不同能量参数Er:YAG激光治疗早期种植体周围炎 照射后的效果分析及对厌氧菌含量的影响

Analysis of clinical effect of Er:YAG laser with different energy parameters in treatment of early peri implantitis after irradiation and its influence on the content of anaerobic bacteria

目的:探讨早期种植体周围炎采用三种能量参数Er:YAG激光治疗效果并分析治疗后厌氧菌含量的变化。方法:选择2017年1月~2021年1月于南方科技大学医院接受治疗的70例早期种植体周围炎患者,经随机数字表法将患者分为A组18例、B组16例、C组18例及D组18例,四组均给予常规龈上洁治与龈下刮治。其中A、B、C组为试验组采用40mJ、60mJ、80 mJ Er:YAG激光照射,D组为对照组采用盐酸米诺环素治疗。对比试验组治疗期间疼痛程度以及治疗后四组第8周菌斑指数(PLI)、出血指数(BI)、探诊深度(PD)、骨缺损深度(DD)、疗效以及治疗前后厌氧菌含量。结果:第8周时各组PLI比较差异无统计学意义(P>0.05);在BI、PD方面比较差异有统计学意义(P<0.05)。治疗期间C组视觉模拟评分法(VAS)评分显著高于A组、B组,差异有统计学意义(P<0.05)。各组第8周时总有效率比较差异无统计学意义(P>0.05)。各组治疗后厌氧菌含量显著低于治疗前,且C组显著低于B组,B组显著低于A组,A、B、C三组显著低于D组,差异均有统计学意义(P<0.05)。结论:在安全范围内第8周时,早期种植体周围炎经三种不同能量参数Er:YAG激光治疗效果相当,但厌氧菌含量变化存在明显差异,随着激光能量参数的增高杀菌性越好。

Objective To explore the therapeutic effect of three energy parameters Er:YAG laser on early periimplant inflammation,and analyze the changes of anaerobic bacteria content after treatment.Method 70 cases of patients with early peri implantitis who were treated in our hospital from January 2017 to January 2021 were selected,and the patients were randomly divided into group A,group B,group C and group D.All patients received traditional supragingival scaling and subgingival manual scaling,while the group A,B and C were treated with 40 mJ,60 mJ and 80 mJEr:YAG laser,and the degree of pain in each group was recorded during operation.And the group D(the control group)treated with minocycline hydrochloride.Then,the clinical indexes of four groups at the 8th week after treatment were compared:plaque index(PLI),bleeding index(BI),probing depth(PD),defect depth(DD),clinical effect and changes of anaerobic bacteria content before and after treatment.Results At the 8th week,there was no significant difference in PLI between each group(P>0.05);There was significant difference in BI and PD(P<0.05).During the treatment,the VAS score of group C was significantly higher than that of group A and B(P<0.05).There was no significant difference in the total effective rate between the groups at the 8th week(P>0.05).The content of anaerobic bacteria in each group after treatment was significantly lower than that before treatment,and that in group C was significantly lower than that in group B,group B was significantly lower than that in group A,B and C were significantly lower than that in group D(P<0.05).Conclusion In the safe range,at the 8th week,the curative effect of early periimplant inflammation treated with three different energy parameters Er:YAG laser is equivalent,but there are significant differences in the content of anaerobic bacteria.With the increase of laser energy parameters,the bactericidal property is better.