弹性纤维带在晚期重度牙周炎治疗中的临床效果评价

Evaluation of the clinical effect of elastic fibers in the treatment of patients with advanced severe periodontitis

目的 评价在牙周牙髓联合治疗的方法上加用弹性纤维带治疗重度牙周炎伴牙齿松动的临床疗效。方法 回顾性分析保定市第一医院口腔科收治的138例重度牙周炎患者的临床资料,根据治疗方法不同,随机分为固定组和非固定组,每组各69例。固定组在治疗过程中对松动牙行弹性纤维带固定;非固定组常规行牙周牙髓联合治疗。比较两组患者治疗前后牙槽骨密度、患牙松动度、牙周探诊深度(PD),附着丧失(AL)和咀嚼功能的差异。结果 两组治疗6个月后牙齿松动位移值、PD、AL与治疗前相比差异有统计学意义(P<0.05);组间相比,固定组患牙松动位移值明显低于非固定组,差异有统计学意义(P<0.05),PD及AL比较差异均有统计学意义(P<0.05);固定组疗效满意度中的良好率高于非固定组,差异有统计学意义(P<0.05);固定组治疗后6、12个月牙槽骨密度灰度值与治疗前比较差异均有统计学意义(P<0.05)。非固定组治疗后6个月牙槽骨密度灰度值与治疗前比较,差异无统计学意义(P>0.05);治疗后12个月与治疗前比较,则差异有统计学意义(P<0.05)。固定组治疗后12个月牙槽骨密度灰度值较非固定组显著升高,差异有统计学意义(P<0.05)。结论 对于重度牙周炎伴牙齿松动,在牙周牙髓联合治疗的基础上辅助弹性纤维带固定,疗效优于单纯牙周牙髓联合治疗,值得在临床推广应用。

Objective To evaluate the clinical effect of combined periodonto-endodontic therapy with elastic fibers for patients suffering from severe periodontitis with loose teeth.Methods Clinical data of 138 patients with severe periodontitis admitted in the Stomatology Department of Baoding First Hospital were retrospectively analyzed.These cases were randomly divided into two groups by different treatments:fixed group and non-fixed group(n=69).In fixed group,loose teeth of patients were fixed with the elastic fibers for treatment,while non-fixed group took the standard combined periodonto-endodontic therapy.The differences in periodontal bone mineral density,looseness of affected teeth,probing depth(PD),attachment loss(AL)and masticatory function were compared between the two groups before and after treatment.Results After being treated for 6 months,both groups showed significant differences in the tooth loosening displacement,PD,AL when compared with those before treatment(P<0.05).When two groups were compared,the loosening displacement of affected teeth in fixed group was significantly lower than that in non-fixed group(P<0.05),and PD and AL were significantly different(P<0.05).In the efficacy satisfaction survey,fixed group gave a higher good rate than non-fixed groupThe comparison of the gray level of bone mineral density(BMD)of both groups before and after treatment showed that there was a significant difference in the gray level of bone mineral density(BMD)in fixed group at 6 and 12 months after treatment(P<0.05);In non-fixed group at 6 months after treatment,there was no significant difference(P>0.05),but after 12 months of treatment,non-fixed group showed a significant difference in the gray level of bone mineral density(BMD).After 12 months of treatment,the gray level of periodontal BMD in fixed group was significantly higher than that in non-fixed group(P<0.05).Conclusion In the treatment of patients suffering from severe periodontitis with loose teeth,the elastic fibers-assisted combined periodonto-endodontic therapy shows a better effect than the combined periodonto-endodontic therapy alone.Therefore,it is recommended to be applied in clinical practice.