth).The hyaluronic acid gel group was treated with hyaluronic acid gel alone,the Nd:YAG laser group was treated with Nd:YAG laser irradiation,and the combined group was treated with hyaluronic acid gel combined with the laster irradiation.The effects were evaluated by Schiff cold air sensitivity index.Results:Scanning electron microscopy showed that hyaluronic acid gel,Nd:YAG laser irradiation,and hyaluronic acid gel combined with Nd:YAG laser irradiation can seal the dentin tubules,but hyaluronic acid gel combined with Nd:YAG laser had the best effect.The clinical observation results showed that the effective rates of hyaluronic acid gel group,the Nd:YAG laser group,and the combined group were 69.70%,83.95%,and 93.13%(P<0.05).Conclusion:Hyaluronic acid gel combined with Nd:YAG laser irradiation has better clinical effects in the treatment of tooth root sensitivity complications after periodontal initial therapy in elderly patients.