微创牙周植骨术对二壁骨下袋患者的疗效及炎性因子水平的影响

Effect of minimally invasive periodontal bone grafting on patients with two-wall intrabony pocket and its effect on inflammatory factors

目的研究微创牙周植骨术对二壁骨下袋患者的疗效及对炎性因子水平的影响。方法选取医院2018年1月至2021年10月收治的经基础牙周治疗6周后仍存在≥5 mm二壁骨下袋患者82例开展研究。以单双数字法将其分作微创组及常规组,每组41例。常规组开展传统术式治疗,微创组则开展微创牙周植骨术治疗。分析2组临床疗效[探针深度(PD)、菌斑指数(PLI)、牙龈退缩量(REC)、牙周附着丧失(CAL)],术后疼痛情况(VAS评分),血清炎性因子[过氧化物酶(MPO)、前列腺素E_(2)(PGE_(2))、细胞间黏膜细胞因子-1(ICAM1)]水平,牙槽骨骨密度等方面的差异。结果术后6个月微创组PD、REC及CAL低于常规组(P<0.05)。术后1、2、3 d时微创组VAS评分低于常规组(P<0.05)。术后微创组血清MPO、PGE2以及ICAM1水平低于常规组(P<0.05)。术后3、6个月时微创组牙槽骨骨密度高于常规组(P<0.05)。结论微创牙周植骨术对二壁骨下袋患者的疗效显著,有利于下调炎性因子水平,提高牙槽骨骨密度,值得推广普及。

Objective To study the efficacy of minimally invasive periodontal bone grafting in patients with two-wall intrabony pocket and its influence on the levels of inflammatory factors.Methods From January 2018 to October 2021,82 patients with a two-wall intrabony pocket≥5 mm after 6 weeks of basic periodontal treatment were selected for this study.They were divided into minimally invasive group(n=41)and conventional group(n=41)by single and double-digit method.Conventional operation,and minimally invasive periodontal bone grafting were performed in the conventional group and minimally invasive group,respectively.The clinical efficacy(probe depth[PD],plaque index[PLI],gingival recession[REC],clinical attachment loss[CAL]),postoperative pain(the Visual Analogue Scale[VAS]score),serum inflammatory factors(myeloperoxidase[MPO],prostaglandin E-2[PGE-2],intercellular adhesion molecule 1[ICAM1]),and alveolar bone mineral density between the two groups were compared.Results The PD,REC and CAL at 6 months postoperatively in the minimally invasive group were significantly lower than those of conventional group(P<0.05).The VAS scores at 1,2 and 3 days postoperatively in the minimally invasive group were significantly lower than those of conventional group(P<0.05).Serum MPO,PGE2 and ICAM1 in the minimally invasive group were significantly lower than those of conventional group(P<0.05).The alveolar bone mineral density in the minimally invasive group was higher than that in the conventional group at 3 and 6 months postoperatively(P<0.05).Conclusion Minimally invasive periodontal bone grafting has a significant effect on patients with two-wall intrabony pocket,which is beneficial to reduce the levels of inflammatory factors and improve alveolar bone mineral density.It is worthy of popularization.