牙周牙髓治疗联合半导体激光对重度牙周炎患者疗效及MMP-8、TIMP-1的影响

Impact of periodontal-endodontic therapy combined with semiconductor laser on curative effect, MMP-8 and TIMP-1 in patients with severe periodontitis

目的:探究牙周牙髓治疗联合半导体激光对重度牙周炎患者疗效及基质金属蛋白酶-8(MMP-8)、基质金属蛋白酶抑制剂1(TIMP-1)水平的影响。方法:选择2020年1月~2022年5月于本院口腔科就诊的80例(105颗患牙)重度牙周炎患者,分成对照组(44例,60颗患牙)和联合组(36例,45颗患牙)。对照组单纯行牙周牙髓治疗,联合组在对照组基础上联合半导体激光治疗。采用视觉模拟评分法(VAS)评估患者疼痛度;分别于治疗前和治疗后3个月测定牙周袋深度(PD)、菌斑指数(PLI)、龈沟出血指数(SBI)、临床附着丧失(CAL)、龈沟液炎性因子、MMP-8和TIMP-1水平。结果:联合组VAS评分显著低于对照组,差异有统计学意义(P<0.05);治疗后3个月联合组PD、PLI、SBI、CAL、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、MMP-8水平显著低于对照组,IL-4、TIMP-1水平显著高于对照组(P<0.05);联合组疗效总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论:重度牙周炎患者采用牙周牙髓治疗联合半导体激光治疗较单纯牙周牙髓治疗更能促进牙周组织愈合,降低炎症反应,提高治疗疗效,减少牙周组织损害。

Objective:To investigate the impact of periodontal-endodontic therapy combined with semiconductor laser on curative effect, matrix metalloproteinases-8(MMP-8)and tissue inhibitor of matrix metalloproteinase 1(TIMP-1)levels in patients with severe periodontitis.Methods:Totally 80 patients(105 affected teeth)with severe periodontitis who were admitted to our hospital from January 2020 to May 2022 were divided into the control group(44 patients with 60 affected teeth)and the combination group(36 patients with 45 affected teeth).The control group was given simple periodontal-endodontic therapy, and the combination group was treated with semiconductor laser based on the treatment for the control group.The visual analogue scale(VAS)was used to evaluate pain degree.The periodontal probing depth(PD),plaque index(PLI),sulcus bleeding index(SBI),clinical attachment loss(CAL),gingival crevicular fluid inflammatory factors, MMP-8 and TIMP-1 levels were measured before treatment and at 3 months after treatment.Results:VAS scores of the combination group were significantly lower than those of the control group(P<0.05).At 3 months after treatment, PD, PLI,SBI,CAL,tumor necrosis factor α(TNF-α),interleukin 6(IL-6)and MMP-8 levels in the combination group were significantly lower than those in the control group.IL-4 and TIMP-1 levels, and the total response rate in the combination group were significantly higher than those in the control group(P<0.05).Conclusion:Periodontal-endodontic therapy combined with semiconductor laser can promote periodontal tissue healing, reduce inflammatory response, improve the therapeutic effect, and reduce periodontal tissue damage in patients with severe periodontitis.