SRP治疗后予以咬合调整方案对慢性牙周炎患者临床疗效分析

Analysis of the clinical effect of occlusal adjustment scheme after SRP treatment on patients with chronic periodontitis

目的:探讨牙周炎龈下刮治术+根面平整(SRP)患者不同时期予以咬合调整治疗对患牙转归的影响。方法:回顾性分析2019年11月~2020年11月期间武汉大学口腔医院收治的30例慢性牙周炎患者临床资料,按照治疗方法分成两组,A组(n=14)采用咬合调整后予以龈下刮治术+根面平整(SRP)治疗,B组(n=16)采用SRP治疗后予以咬合调整治疗。比较两组不同时间牙周指标、咬合指标、龈沟液内TNF-α与IL-8水平以及疼痛感受评价结果。结果:治疗4周、8周后,B组PD、CAL、BI及龈沟液内TNF-α、IL-8水平均低于A组(P<0.05);治疗4周后,B组疼痛感受评价结果低于A组(P<0.05);治疗4周、8周后,两组龈沟液内TNF-α、IL-8水平及疼痛感受评价结果均低于治疗前(P<0.05),且治疗8周后各指标低于治疗4周后(P<0.05)。治疗4周、8周后,B组咬合力、咬合面积均大于A组(P<0.05);治疗4周、8周后,两组咬合力、咬合面积均大于治疗前(P<0.05),且治疗8周后大于治疗4周后(P<0.05)。结论:SRP治疗后予以咬合调整方案能改善慢性牙周炎患者牙周指标、咬合指标,调节龈沟液内TNF-α与IL-8水平,且能减轻疼痛。

Objective:To explore the effect of occlusal adjustment treatment in different periods on the outcome of patients with periodontitis after subgingival scaling and root planing(SRP).Methods:The clinical data of 30 patients with chronic periodontitis admitted to Hospital of Stomatology of Wuhan University from November 2019 to November 2020 were analyzed retrospectively.They were grouped into two groups according to the treatment method,group A(n=14)received SRP after occlusal adjustment,and group B(n=16)received occlusal adjustment after SRP treatment.The measurement result of periodontal indexes at dfferent time,occlusal indexes,the levels of TNF-αand IL-8 in gingival crevicular fluid and pain perception evaluation result were compared between the two groups.Results:After 4 and 8 weeks of treatment,the values of PD,CAL and BI and the levels of TNF-αand IL-8 in gingival crevicular fluid in group B were lower than those in group A(P<0.05),after 4 weeks of treatment,the evaluation result of pain perception in group B was lower(P<0.05).After 4 and 8 weeks of treatment,the levels of TNF-αand IL-8 in gingival crevicular fluid and the evaluation results of pain perception in two groups were lower than before treatment(P<0.05),and the indexes after 8 weeks of treatment were lower than after 4 weeks of treatment(P<0.05).After 4 and 8 weeks of treatment,the bite force and occlusal area of group B were higher than those of group A(P<0.05),the bite force and occlusal area of both groups were greater than before treatment(P<0.05),and after 8 weeks of treatment were greater than after 4 weeks of treatment(P<0.05).Conclusion:Occlusal adjustment after SRP treatment can improve the periodontal indexes and occlusal indexes of patients with chronic periodontitis,regulate the levels of TNF-αand IL-8 in gingival crevicular fluid,and reduce the pain.