口腔种植修复对慢性牙周炎合并牙列缺损患者牙周指数及MMP水平的影响分析

Effect analysis of dental implant restoration on periodontal index and MMP level in patients with chronic periodontitis and dentition defect

目的分析口腔种植修复对慢性牙周炎合并牙列缺损患者牙周指数及基质金属蛋白酶(MMP)水平的影响。方法98例牙列缺损患者,其中49例牙周健康患者作为对照组,49例合并慢性牙周炎患者作为研究组。两组患者均进行口腔种植修复治疗。比较两组患者治疗前后牙周指数[牙周探诊深度(PD)、菌斑指数(PLI)、牙龈出血指数(SBI)、牙龈乳头指数(PIS)]、MMP(MMP-9、MMP-8、MMP-2)水平及种植体存留率。结果治疗前,研究组PD(1.44±0.15)mm、PLI(0.38±0.08)、SBI(0.21±0.10)、PIS(2.64±0.43)均高于对照组的(1.38±0.11)mm、(0.26±0.04)、(0.10±0.03)、(2.22±0.42),差异有统计学意义(P<0.05);治疗1年后,研究组PD、PLI、SBI水平略高于对照组,但差异无统计学意义(P>0.05);研究组治疗1年后PIS(2.07±0.37)明显高于对照组的(0.83±0.35),差异有统计学意义(P<0.05);研究组治疗1年后PD、PLI、SBI、PIS均低于治疗前,差异有统计学意义(P<0.05);对照组治疗1年后PLI高于治疗前,PIS低于治疗前,差异有统计学意义(P<0.05),PD、SBI与治疗前比较差异无统计学意义(P>0.05)。治疗前和治疗1年后,研究组MMP-9、MMP-8、MMP-2水平分别为(31.70±6.22)、(2.53±0.85)、(10.22±2.21)ng/ml和(43.74±7.27)、(4.86±0.92)、(18.44±3.86)ng/ml,均高于对照组的(21.43±5.61)、(0.44±0.10)、(5.59±1.43)ng/ml和(22.46±6.59)、(0.45±0.12)、(5.25±1.38)ng/ml,差异有统计学意义(P<0.05);研究组治疗1年后MMP-9、MMP-2、MMP-8水平均高于治疗前,差异有统计学意义(P<0.05);对照组治疗1年后MMP-9、MMP-2、MMP-8水平与治疗前比较,差异无统计学意义(P>0.05)。两组治疗1年后种植体存留率比较,差异无统计学意义(P>0.05)。结论慢性牙周炎合并牙列缺损患者接受口腔种植修复治疗短期效果好,不会加重牙周炎症状,但会受牙周炎影响,需结合牙周炎针对治疗,保证种植修复远期效果。

Objective To analyze the effect of dental implant restoration on periodontal index and matrix metalloproteinase(MMP)level in patients with chronic periodontitis and dentition defect.Methods There were 98 patients with dentition defect,including 49 healthy patients(control group)and 49 patients with chronic periodontitis(study group).Both groups underwent dental implant restoration.Both groups were compared in terms of periodontal index[probing depth(PD),plaque index(PLI),sulcus bleeding index(SBI),papilla index score(PIS)],MMP(MMP-9,MMP-8,MMP-2)and implant retention rate before and after treatment.Results Before treatment,the study group had PD of(1.44±0.15)mm,PLI of(0.38±0.08),SBI of(0.21±0.10)and PIS of(2.64±0.43),which were higher than those of(1.38±0.11)mm,(0.26±0.04),(0.10±0.03)and(2.22±0.42)in the control group,and the differences were statistically significant(P<0.05).After 1 year of treatment,the levels of PD,PLI and SBI in the study group were slightly higher than those in the control group,but the differences were not statistically significant(P>0.05).After 1 year of treatment,PIS of(2.07±0.37)in the study group was significantly higher than that of(0.83±0.35)in the control group,and the difference was statistically significant(P<0.05).After 1 year of treatment,PD,PLI,SBI and PIS in the study group were lower than those before treatment in this group,and the differences were statistically significant(P<0.05).After 1 year of treatment,PLI in the control group was higher than that before treatment in this group,and PIS was lower than that before treatment in this group.The differences were statistically significant(P<0.05);PD and SBI in the control group were not statistically significant compared with those before treatment in this group(P>0.05).Before treatment and after 1 year of treatment,the levels of MMP-9,MMP-8 and MMP-2 in the study group were(31.70±6.22),(2.53±0.85),(10.22±2.21)ng/ml and(43.74±7.27),(4.86±0.92),(18.44±3.86)ng/ml,which were higher than those of(21.43±5.61),(0.44±0.10),(5.59±1.43)ng/ml and(22.46±6.59),(0.45±0.12),(5.25±1.38)ng/ml in the control group,and the differences were statistically significant(P<0.05).After 1 year of treatment,the levels of MMP-9,MMP-2 and MMP-8 in the study group were higher than those before treatment in this group,and the differences were statistically significant(P<0.05).In the control group,there was no statistically significant difference in the levels of MMP-9,MMP-2 and MMP-8 after 1 year of treatment as compared with those before treatment(P>0.05).There was no statistically significant difference in implant retention between the two groups after 1 year of treatment(P>0.05).Conclusion Dental implant restoration has good short-term effect on patients with chronic periodontitis and dentition defect,which will not aggravate the symptoms of periodontitis,but will be affected by periodontitis.It is necessary to combine the targeted treatment of periodontitis to ensure the long-term effect of implant restoration.