Nd:YAG激光辅助翻瓣术对广泛型侵袭性牙周炎的疗效研究

The Effect of Nd:YAG laser-assisted flap flap for extensive invasive periodontitis patients

目的分析Nd:YAG激光辅助翻瓣术对广泛型侵袭性牙周炎牙周相关指数、致病菌、龈沟液核因子-kB受体活化因子配体(receptor activator of nuclear factor-kB ligand,RANKL)和骨保护素(osteoprotegerin,OPG)的影响,为其临床应用提供依据。方法选择南京医科大学附属苏州医院2019年1月-2021年2月收治的97例广泛型侵袭性牙周炎患者,依照随机信封法分为激光组和对照组。对照组患者接受普通光纤辅助翻瓣术治疗,激光组患者接受Nd:YAG激光辅助翻瓣术治疗。治疗前及治疗三个月后对患者出血指数(bleeding index,BI)、牙龈指数(gingival index,GI)、探诊后出血(bleeding on probing,BOP)、牙松动度(tooth mobility,TM)、附着丧失(attachment loss,AL)、菌斑指数(plague index,PLI)及牙周袋深度(pocket depth,PD)情况进行评估,测定并对比两组受试者龈沟液中核因子-kB受体活化因子配体(receptor activator of nuclear factor-kB ligand,RANKL)和骨保护素(osteoprotegerin,OPG)蛋白表达水平。结果治疗后激光组患者BI、GI、BOP、TM、AL及PD水平低于对照组患者(P<0.05)。激光组患者的PLI评分低于对照组患者(P<0.05)。治疗后,激光组患者龈沟液中RANKL水平低于对照组患者,OPG水平高于对照组(P<0.05)。结论采用Nd:YAG激光辅助翻瓣术对广泛型侵袭性牙周炎患者治疗后可显著降低牙周相关指数和致病菌水平,改善患者龈沟液RANKL/OPG水平。

Objective To analyze the effects of Nd:YAG laser-assisted flap surgery on the periodontal correlation index,pathogenic bacteria,receptor activator of nuclear factor-kB ligand(RANKL)level,and osteoprotegerin(OPG)level in the gingival crevicular fluid of extensive invasive periodontitis patients,and provide a basis for its clinical application.Methods Ninety-seven patients with extensive aggressive periodontitis admitted to our hospital between January 2019 and February 2021 were randomly divided into the laser group and control group.The patients in the control group received ordinary fiber-assisted flap surgery and the laser group received Nd:YAG laser-assisted flap surgery treatment.Before and three months after the treatment,the bleeding index(BI),gingival index(GI),bleeding on probing(BOP),tooth mobility(TM),attachment loss(AL),plaque index(PLI)and pocket depth(PD)were evaluated.The expression level of receptor activator of nuclear factor-kB ligand(RANKL)and osteoprotegerin(OPG)in the gingival crevicular fluid were tested.Results After treatment,the levels of BI,GI,BOP,TM,AL and PD in the laser group were lower than these in the control group(P<0.05).The PLI scores of the patients in the laser group were lower than these in the control group(P<0.05).After treatment,he RANKL level in the gingival crevicular fluid was lower than that in the control group,and the OPG level was significantly higher than that in the control group(P<0.05).Conclusion Nd:YAG laser-assisted flap surgery can significantly reduce the periodontal correlation index,the level of pathogenic bacteria and improve the level of gingival crevicular fluid RANKL/OPG in patients with extensive aggressive periodontitis.