Nd:YAG激光辅助龈下刮治术和根面平整术治疗重度慢性牙周炎的临床疗效观察

Clinical efficacy of Nd:YAG laser adjunct to subgingival scaling and root planning for treating severe chronic periodontitis

目的评估Nd:YAG激光辅助龈下刮治术和根面平整术(SRP)在重度慢性牙周炎治疗中的疗效。方法重度慢性牙周炎纳入患者的牙齿分布在口内4个象限,牙周探诊深度(PD)5~8 mm,附着丧失(AL)≥5 mm,探诊出血(BOP)阳性。符合纳入标准的患者按照就诊顺序随机分为SRP组、SRP+L组(SRP后行Nd:YAG激光治疗)及L+SRP组(Nd:YAG激光治疗后行SRP)。记录各组在基线时与治疗8周时临床牙周指标BOP、PD和AL,并进行统计学分析。结果治疗后8周,各组的BOP、PD和AL较基线均有所改善(P<0.05)。SRP+L组和L+SRP组的BOP阳性率较SRP组明显减少(P<0.05)。SRP+L组的PD较SRP组和L+SRP组明显变浅(P<0.05),其中基线时PD=7 mm的位点,SRP+L组较SRP组和L+SRP组明显变浅(P<0.05)。SRP组较SRP+L组和L+SRP组的AL明显减少(P<0.05)。结论Nd:YAG激光辅助SRP治疗重度慢性牙周炎可以更好地减少BOP,使PD变浅,且SRP后进行Nd:YAG激光治疗对于较深的牙周袋PD减少更明显,但对AL的改善无优势。

Objective To evaluate the efficacy of Nd: YAG laser therapy adjunct to subgingival scaling and root planning(SRP) for treating severe chronic periodontitis. Methods We selected patients with severe chronic periodontitis whose teeth were distributed in 4 quadrants of the mouth, with probing depth(PD) of 5-8 mm, attachment loss(AL)≥5 mm and bleeding on probing(BOP). These teeth were randomly divided into three groups: SRP group, SRP+L group(Nd: YAG laser after SRP treatment), and L+SRP group(SRP after Nd: YAG laser treatment). We recorded parameters including BOP, PD and AL of the three groups at baseline and 8 weeks after treatment and made statistical analysis. Results At 8 weeks after treatment, BOP, PD and AL of the three groups were improved than those in the baseline(P<0.05). BOP positive percentage of SRP+L group and L+SRP group significantly reduced compared with SRP group(P<0.05). PD of SRP+L group significantly decreased compared with SRP group and L+SRP group(P<0.05), for sites with PD=7 mm, SRP+L group was significantly decreased compared with SRP and L+SRP groups(P<0.05).AL of SRP group significantly decreased compared with SRP+L group and L+SRP group(P<0.05).Conclusion Severe periodontal treatment with Nd:YAG laser adjunct to SRP is more effective in reducing BOP and PD,and for deeper pockets PD is significantly decreased in SRP+L group,but there is no advantage in the improvement of AL.