低能量激光对中重度牙周炎患者龈沟液中IL-18、CCL2和ICAM-1的影响

Effect of Low Level Laser on Moderate and Severe Periodontitis & Expression of IL-18, CCL2 and ICAM-1 in Gingival Crevicular Fluid

目的探讨低能量激光治疗(low level laser therapy,LLLT)对中重度牙周炎的治疗效果,以及对龈沟液中IL-18、CCL2和ICAM-1的影响。方法回顾性分析2019年1月至2021年3月,中重度牙周炎患者98例。根据治疗方法的不同分为对照组和LLLT组,其中对照组患者43例,给予牙周基础治疗;LLLT组患者55例,采用牙周基础治疗联合LLLT照射,治疗光参数,波长为808 mm,功率为80 mW,光斑面积为0.28 cm^(2),能量密度为4 J/cm^(2)。治疗后1和3个月,比较两组牙周探诊深度(periodontal probing depth,PPD)、龈沟出血指数(sulcusbleeding index,SBI)、临床附着丧失值(clinical attachment loss,CAL)及菌斑指数(plaque index,PI)水平。治疗后1个月,观察两组龈沟液中IL-18、CCL2及ICAM-1水平改变。治疗前、治疗后1、3和6个月,采用视觉模拟量表(visnal analogue scale,VAS)对两组疼痛程度进行评估。结果治疗后1、3个月,两组PPD、SBI、CAL、PI水平较术前均显著降低(P<0.05),且LLLT组显著低于对照组(P<0.05)。治疗后1、3和6个月,两组VAS评分较术前均显著降低(P<0.05),且LLLT组显著低于对照组(P<0.05)。治疗后1个月,两组龈沟液中IL-18、CCL2和ICAM-1水平较治疗前均显著降低(P<0.05),且LLLT组显著低于对照组(P<0.05)。结论LLLT对中重度牙周炎的治疗效果显著,不仅能够有效改善牙周状态,减轻患者的疼痛度,而且还可有效控制患者的炎症反应。

Objective To investigate the therapeutic effect of low level laser therapy(LLLT) on moderate and severe periodontitis and the expression of IL-18,CCL2 and ICAM-1 in gingival crevicular fluid.Methods Totally 98 patients with moderate and severe periodontitis treated during the period from Jan.2019 to Mar.2021 were analyzed retrospectively.According to treatment methods,they were divided into a control group(43 patients) and LLLT group(55 patients).The patients in the control group were given periodontal basic treatment and those in the LLLT group were treated with lowenergy laser in addition.The light parameters for the treatment were given as below:wavelength 808 mm,power 80 mW,spot area0.28 cm^(2) and energy density 4 J/cm~2.The levels of periodontal probing depth(PPD),sulcus bleeding index(SBI),clinical attachment loss(CAL) and plaque index(PI) were compared between the two groups 1 month and 3 months after the treatment respectively.One month after the treatment,the levels of IL-18,CCL2 and ICAM-1 in gingival crevicular fluid of both groups were observed.The VAS scores of the two groups were recorded 1 month and 6 months after the treatment respectively.Results For both groups,the levels of PPD,SBI,CAL and PI acquired 1 month and 3 months after the treatment were significantly lower than those before the treatment(P<0.05),and those in the LLLT group were significantly lower than those in the control group(P<0.05).For both groups,1 month and 3 and 6 months after the treatment,the VAS scores were significantly lower than those before the treatment(P<0.05),and those of the LLLT group were significantly lower than those of the control group(P<0.05).One month after treatment,the levels of IL-18,CCL2 and ICAM-1 in gingival crevicular fluid in both groups were significantly lower than those before the treatment(P<0.05),and the levels in the LLLT group were significantly lower than those in the control group(P<0.05).Conclusions Low level laser has a significant therapeutic effect on moderate and severe periodontitis.It will not only effectively improve the periodontal state and reduce the pain of patients,but also effectively control their inflammatory responses.