牙周刮治结合根面平整术对牙周炎大鼠模型龈下菌群的影响及对骨吸收抑制的作用

Effect of periodontal scaling combined with root planing on subgingival flora and bone absorption inhibition in periodontitis rats

目的 探究牙周龈下刮治结合根面平整术对牙周炎大鼠模型龈下菌群的影响及对骨吸收的抑制作用。方法 24只SPF级大鼠随机挑选6只作为健康组,剩余大鼠建立牙周炎模型后随机分为模型组、对照组和观察组,每组6只。模型组大鼠不进行任何治疗,对照组进行龈下刮治,观察组龈下刮治结合根面平整术;30 d后进行牙周检查,比较各组大鼠牙周袋深度、菌斑指数、附着水平和探诊出血指数,收集大鼠龈下菌斑,检测龈下菌群含量,测定牙槽骨吸收值,HE染色后观察牙周组织形态。结果 牙周检查观察组大鼠红肿、出血和松动等牙周炎症状均显著轻于对照组和模型组。观察组大鼠牙龈菌斑指数、探诊出血指数、牙周袋深度、附着水平均显著低于对照组和模型组(均P<0.050)。观察组大鼠总细菌数、G^(+)球菌和G^(-)杆菌显著低于对照组和模型组(均P<0.050)。观察组大鼠牙龈卟啉单胞菌、伴放线杆菌、福赛斯坦纳菌、中间普雷沃菌、齿垢密螺旋体显著低于对照组和模型组(均P<0.050)。健康组、模型组、对照组、观察组大鼠的牙槽骨吸收值分别为(0.15±0.03)、(1.18±0.21)、(0.70±0.24)、(0.47±0.13)mm,经比较差异有统计学意义(F=75.421,P<0.001)。HE染色结果显示观察组大鼠伴有轻度炎症细胞浸润和牙槽嵴顶轻度降低,改善程度优于对照组和模型组。结论 牙周龈下刮治结合根面平整术能减少龈下微生物,降低龈下致病菌群数量,改善牙周炎症和牙槽骨吸收,值得临床推广。

Objective To analyze the effect of periodontal curettage combined with root planing on subgingival flora and bone absorption inhibition in periodontitis rats. Methods 6 out of 24 SPF rats were randomly selected as the healthy control group, and the remaining 18 rats were randomly divided into model group, control group or observation group after the periodontitis model was established(n=6). The rats in the model group were not given any treatment, those in the control group were given subgingival scaling, while those in the observation group were given subgingival scaling combined with root planning. After 30 days, periodontal examination was performed, and the depth of periodontal bag, plaque index, attachment level and probing bleeding index were compared between groups. The subgingival plaque was collected, the content of subgingival flora was detected, the alveolar bone absorption value was measured, and the periodontal tissue morphology was observed after HE staining. Results Periodontal examination showed that the symptoms of periodontitis such as swelling, bleeding and loosening in the observation group were significantly milder than those in the control group and the model group. The gingival plaque index, probe bleeding index, periodontal pocket depth and attachment level in the observation group were significantly lower than those in the control group and the model group(all P<0.050). The total counts of bacteria, Gcocci and Gbacilli in the observation group were significantly lower than those in the control group and the model group(all P<0.050). Porphyromonas gingivalis, Actinobacillus paragingivalis, Forsythiae stennerella, Prevotella intermedia and Treponema denticola in the observation group were significantly lower than those in the control group and the model group(all P<0.050). The alveolar bone resorption values in the healthy control group, model group, control group and observation group were(0.15±0.03)mm,(1.18±0.21)mm,(0.70±0.24)mm and(0.47±0.13)mm respectively, with statistically significant difference(F=75.421, P<0.001). HE staining results showed that the observation group showed mild inflammatory cell infiltration and alveolar crest slightly decreased, and the improvement was better than in the control group and model group. Conclusion Periodontal subgingival scaling combined with root planing can reduce subgingival microorganisms, reduce the count of subgingival pathogenic bacteria, and improve periodontal inflammation and alveolar bone resorption, which is worthy of clinical promotion.