龈下刮治在伴牙周炎口腔扁平苔藓患者治疗中的意义和疗效评估

The efficacy evaluation of subgingival scaling in treating oral lichen planus plus periodontitis

目的:探讨在伴牙周炎口腔扁平苔藓(oral lichen planus plus periodontitis,OLPP)患者系统性治疗中,是否行龈下刮治对口腔扁平苔藓整体疗效的影响。方法:纳入OLPP患者40例,其中糜烂型(erosive OLPP,EOLPP)与非糜烂型(non-erosive OLPP,NEOLPP)各20例,记录其牙龈炎症平均指数(average of gingival index,GI-Avg)、激惹痛强度数字评分(numerical rating scale,NRS)、口腔扁平苔藓RAE计分(reticular atrophic and erosive scoring system,RAE scores)作为基线水平。龈上洁治1周后,重新记录GI-Avg、NRS、RAE计分;并随机将非糜烂型分为A,B组,糜烂型分为C,D组,B组与D组在1周内进行全口超声龈下刮治,龈下刮治1周后记录各组患者GI-Avg、NRS、RAE计分。结果:在基线水平,EOLPP组与NEOLPP组GI-Avg水平存在明显差异,且GI-Avg与RAE计分成正相关(r=0.643,P<0.01);龈上洁治1周后,ELPP组NRS、RAE计分均显著降低(P<0.01);龈下刮治1周后,B组较A组NRS、RAE计分均无差别,而D组较C组RAE计分显著降低(P<0.01)。结论:龈下刮治对EOLPP患者的整体疗效具有明显的促进作用,在系统性治疗中应予以推荐,同时GI-Avg可以作为评估和预测OLPP患者病情走向的重要指标。

Objective:To assess the efficacy evaluation of subgingival scaling in treating oral lichen planus plus periodontitis(OLPP).Methods:Forty OLPP patients were recruited,and 20 cases were erosive OLPP(EOLPP),the others were non-erosive OLPP(NEOLPP).The average of gingival index(GI-Avg),irritation pain using numerical rating scale(NRS),and activities of OLP using reticular atrophic and erosive scoring system(RAE scores)as the baseline were recorded.All the patients accepted supragingival scaling.After a week observation,the GI-Avg,NRS and RAE scores were recorded again.Then the NEOLPP cases were divided into group A and group B,and the EOLPP cases were divided into group C and group D.After that,group B and group D received subgingival scaling in one week.A week passed away,then the GI-Avg,NRS and RAE scores were recorded.Results:At the baseline,the GI-Avg of EOLPP cases was obviously higher than that of NEOLPP cases,and was positive related with RAE scores(r=0.643,P<0.01).After supragingival scaling,the NRS and RAE scores were decreased in EOLPP patients(P<0.01).Following the subgingival scaling,the NRS and RAE scores of group B represented no obvious difference with group A,while RAE scores decreased in group D compared with group C(P<0.01).Conclusion:subgingival scaling was recommended to improve the efficacy of treatment for EOLPP,and GI-Avg was a good symbol in assessing the activities of OLPP.