铒激光联合钕激光辅助重度慢性牙周炎非手术治疗的临床研究

Clinical study of erbium laser combined with neodymium laser-assisted non-surgical treatment of severe chronic periodontitis

目的 探究铒激光(Er∶YAG)联合钕激光(Nd∶YAG)辅助重度慢性牙周炎非手术治疗患者的临床疗效。方法 选取2020年1月至2022年1月于厦门医学院附属口腔医院接受治疗的96例重度慢性牙周炎患者作为研究对象,随机分为对照组(n=48)和研究组(n=48)。对两组患者均采取超声龈上洁治术以及个人口腔卫生指导,超声龈上洁治术7 d后进行临床相关指标的检验,再对患者采取龈下刮治术及根面平整术。对照组采取超声及手工龈下刮治术及根面平整术进行治疗,研究组在对照组基础上采用Er∶YAG联合Nd∶YAG辅助对患者进行牙周治疗。比较两组患者治疗前后牙周探诊深度(PD)、龈沟出血水平(SBI)以及临床附着丧失(CAL),采集两组患者龈沟液,对龈沟液中的脂多糖(LPS)、瘦素(Leptin)以及炎症因子水平值进行检测。结果 治疗后,研究组的PD、SBI以及CAL的水平值低于对照组,差异有统计学意义(P <0.05);研究组龈沟液中白介素(IL)-1β、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α及LPS水平低于对照组,Leptin水平高于对照组,差异均有统计学意义(P <0.05)。结论 Er∶YAG联合Nd∶YAG辅助重度慢性牙周炎非手术治疗可有效改善牙周指标,降低患者龈沟液炎性因子、LPS水平,提高患者Leptin水平。

Objective To investigate the clinical efficacy of erbium laser(Er∶YAG)combined with neodymium laser(Nd∶YAG)in the non-surgical treatment of patients with severe chronic periodontitis.Methods A total of 96 patients with severe chronic periodontitis treated at the Affiliated Stomatological Hospital of Xiamen Medical College from January 2020 to January 2022 were selected as the subjects of this study and were divided into a control group(n=48)and a study group(n=48)randomly.In both groups,ultrasonic supragingival scaling and personal oral hygiene instruction were performed.7 d after ultrasonic supragingival scaling,clinical indexes were examined,and then subgingival scaling and root planing were performed.The control group was treated with ultrasonic and manual subgingival scraping and root planing,while the study group was treated with Er∶YAG combined with Nd∶YAG on top of the control group.Compare the periodontal probing depth(PD),gingival sulcus bleeding level(SBI),and clinical attachment loss(CAL)between two groups of patients before and after treatment.The gingival sulcus fluid was collected and the levels of lipopolysaccharide(LPS),leptin and inflammatory factors in the gingival sulcus fluid were measured.Results After treatment,the levels of PD,SBI and CAL in the study group were lower than those in the control group,with statistically significant differences(P<0.05);the levels of IL-1β,hs-CRP,TNF-αand LPS in the gingival sulcus fluid in the study group were lower than those in the control group,and the levels of Leptin were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Non-surgical treatment of severe chronic periodontitis with Er∶YAG combined with Nd∶YAG can effectively improve periodontal indexes,reduce inflammatory factors and LPS levels in the gingival sulcus fluid and increase Leptin levels in patients.