光动力疗法联合口腔正畸治疗对牙周炎患者血清单核细胞趋化因子-1及可溶性细胞间黏附分子-1的影响

Effect of photodynamic therapy combined with orthodontic treatment on serum MCP-1 and sICAM-1 levels in patients with periodontitis

目的分析光动力疗法联合口腔正畸治疗对牙周炎患者临床疗效、牙周指标、炎性因子水平及咀嚼功能的影响。方法根据治疗方式,将在2020年5月至2022年5月间于河南省邓州市中心医院就诊的130例牙周炎患者分为对照组(65例)和观察组(65例)。2组患者均进行刮治牙石/牙菌斑、根面平整等牙周基础治疗并观察3个月,牙周炎症控制后对照组患者在以上治疗的基础上加以正畸治疗,观察组患者在对照组的基础上加以光动力疗法。比较2组临床疗效,治疗前后的牙周指标、炎性因子水平及咀嚼功能。结果观察组临床疗效(95%,62/65)比对照组(82%,53/65)高(P<0.05);治疗后的牙龈指数(1.3±0.3)、菌斑指数(1.2±0.3)及出血指数(1.3±0.4)比对照组(1.6±0.3、1.6±0.4、1.6±0.5)低,临床附着丧失(3.7±0.9)和牙周袋深度(3.0±0.5)比对照组(4.7±0.9、4.1±0.7)小(P<0.05);血清单核细胞趋化因子-1(MCP-1)(60.0±6.0)mg/L、可溶性细胞间黏附分子-1(sICAM-1)(133.8±26.7)ng/ml、超敏C反应蛋白(hs-CRP)(2.2±0.3)mg/L及NOD样受体热蛋白结构域相关蛋白3(NLRP3)(20.9±4.5)pg/ml水平比对照组(63.0±6.7 mg/L、150.2±30.2 ng/ml、2.6±0.4 mg/L、23.0±4.5 pg/ml)低(P<0.05);咬合力(59±6)kg和咀嚼效率(92±9)%比对照组[55±6 kg、(86±8)%]高(P<0.05)。结论光动力疗法联合口腔正畸治疗牙周炎疗效确切,可有效改善牙周状态及咀嚼功能,调节血清MCP-1及sICAM-1水平,减轻患者炎性反应。

Objective To analyze the impact of photodynamic therapy combined with orthodontic treatment on the clinical efficacy,periodontal indicators,inflammatory factor levels,and chewing function of patients with periodontitis.Methods According to the treatment,130 patients with periodontitis who visited Dengzhou Central Hospital in Henan Province from May 2020 to May 2022 were divided into the control group(65 cases)and the observation group(65 cases).Both groups of patients underwent periodontal basic treatment such as curettage of tartar/plaque and root leveling,and were observed for 3 months.After controlling periodontitis,the control group received orthodontic treatment on the basis of the above treatment,while the observation group received photodynamic therapy on the basis of the control group,and compared the clinical efficacy,periodontal indicators,inflammatory factor levels,and chewing function between the two groups before and after treatment.Results The clinical efficacy of the observation group(95%,62/65)was better than that of the control group(82%,53/65)(P<0.05).After treatment,the gingival index(1.3±0.3),plaque index(1.2±0.3),and bleeding index(1.3±0.4)were lower than those in the control group(1.6±0.3,1.6±0.4,1.6±0.5),clinical attachment loss(3.7±0.9),and periodontal pocket depth(3.0±0.5)were lower than those in the control group(4.7±0.9,4.1±0.7)(P<0.05).The levels of serum monocyte chemokine-1(MCP-1)(60.0±6.0)mg/L,soluble intercellular adhesion molecule-1(sICAM-1)(133.8±26.7)ng/ml,hypersensitive C-reactive protein(hs CRP)(2.2±0.3)mg/L,and NOD like receptor heat protein domain related protein 3(NLRP3)(20.9±4.5)pg/ml were lower than those of the control group(63±7 mg/L,150.2±30.2 ng/ml,2.6±0.4 mg/L,23.0±4.5 pg/ml)(P<0.05).The bite force(59±6)kg and chewing efficiency(92±9)%were higher than those of the control group[55±6 kg,(86±8)%](P<0.05).Conclusion Photodynamic therapy combined with orthodontic treatment of periodontitis is effective in improving periodontal status and masticatory function,regulating serum MCP-1 and sICAM-1 levels,and reducing the inflammatory response of patients.