慢性牙周炎牙列缺损患者种植修复前后炎性因子及口腔功能的变化

Changes of inflammatory factors and oral function in patients with chronic periodontitis dentition defect before and after implantation

目的采用种植修复治疗慢性牙周炎牙列缺损,并分析患者修复前后炎性因子及口腔功能的变化。方法选取2020年6月至2022年12月于河南省直第三人民医院就诊的60例慢性牙周炎牙列缺损患者作为研究对象并将其纳入观察组,同期选择50例单纯牙列缺损患者作为对照并纳入对照组,两组均接受种植修复治疗,随访1周,记录并对比两组患者的种植体植入情况。分别于治疗前、治疗后4周检测两组患者的牙周指数及龈沟液炎性因子,分别于治疗前、治疗后1年评估两组患者的口腔功能及临床疗效。结果治疗后1周,观察组与对照组患者的种植体植入成功率、感染率及脱落率相比,无统计学差异(P>0.05)。治疗后4周,观察组患者的菌斑指数(plaque index,PLI)、牙周袋探诊深度(probing depth,PD)、牙龈乳头指数(papilla index score,PIS)、龈沟出血指数(sulcus bleeding index,SBI)水平均高于对照组(P<0.05);观察组患者的龈沟液白细胞介素-1β、白细胞介素-6、高敏C反应蛋白、肿瘤坏死因子-α水平较均高于对照组(P<0.05)。治疗后1年,两组患者的语言清晰度、咀嚼功能评分均升高,牙齿动度值(periotest value,PTV)评分均降低(P<0.05),但组间相比无统计学差异(P>0.05);观察组患者的总有效率(80.00%)低于对照组(94.00%)(P<0.05)。结论应用种植修复治疗慢性牙周炎牙列缺损可有效改善患者的口腔功能,且种植体植入成功率较高。但相较于单纯牙列缺损患者,慢性牙周炎牙列缺损患者种植修复后的炎症反应较严重,对种植体周围组织影响也较大。

Objective To adopt implant restoration for the treatment of chronic periodontitis dentition defect,and to analyze the changes in inflammatory factors and oral functions before and after the restoration in patients.Methods A totaly of 60 patients with chronic periodontitis dentition defect who received implant repair in the Third People's Hospital of Henan Province from June 2020 to December 2022 were selected as the observation group,and 50 patients with simple dentition defect were selected as the control group during the same period.Both group were treated with implant restorations and followed up for one week,and the implant implantation conditions of the two groups were recorded and compared.Periodontal index and gingival fluid inflammatory factor were measured before and 4 weeks after treatment,and oral function and clinical efficacy were evaluated before and 1 year after treatment,respectively.Results One week after treatment,there was no significant difference in the success rate of implant implantation,infection rate and implant shedding rate between observation group and control group(P>0.05).Compared with the control group,the plaque index(PLI),periodontal pocket probing depth(PD),gingival papilla index score(PIS)and sulcus bleeding index(SBI)of the observation group were higher at 4 weeks after treatment(P<0.05).The levels of interleukin-1β,interleukin-6,high-sensitivity C-reactive protein and tumor necrosis factor-αin gingival crevicular fluid of the observation group were higher at 4 weeks after treatment than those in control group(P<0.05).One year after treatment,the scores of speech articulation and chewing function were increased,and the scores of periotest value(PTV)were decreased in both groups(P<0.05),but there was no statistical difference between groups(P>0.05).Compared with the control group(94.00%),the total effective rate of the observation group(80.00%)was lower(P<0.05).Conclusion The application of implant repair in the treatment of chronic periodontitis dentition defect can effectively improve the oral function of patients,and the success rate of implant implantation is high.However,compared with patients with simple denture defect,the inflammatory response of patients with chronic periodontitis with denture defect after implantation is more serious,and the influence on the tissue around the implant is also greater.