龈下超声刮治联合甘氨酸龈下喷砂在Ⅱ度根分叉病变中应用的有效性及安全性分析

Efficacy and Safety Analysis of Subgingival Ultrasonic Curettage combined with Glycine Subgingival Sandblasting in Patients with GradeⅡBifurcation Root Lesion

目的探讨采用龈下超声刮治法联合甘氨酸龈下喷砂在治疗Ⅱ度根分叉病变中的有效性及安全性。方法选取河南大学赛思口腔医院2018年6月至2020年10月收治的90例Ⅱ度根分叉病变患者,按照随机数字表法分为对照组(45例)与研究组(45例)。对照组患者采用龈下超声刮治,研究组患者在对照组基础上联合甘氨酸龈下喷砂进行治疗,12周后对两组患者的炎性因子水平进行比较分析,并开展苯甲酰精氨酸萘酰胺(BANA)试验,与基线指标进行比较以评价治疗效。比较两组牙周临床指标、炎性及细菌学指标、两组患者患牙各时间点600 mm吸光度值、治疗满意度。结果术前,两组患者患牙菌斑指数(PLI)、龈沟出血指数(BOP)、患牙探诊深度(PD)及附着水平(CAL)比较,差异无统计学意义(P>0.05);术后12周,研究组PLI、BOP、PD及CAL均显著低于对照组,差异有统计学意义(P<0.05)。术前,两组患者肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及龈下菌斑胰蛋白酶样酶(TLE)比较,差异无统计学意义(P>0.05);术后12周,研究组TNF-α、CRP及TLE水平显著低于对照组,差异有统计学意义(P<0.05)。治疗后4周,牙周致病菌数总体均呈下降趋势,两组治疗前后差异有统计学意义(P<0.05)。治疗12周后,研究组牙周致病菌总数显著低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗满意度(95.56%)高于对照组(80.00%),差异有统计学意义(P<0.05)。结论采用龈下超声刮治法联合甘氨酸龈下喷砂在治疗Ⅱ度根分叉病中,可显著改善患者临床症状、炎症水平,减少龈下菌斑中的厌氧菌,提高患者的治疗满意度。

Objective To investigate the efficacy and safety of subgingival ultrasonic curettage combined with glycine subgingival sandblasting in the treatment of GradeⅡbifurcation root lesion.Methods A total of the 90 patients of GradeⅡbifurcation root lesion admitted to Saisi Stomatological Hospital from June 2018 to October 2020 were selected,to random number expression method,divided into control group(45 cases)and research group(45 cases).The control group received subgingival ultrasonic curetting,and the research group patients were treated with glycine subgingival sandblasting treatment on the basis of the control group.After 12 weeks,compare and analyze the levels of inflammatory factors between the two groups of patients,and the benzoylarginine naphthamide(BANA)test was carried out to evaluate the treatment efficacy compared with baseline indicators.Results Before operation,there was no significant difference in plaque index(PLI),gingival crevicular bleeding index(BOP),probing depth(PD)and attachment level(CAL)between the two groups(P>0.05).At 12 weeks after operation,PLI,BOP,PD and CAL in the study group were significantly lower than those in the control group,the difference is statistically significant(P<0.05).Before operation,tumor necrosis factor in two groups of patients-α(Tumor Necrosis Factor–α,TNF-α)、There was no significant difference between C-reactive protein(CRP)and subgingival plaque trypsin-like enzyme(TLE)(P>0.05).At 12 weeks after operation,TNF in the study group-α、the levels of CRP and TLE were significantly lower than those of the control group,the difference is statistically significant(P<0.05).After 4 weeks of treatment,the overall number of periodontal pathogens showed a downward trend,and the difference between the two groups before and after treatment was significant(P<0.05).After 12 weeks of treatment,the total number of periodontal pathogens in the research group was significantly lower than that in the control group,the difference is statistically significant(P<0.05).The total satisfaction of patients in the observation group(95.56%)was higher than that of the control group(80.00%),and the difference was statistically significant(P<0.05).Conclusions Subgingival ultrasonic curettage combined with glycine subgingival sandblasting in the treatment of gradeⅡbifurcation root lesion can significantly improve the clinical symptoms and inflammation level,reduce the anaerobic bacteria in subgingival plaque,and improve the treatment satisfaction of patients.