Er:YAG激光治疗侵袭性牙周炎对疗效及牙龈卟啉单胞菌的影响

Effect of Er:YAG Laser on Porphyromonas Gingivalis and Curative Results of Invasive Periodontitis

目的 探讨Er:YAG激光治疗侵袭性牙周炎的疗效及对牙龈卟啉单胞菌的影响。方法 选取2021年10月至2022年10月,侵袭性牙周炎患者108例,随机分为观察组和对照组,每组患者54例。对照组予以超声龈下刮治+根面平整术治疗,观察组在对照组基础上予以Er:YAG激光治疗,治疗能量100 mJ,功率1.0 W,频率10 Hz,每周治疗1次,连续治疗3个月。比较治疗前和末次激光治疗3个月后两组患者牙周袋探诊深度、出血指数和血清白细胞介素6(interleukin 6,IL-6)、高迁移率族蛋白1(high mobility group box1,HMGB1)、白细胞介素1β(interleukin 1β,IL-1β)水平、牙龈卟啉单胞菌浓度及感染率情况,并记录治疗期间不良反应发生情况。结果 治疗前,观察组和对照组患者牙周袋探诊深度分别为(6.23±1.2) nm、(6.27±1.2) nm,组间比较差异无统计学意义(P>0.05);治疗3个月后,观察组和对照组牙周袋探诊深度分别为(3.58±0.7) nm、(4.11±0.8) nm,均低于治疗前(P<0.05),且观察组较对照组降低更明显(P<0.05)。治疗前,观察组和对照组患者出血指数分别为(3.61±0.6)、(3.58±0.5),两组比较差异无统计学意义(P>0.05);治疗3个月后,观察组和对照组患者出血指数分别为(1.42±0.4)、(1.76±0.4),均低于治疗前,且观察组较对照组降低更明显(P<0.05)。治疗前,两组患者龈卟啉单胞菌浓度及牙龈卟啉单胞菌感染阳性率比较,差异无统计学意义(P>0.05);治疗3个月后,两组患者龈卟啉单胞菌浓度及牙龈卟啉单胞菌感染阳性率较治疗前降低,且观察组较对照组降低更明显(P<0.05)。治疗前,两组患者血清IL-6、HMGB1、IL-1β水平比较差异无统计学意义(P>0.05);治疗3个月后,两组患者血清IL-6、HMGB1、IL-1β水平较治疗前降低(P>0.05),且观察组较对照组降低更明显(P<0.05)。结论 Er:YAG激光治疗可有效降低侵袭性牙周炎患者牙周袋探诊深度、出血指数,改善炎症情况,对抑制侵袭性牙周炎患者龈卟啉单胞菌感染具有积极作用。

Objective To investigate the effect of Er:YAG laser on porphyromonas gingivalis and curative results of invasive periodontitis.Methods Totally 108 patients with invasive periodontitis treated over the period from Oct.2021 to Oct.2022 were randomly divided into an observation group and a control group,54 patients in each group.The patients in the control group were treated with ultrasonic subgingival curetting and root surface leveling,and those in the observation group with Er:YAG laser once a week for 3 months.The periodontal pocket probing depth,bleeding index,serum interleukin 6(IL-6),high mobility group box protein 1(HMGB1),interleukin 1β(IL-1β)level,porphyromonas gingivalis concentration and infection rate were compared between the two groups before the treatment and 3 months after the last treatment respectively,and adverse reactions during the treatment were recorded.Results Before the treatment,the probing depth of periodontal pocket in the observation group and control group was(6.23±1.2)nm and(6.27±1.2)nm respectively,and there was no statistical significance between two groups(P>0.05).Three months after the treatment,the probing depth of periodontal pocket in the observation group and control group was(3.58±0.7)nm and(4.11±0.8)nm respectively,which was lower than that before the treatment(P<0.05),and the decrease in the observation group was more obvious than that in the control group(P<0.05).Before the treatment,the bleeding index of the observation group and control group was(3.61±0.6)and(3.58±0.5)respectively,and the difference between two groups was not statistically significant(P>0.05).After the treatment,the bleeding index of observation group and control group was(1.42±0.4)and(1.76±0.4)respectively,which was lower than that before the treatment,and the decrease of the observation group was more obvious than that of the control group(P<0.05).Before the treatment,there was no significant difference in the concentration of porphyromonas gingivalis and positive rate of porphyromonas gingivalis infection between two groups(P>0.05).Three months after the treatment,the concentration of porphyromonas gingivalis and positive rate of porphyromonas gingivalis infection in both groups were lower than those before the treatment,and the decrease was more obvious in the observation group than that in the control group(P<0.05).Before the treatment,there was no difference in serum IL-6,HMGB1 or IL-1βlevels between two groups(P>0.05).Three months after the treatment,the serum levels of IL-6,HMGB1 and IL-1βin both groups were lower than those before treatment,and the levels of observation group were much lower than those of the control group(P<0.05).Conclusions Er:YAG laser treatment will effectively reduce the depth of periodontal pocket exploration and bleeding index,improve inflammation and inhibit porphyromonas gingival infection in patients with invasive periodontitis.