根尖刮治术联合富血小板纤维蛋白在根尖周炎患者中的应用及对炎症因子的影响研究

Application of Apical Curettage Combined with Platelet-rich Fibrin in Patients with Periapical Periodontitis and Its Influence on Inflammatory Factors

目的:探讨根尖刮治术联合富血小板纤维蛋白在根尖周炎患者中的应用效果及对炎症因子的影响。方法:选择2019年3月-2021年1月赣州市立医院根尖周炎患者124例作为对象,按照随机数字表法分为两组,各62例。对照组采用根尖刮治术治疗,观察组在对照组基础上联合富血小板纤维蛋白治疗。治疗后4周,比较两组牙周状况、牙龈沟液炎症细胞因子、肿痛程度。结果:观察组治疗后4周菌斑指数(PLI)、牙周袋探诊深度(PD)、牙龈出血指数(GBI)及牙周附着水平(CAL)均低于对照组(P<0.05)。两组治疗后4周炎症因子均低于治疗前(P<0.05)。观察组治疗后4周牙龈龈沟液炎症细胞因子IL-17、TNF-α及CRP均低于对照组(P<0.05)。两组治疗后4周肿痛程度均得到明显改善,观察组治疗后4周Ⅰ度病例比例高于对照组(P<0.05);Ⅱ、Ⅲ度病例比例均低于对照组(P<0.05)。结论:根尖刮治术联合富血小板纤维蛋白用于根尖周炎患者中有助于改善患者牙周状况,能降低牙龈沟液炎症细胞因子水平,减轻患者肿痛,值得推广应用。

Objective:To explore the application effect of apical curettage combined with platelet-rich fibrin in patients with periapical periodontitis and its influence on inflammatory factors.Method:A total of 124 patients with periapical periodontitis Ganzhou Municipal Hospital from March 2019 to January 2021 were randomly divided into two groups,with 62 cases in each group.The control group was treated with apical curettage,while the observation group was treated with platelet-rich fibrin on the basis of the control group.4 weeks after treatment,the periodontal status,inflammatory cytokines in gingival crevicular fluid and swelling and pain were compared between the two groups.Result:4 weeks after treatment,plaque index (PLI),probing depth of periodontal pocket (PD),gingival bleeding index (GBI) and periodontal attachment level (CAL) in the observation group were lower than those in the control group (P<0.05).4 weeks after treatment,the inflammatory factors in both groups were lower than those before treatment (P<0.05).The levels of inflammatory cytokines IL-17,TNF-α and CRP in gingival crevicular fluid of observation group were lower than those of control group 4 weeks after treatment (P<0.05).The degree of swelling and pain in the two groups was significantly improved 4 weeks after treatment,4 weeks after treatment,the proportion of cases with grade Ⅰ in observation group was more than that in control group (P<0.05);the proportion of cases with grade Ⅱ and Ⅲ were lower than those of the control group (P<0.05).Conclusion:The application of apical curettage combined with platelet-rich fibrin in patients with periapical periodontitis can improve the periodontal condition,reduce the inflammatory cytokines in gingival crevicular fluid,and relieve the swelling and pain of patients,which is worthy of popularization and application.