不同阶段使用半导体激光辅助治疗Ⅲ期、Ⅳ期牙周炎的临床疗效比较

Comparison of the clinical efficacy of stageⅢandⅣperiodontitis with Diode laser-assisted treatment at different stages

目的:比较不同阶段使用半导体激光(DL)辅助治疗Ⅲ期、Ⅳ期牙周炎的临床疗效。方法:选取2023年12月至2024年06月就诊于新疆医科大学第一附属医院牙周病科Ⅲ期、Ⅳ期牙周炎患者30例(根据2018年牙周病新分类)。所有患者行全口龈上洁治,术后1周,记录临床指标:探诊深度(PD)、牙龈指数(GI)和探诊出血(BOP),测量龈沟液内炎症因子水平:白介素-6(IL-6),肿瘤坏死因子-α(TNF-α),C-反应蛋白(CRP)作为基线。将患者依照随机信封法分为3组:SRP组、DL1组、DL2组。SRP组仅行龈下刮治术及根面平整术(SRP);DL1组先对所有试验位点行DL照射,1周后再行SRP治疗;DL2组,先行SRP治疗,1周后再对试验位点行DL照射。6周、12周随访观察,比较3组临床指标(PD、GI、BOP)和龈沟液内IL-6、TNF-α、CRP水平。采用SPSS 26.0软件包对数据进行统计学分析。结果:本试验共纳入1 378个位点,每组各10例患者,位点数分别为DL1组:438个(31.8%),DL2组:466个(33.8%),DL3组:474个(34.4%)。3组治疗后6周、12周进行复查,PD、GI、BOP及龈沟液内IL-6、TNF-α、CRP水平较基线均显著降低(P<0.05);6周与12周的复查结果无显著差异。对于PD≥5 mm的位点,3组均可降低患牙的GI和BOP阳性率(P<0.05);而当PD≥7 mm时,激光组PD降低更明显,DL2组效果更好(P<0.05)。结论:DL辅助SRP治疗相较于单纯使用SRP可以获得更好的临床效果。DL2组比DL1组效果好。

AIM:To evaluate the clinical efficacy of stageⅢandⅣperiodontitis with Diode laser-assisted(DL)treatment at different stages.METHODS:According to 2018 Classification of Periodontitis,30 patients with stageⅢandⅣperiodontitis admitted to Department of Periodontology,the First Affiliated Hospital of Xinjiang Medical University from December 2023 to June 2024 were enrolled.After 1 week of supragingival cleaning,the periodontal probing depth(PD),gingival index(GI)and bleeding on probing(BOP)were recorded as the baseline.The level of inflammatory factors in the gingival crevicular fluid,such as interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP),was also measured as the baseline.All patients were divided into 3 groups.SRP group:received whole mouth SRP treatment.DL1 group:all sites with sites in the counterpart were laser radiated,SRP treatment was followed up to 1 week later.DL2 group:all sites with sites were laser radiated followed by SRP treatment 1 week later.The follow-up was conducted at 6 and 12 weeks after treatment and the clinical indicators(PD,GI,BOP)and the level of inflammation factors(IL-6,TNF-αand CRP)was compared.Data were analyzed using the SPSS 26.0 software package.RESULTS:A total of 30 patients and 1378 test sites were included in this trial.There were 10 patients in group SRP(the number of tests sites:438,31.8%),DL1(466,33.8%)and DL2(47434.4%)respectively.For these three groups,PD,GI and BOP were decreased at 6 weeks of follow-up and 12 weeks of follow-up(P<0.05),and there was no significant difference between 6 weeks and 12 weeks of follow-up.In the PD≥5mm site,the GI and BOP positive rates were significantly decreased in the DL 1 and DL 2 groups.When PD≥7 mm,significant PD reduction was observed in group DL2(P<0.05).CONCLUSIONS:In stageⅢand stageⅣperiodontitis,DL adjuvant SRP treatment achieved better clinical results than SRP alone.