上海口腔医学

上海口腔医学 ›› 2017, Vol. 26 ›› Issue (3): 285-289.doi: 10.19439/j.sjos.2017.03.011

• 论著 • 上一篇    下一篇

Er:YAG激光治疗慢性牙周炎对龈沟液中Dickkopf-1水平和ALP活性的影响

吴凯悦, 许春姣, 池毓坦, 孙晓娟, 王宏峰, 王苗苗   

  1. 中南大学湘雅医院 口腔医学中心,湖南 长沙 410008
  • 收稿日期:2016-09-15 修回日期:2016-12-09 出版日期:2017-06-25 发布日期:2017-07-05
  • 通讯作者: 许春姣,E-mail：chunjiaoxu@126.com
  • 作者简介:吴凯悦（1990-）,女,硕士,E-mail：359753689@qq.com
  • 基金资助:
    湖南省科技计划项目（2014FJ3152）; 湖南省发改委高新技术计划项目[湘发改高技（2012）1493号]

Detection of Dickkopf-1 and alkaline phosphatase activity in gingival crevicular fluid from chronic periodontitis with Er: YAG laser as an adjunctive treatment

WU Kai-yue, XU Chun-jiao, CHI Yu-tan, SUN Xiao-juan, WANG Hong-feng, WANG Miao-miao   

  1. Center of Stomatology, Xiangya Hospital, Central South University. Changsha 410008, Hunan Province, China
  • Received:2016-09-15 Revised:2016-12-09 Online:2017-06-25 Published:2017-07-05

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311

被引次数

11

摘要： 目的检测龈沟液中Dickkopf-1（DKK1）水平和碱性磷酸酶（alkaline phosphatase,ALP）活性,比较Er：YAG激光辅助超声龈下刮治联合根面平整术（scaling and root planing,SRP）与单纯SRP对慢性牙周炎（chronic periodontitis,CP）疗效的影响。方法采取半口对照设计方案,纳入11例CP患者,19对38颗患牙,以超声洁治后1周作为基线。按照随机原则,一侧（实验侧）应用Er:YAG激光辅助SRP,另一侧（对照侧）仅采用SRP。分别在基线、治疗完成后1周、1个月、3个月收集龈沟液并通过酶联免疫吸附法检测龈沟液中DKK1水平及磷酸苯二钠法检测ALP活性;并于基线、刮治后1个月、刮治后3个月记录受试牙出血指数（bleeding index,BI）、牙周探诊深度（probing depth,PD）、临床附着丧失（clinical attachment loss,CAL）。采用SPSS19.0软件包对实验数据进行统计学分析。结果无论是激光组还是对照组,治疗后1个月及治疗后3个月,BI、PD、CAL较基线均明显下降,但2组之间临床指标比较无显著差异（P>0.05）。实验组基线、治疗1周、治疗后1个月和治疗后3个月龈沟液中ALP活性逐渐下降,分别为（396.19±150.55）、（386.69±146.42）、（341.22±171.62）、（249.27±98.72）U/L;DKK1浓度亦逐渐下降,分别为（307.12±45.63）、（297.32±91.34）、（265.87±41.40）、（244.43±43.09）μg/L。对照组同期ALP活性分别为（394.09±120.25）、（374.72±131.27）、（344.42±127.80）、（252.36±90.4）U/L,DKK1浓度分别为（305.33±47.40）、（310.34±84.68）、（270.04±55.14）、（247.31±56.99）μg/L,ALP及DKK1均呈下降趋势,但2组同期ALP活性及DKK1水平无显著差异（P>0.05）。DKK1与CAL呈显著正相关（r=0.675,P=0.00）。结论Er:YAG激光作为非手术方法辅助SRP治疗慢性牙周炎安全有效,远期疗效有待进一步观察。

关键词: 慢性牙周炎, Er:YAG激光, DKK1, 碱性磷酸酶

Abstract: PURPOSE: The aim of this study was to evaluate the clinical efficacy and the level of DKK1 and alkaline phosphatase (ALP) activity in gingival crevicular fluid (GCF) while taking Er:YAG laser as an adjunctive to scaling and root planning in the treatment of chronic periodontitis (CP). METHODS: Eleven patients with CP were included and there were nineteen pairs of homonym teeth(thirty-eight teeth) in this split-mouth design, and they were randomly assigned to experimental group or control group. In the experimental group, a combination of ultrasonic subgingigval scaling and root planning with hand instrument (SRP) were performed with Er: YAG laser as an adjunctive; in the control group, only SRP was performed. The main variables were bleeding index (BI), probing depth (PD), clinical attachment loss (CAL) which were assessed at baseline (1 week after ultrasonic subgingival scaling), l month and 3 months after treatment. GCF was collected at baseline, l week, l month and 3 months, and the levels of DKK1 and ALP activity were detected at the same time point. The data were analyzed with SPSS 19.0 software package. RESULTS: Both groups showed significant reduction of PD, CAL, BI values 1 month and 3months after treatment, but no significant difference in clinical parameters were found between the two groups. In the experimental group, the activity of ALP reduced to (386.69±146.42), (341.221±171.62), (249.27±98.72) from (396.191±150.55) U/L and the level of DKK1 dropped to (310.34±184.68), (270.04±55.14), (247.31±56.99) from (307.12±45.63) μg/L at the end of 1 week, 1 month, 3 months, respectively. Meanwhile, in the control group, the activity of ALP reduced to (374.72±131.27), (344.42±127.80), (252.36±90.4 ) from (394.09±120.25) U/L and the level of DKK1 dropped to (310.34±84.68), (270.04±55.14), (247.31±56.99) from (305.33±147.40) μg/L at the end of l week, l month, 3months, respectively. There is no significant difference between the two groups at any period for ALP or DKK1. CONCLUSIONS: Er:YAG laser was a safe no-surgical adjunctive therapy in treating chronic periodontitis, further observation is needed to determine its long-term effectiveness.

Key words: Periodontitis, Er:YAG laser, Dickkopf-1, Alkaline phosphatase

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