激光联合牙周基础治疗对牙周炎患者牙周指标、龈下菌群及龈沟液脂联素、MMP-13、IL-1β的影响

doi:10.19439/j.sjos.2024.03.015

摘要/Abstract

摘要： 目的：探讨激光联合牙周基础治疗对牙周炎患者牙周指标、龈下菌群及龈沟液脂联素、基质金属蛋白酶13（MMP-13）、白细胞介素1β（IL-1β）的影响。方法：回顾性分析2022年12月—2023年7月衡水市人民医院收治的牙周炎患者100例,按照治疗方法分为对照组（51例）和试验组（49例）。对照组给予牙周基础治疗,试验组在对照组基础上给予激光治疗。比较2组治疗前后的牙周指标、龈下菌群、龈沟液脂联素、MMP-13、IL-1β和骨代谢因子及临床疗效。采用SPSS 22.0软件包对数据进行统计学分析。结果：治疗后,试验组牙周袋深度（PD）、探诊出血指数（BOP）、牙龈指数（GI）和菌斑指数（PLI）较治疗前显著降低（P<0.05）,对照组PD、BOP、PLI较治疗前显著降低（P<0.05）;试验组PD、BOP、GI和PLI显著低于对照组（P<0.05）。治疗后,2组乳杆菌、梭杆菌和拟杆菌较治疗前显著降低（P<0.05）,试验组显著低于对照组（P<0.05）。治疗后,2组龈沟液脂联素较治疗前显著升高（P<0.05）,MMP-13、IL-1β较治疗前显著降低（P<0.05）;试验组龈沟液脂联素显著高于对照组（P<0.05）,龈沟液MMP-13、IL-1β显著低于对照组（P<0.05）。治疗后,2组龈沟液Ⅰ型胶原N端前肽（PINP）、Ⅰ型胶原C端肽（CXT）和骨钙素（BGP）较治疗前显著升高（P<0.05）,试验组显著高于对照组（P<0.05）。试验组临床总有效率显著高于对照组（P<0.05）。结论：激光联合牙周基础治疗可有效改善牙周炎患者牙周指标,减少龈下菌群,提高龈沟液脂联素和骨代谢因子水平,降低龈沟液MMP-13、IL-1β水平,提高临床疗效。

关键词: 激光, 牙周基础治疗, 牙周炎, 龈下菌群, 脂联素, 基质金属蛋白酶13, 白细胞介素1β

Abstract: PURPOSE: To investigate the effects of laser combined with periodontal basic treatment on periodontal indices, subgingival flora, adiponectin, matrix metalloproteinase-13 (MMP-13) and interleukin-1β (IL-1β) in patients with periodontitis. METHODS: A retrospective analysis was performed on 100 patients with periodontitis diagnosed and treated in Hengshui People's Hospital from December 2022 to July 2023. According to treatment methods, the patients were divided into control group (n=51) and experimental group (n=49). The control group received periodontal basic treatment, and the experimental group received laser treatment on the basis of the control group. The periodontal indexes, subgingival microflora, adiponectin, MMP-13, IL-1β and bone metabolic factors of gingival crevicular fluid before and after treatment were compared between the two groups, as well as the clinical therapeutic effect. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: After treatment, probing depth(PD), bleeding on probing(BOP), gingival index(GI) and plaque index (PLI) in the experimental group were lower than before treatment (P<0.05), PD, BOP and PLI in the control group were lower than before treatment (P<0.05), and PD, BOP, GI and PLI in the experimental group were significantly lower than those in control group (P<0.05). After treatment, Lactobacillus, Clostridium and Bacteroides in both groups were significantly lower than before treatment (P<0.05), and the experimental group was significantly lower than the control group(P<0.05). After treatment, adiponectin in gingival crevicular fluid increased in both groups compared with before treatment(P<0.05), and MMP-13 and IL-1β in gingival crevicular fluid decreased in both groups compared with before treatment (P<0.05), and adiponectin in gingival crevicular fluid in the experimental group was significantly higher than that in the control group (P<0.05), MMP-13 and IL-1β in the experimental group were significantly higher than that in the control group (P<0.05). After treatment, procollagenⅠtype N-terminal peptide (PINP), cross linked C-telopeptide of type Ⅰ collagen(CXT) and bone glaprotein (BGP) were significantly higher than those before treatment (P<0.05), and the experimental group was significantly higher than the control group (P<0.05). The total effective rate of the experimental group was significantly higher than that of the control group (P<0.05). CONCLUSIONS: Laser combined with periodontal basic treatment can effectively improve periodontal indexes, reduce subgingival flora, increase the levels of adiponectin and bone metabolic factor in gingival crevicular fluid, reduce the levels of MMP-13 and IL-1β in gingival crevicular fluid, and improve the clinical therapeutic effect in patients with periodontitis.

Key words: Laser, Periodontal basic treatment, Periodontitis, Subgingival flora, Adiponectin, Matrix metalloproteinase 13, Interleukin 1β

中图分类号:

R781.4

张中月, 陈丽, 闫娜, 张淑华. 激光联合牙周基础治疗对牙周炎患者牙周指标、龈下菌群及龈沟液脂联素、MMP-13、IL-1β的影响[J]. 上海口腔医学, 2024, 33(3): 295-300.

ZHANG Zhong-yue, CHEN Li, YAN Na, ZHANG Shu-hua. Effects of laser combined with periodontal basic treatment on periodontal indices, subgingival microflora, adiponectin, MMP-13 and IL-1β in gingival crevicular fluid in patients with periodontitis[J]. Shanghai Journal of Stomatology, 2024, 33(3): 295-300.

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