Er∶YAG激光治疗慢性牙周炎的临床效果及对细胞因子的影响

Clinical efficacy of Er∶YAG laser in the treatment of chronic periodontitis and its effect on cytokines

目的观察Er∶YAG激光治疗慢性牙周炎患者的临床效果,比较患者治疗前后细胞因子水平。方法180例慢性牙周炎患者随机分为观察组(Er∶YAG激光治疗)和对照组(常规牙周治疗),各90例。观察2组治疗前后龈沟液中菌落数的变化情况,比较患者治疗前后出血指数(BI)、探诊深度(PD)及临床附着水平(CAL)。采用酶联免疫吸附法(ELISA)测定患者龈沟液中炎症因子白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、脂多糖(LPS)、瘦素(leptin)及Dickkopf-1(DKK1)水平。结果治疗前,2组龈沟液中细菌量及BI、PD、CAL、IL-6、hs-CRP、TNF-α、LPS、leptin及DKK1水平比较差异无统计学意义(P>0.05);治疗后,2组龈沟液中细菌量及IL-6、hs-CRP、TNF-α、LPS水平均减少,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,2组BI、PD、CAL、DKK1水平均减少,差异有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05)。结论Er∶YAG激光治疗可有效清除慢性牙周炎患者牙龈液中的细菌量,改善牙周状态和龈沟液中细胞因子水平。

Objective To observe the clinical efficacy of Er∶YAG laser in the treatment of chronic periodontitis,and compare the levels of cytokines before and after treatment.Methods A total of 180 patients with chronic periodontitis were randomly divided into an observation group(Er∶YAG laser treatment,n=90)and a control group(conventional periodontal treatment,n=90).The changes of colony number in gingival crevicular fluid before and after treatment were compared.Bleeding index(BI),probing depth(PD),and clinical attachment level(CAL)of the patients before and after treatment were compared.The levels of IL-6,hs-CRP,TNF-α,LPS,leptin,and DKK1 in the gingival crevicular fluid weremeasured by enzyme-linked immunosorbent assay(ELISA).Results Before the treatment,there were no significant differences in the number of bacteria and the levels of BI,PD,CAL,IL-6,hs-CRP,TNF-α,LPS,leptin,and DKK1 in the gingival crevicular fluid between the two groups(P>0.05).After treatment,the number of bacteria in gingival crevicular fluid and the levels of IL-6,hs-CRP,TNF-α,and LPS in the two groups were significantly reduced,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,BI,PD,CAL,and DKK1 levels were significantly decreased in both groups(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusions Er∶YAG laser treatment can effectively remove the bacteria in the gingival crevicular fluid of patients with chronic periodontitis,improve the periodontal status and the level of cytokines.