Er,Cr:YSGG激光与传统手术治疗牙龈瘤的舒适化疗效比较

Comparison of Comfort Effect Between Er,Cr:YSGG Laser and Conventional Scalpel in Epulis Treatment

目的:比较Er,Cr:YSGG激光及传统手术方法切除牙龈瘤的舒适化疗效。方法:选取2016年1月-2019年12月南方医科大学口腔医院牙周科就诊的74例牙龈瘤患者资料进行回顾性分析,随机进行分组,包括传统手术组和激光切除组,每组37例。术前以Corach’s牙科焦虑量表(Corach’s dental anxiety scale,DAS)和牙科畏惧量表(Dental fear scale,DFS)进行牙科焦虑状况评分;两组患者于术后当天、1、3、5、7 d进行视觉模拟评分(Visual analog scale,VAS)记录疼痛值,同时记录术后临床表现评价表,术后6~12个月回访观察复发情况评判牙龈瘤治疗效果。结果:激光切除组DAS、DFS值显著低于传统手术组,激光切除组术后VAS评分均显著下降。传统手术组术后仅3、5、7 d VAS值差异有统计学意义,并呈逐渐下降趋势。激光切除组术后除第7天外,VAS值均低于传统手术组。焦虑值与VAS相关分析显示激光切除组DAS及DFS焦虑值与术后当天、1 d及3 d的VAS显著相关。传统手术组DAS及DFS焦虑值与术后各时段VAS均显著相关。激光切除组患者术后当天、1 d肿胀及出血程度显著低于传统手术组。6~12个月回访,两组患者均未见复发。结论:Er,Cr:YSGG激光治疗牙龈瘤较传统手术可引起更少牙科焦虑,能提高患者术中舒适度,减少术后疼痛,且具有术后反应轻微和复发率低的特点。

Objective To compare the comfort dentistry effect of Er,Cr:YSGG laser and conventional scalpel in treating epulis resection.Methods A total number of 74 epulis patients underwent epulis resection with either Er,Cr:YSGG laser or conventional scalpel in Stomatological Hospital,Southern Medical University from January 2016 to December 2019 were included in this retrospective study.There were 37 patients in Er,Cr:YSGG laser group while 37 patients in conventional scalpel group.Pre-operation Corach’s Dental Anxiety Scale (DAS) and Dental Fear Scale (DFS) were recorded.Post-operative Visual analog scale (VAS) at day 0,day 1,day 3,day 5 and day 7 was recorded.Post-operative manifestation was recorded including swelling,bleeding,nausea and breath.Post-operative epulis treatment effect evaluation was at 6-12 months after the surgery.Results DAS,DFS and VAS were significantly decreased in Er,Cr:YSGG laser group (P<0.05).In conventional scalpel group,VAS was significantly decreased in day 3,day 5 and day 7 (P<0.05).Compared to conventional scalpel group,VAS was significantly decreased except day 7 in Er,Cr:YSGG laser group (P<0.05).In the correlation study,significance of VAS with DAS and DFS was shown on day 0,day 1,day 3 in both groups,and day 5,day 7 in conventional scalpel group.But the significance was not shown on day 5 and day 7 in Er,Cr:YSGG laser group.Er,Cr:YSGG laser group presented less swelling and bleeding at day 0 and day 1 post-operation.There was no recurrence in both groups after 6-12months.Conclusion Er,Cr:YSGG laser can cause less dental fear and pain feeling in epulis treatment,while the post-operation manifestation and prognosis are also better.In this case,Er,Cr:YSGG laser is propitious to comfort dentistry in clinical utilization.