牙周内窥镜辅助牙周基础治疗效果分析

Analysis of the effect of endoscopic assisted periodontal therapy

目的利用牙周内窥镜去除基础治疗后残留的龈下牙石,比较牙周内窥镜辅助治疗前后不同牙位的探诊深度、松动度变化,探讨牙周内窥镜辅助牙周基础治疗的适用范围。方法按照纳入标准,选择被确诊为慢性牙周炎患者12例,患者均在牙周基础治疗后3个月复诊时发现残存≥4 mm牙周袋,对残存牙周袋进行牙周内窥镜辅助治疗,3个月时复诊,每次复诊时采用Florida探针系统记录牙周情况,包括探诊深度(probing depth,PD)、探诊出血(bleeding on probing,BOP)、牙齿松动度等。以牙周基础治疗后3个月为基线,根据牙根形态、探诊深度及牙齿松动度分组,分析基线时与内窥镜治疗后3个月时每组的变化。结果经内窥镜治疗后3个月,残留中度牙周袋(4 mm≤PD<6 mm)的单根牙和多根牙PD值及BOP位点百分比与基线时相比明显降低,差异有统计学意义;但对于重度牙周袋,6 mm≤PD<8 mm时,单根牙及多根牙PD值及BOP位点百分比均较基线时降低,单根牙比多根牙降低更明显,差异有统计学意义;PD≥8 mm时,单根牙及多根牙PD值及BOP位点百分比均改善不明显,差异无明显统计学意义。牙齿松动度总改善率为55.29%(47/85),并随松动度加重改善率下降。结论牙周内窥镜辅助牙周基础治疗可改善牙周袋深度,探诊出血,松动度,尤其是单根牙PD<8 mm时效果良好,在一定程度上可避免牙周手术。

Objective To compare the changes in the probing depth(PD)and mobility of different teeth positions before and after periodontal endoscope assisted treatment for removing residual subgingival calculus,and to explore the application scope of periodontal endoscope assisted basic periodontal treatment.Methods According to the inclusion criteria,12 patients with chronic periodontitis were selected.The residual periodontal pocket≥4 mm at the 3-month follow-up after basic periodontal treatment was found in all patients,and then given periodontal endoscope assisted treatment.The periodontal condition was recorded by Florida probe system at the 3-month follow-up,including PD,bleeding on probing(BOP),tooth mobility,etc.A 3-month trial period after basic periodontal treatment was taken as the baseline,and they were grouped according to the root shape,PD and tooth mobility.The changes in each group at baseline and at 3 months after endoscopic treatment were analyzed.Results At 3 months after endoscopic treatment,PD value and percentage of BOP sites in single and multiple teeth with moderate residual periodontal pocket(4 mm≤PD<6 mm)were significantly lower than those at baseline,with significant difference.However,for severe periodontal pocket(6 mm≤PD<8 mm),the PD value and percentage of BOP sites of single root teeth and multiple root teeth were lower than those at baseline,and the decrease of single root teeth was more obvious than that of multiple root teeth,suggesting significant difference.At PD≥8 mm,the imrovement in the PD value and percentage of BOP sites of single root teeth and multiple root teeth was not significant,with no significant difference.The total improvement rate of tooth mobility was 55.29%(47/85),and the improvement rate decreased with the increase of tooth mobility.Conclusion Periodontal endoscopic assisted basic periodontal treatment can improve the depth of periodontal pocket,detect bleeding and mobility,which is especially effective when PD of single tooth is less than 8 mm,and can avoid periodontal surgery to a certain extent.