生物抗菌多肽辅助治疗Ⅲ期牙周炎的短期疗效观察

doi:10.13591/j.cnki.kqyx.2023.03.009

摘要/Abstract

摘要：

目的探讨生物抗菌多肽在辅助治疗Ⅲ期牙周炎患者中的疗效。方法将51例患者根据治疗方式随机分为单纯机械刮治组、盐酸米诺环素组和生物抗菌多肽组,3组患者均进行牙周序列治疗,超声龈上洁治后进行刮治、根面平整、抛光、冲洗。盐酸米诺环素组、生物抗菌多肽组分别于治疗后的牙周袋内注入盐酸米诺环素软膏及生物抗菌多肽牙周凝胶,单纯机械刮治组不用药。记录基线及治疗后90 d的牙周检查表,比较3组间牙周探诊深度(probing depth,PD)、牙龈出血指数(bleeding index,BI)、附着水平(attachment level,AL)差异;收集3组基线、治疗后7 d、治疗后90 d的龈沟液,利用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELSIA)检测肿瘤坏死因子-α(tumour necrosis factor-α,TNF-α)、白细胞介素(interleukin,IL)-1β变化。结果基线时,3组牙周临床检查指标(PD、BI、AL)以及龈沟液中TNF-α、IL-1β含量差异无统计学意义(P>0.05)。治疗后7 d及90 d,3组各项指标均较治疗前改善;分层分析发现,在PD≤5 mm的牙周袋中,3组间各项指标差异无统计学意义;在 PD≥6 mm的牙周袋中,盐酸米诺环素组、生物抗菌多肽组各项指标差异无统计学意义,但均优于单纯机械刮治组。结论牙周基础治疗为Ⅲ期牙周炎的重要治疗手段,对有PD≥6 mm的深牙周袋患者而言,盐酸米诺环素和生物抗菌多肽均为辅助治疗的有效药物。

关键词: 牙周炎, 生物抗菌多肽, 盐酸米诺环素

Abstract:

Objective To investigate the efficacy of antibacterial peptides in the adjuvant therapy of stage Ⅲ periodontitis. Methods Fifty-one patients were randomly divided into simple mechanical curettage group, minocycline hydrochloride group and antibacterial peptide group according to the treatment mode. Three groups received periodontal sequential treatment, and after the ultrasonic supragingival scaling, they were performed with curettage, root surface planing, polishing and flushing. After treatment in the minocycline hydrochloride group and the biological antibacterial peptide group, minocycline hydrochloride ointment and biological antibacterial peptide periodontal gel were injected into the periodontal pocket respectively. The mechanical curettage group did not take medicine. Periodontal checklists at baseline and 90 d after treatment were recorded to compare differences of the three groups in periodontal probing depth (PD), bleeding index (BI) and attachment level (AL). Enzyme-linked immunosorbent assay (ELSIA) was used to detect the change of tumour necrosis factor-α (TNF-α), interleukin (IL)-1β by collecting the gingival crevicular fluid of the three sets at baseline, 7 d after treatment and 90 d after treatment. Results There was no statistically significant difference in periodontal clinical examination indexes(PD,BI,AL) and contents of TNF-α and IL-1β in the gingival crevicular fluid between the three groups at baseline (P>0.05). At 7 and 90 d after treatment, all indexes in the three groups were improved compared with those before treatment. The comparison between groups showed that in periodontal pockets with PD≤5 mm, there was no statistically significant difference in the indicators between the three groups. In periodontal pockets with PD≥6 mm, the minocycline hydrochloride group and the bio-antibacterial peptide group had no statistically significant difference in various indicators, but they were all better than the mechanical scaling group. Conclusion Basic periodontal therapy is an important treatment for stage Ⅲ periodontitis. Minocycline hydrochloride and biological antibacterial peptides are both effective adjuvant drugs for deep periodontal pockets with PD≥6 mm.

Key words: periodontitis, biological antibacterial peptide, minocycline hydrochloride

中图分类号:

R781.4

谢咏梅, 葛化冰, 冯㛃, 刘琪, 张宁, 钟晓丽. 生物抗菌多肽辅助治疗Ⅲ期牙周炎的短期疗效观察[J]. 口腔医学, 2023, 43(3): 237-241.

XIE Yongmei, GE Huabing, FENG Jie, LIU Qi, ZHANG Ning, ZHONG Xiaoli. A short-term efficacy evaluation of biological antibacterial peptides in the adjuvant therapy of stageⅢ periodontitis[J]. Stomatology, 2023, 43(3): 237-241.

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组别	年龄/岁	性别		PD/mm	BI	AL/mm
组别	年龄/岁	男	女	PD/mm	BI	AL/mm
单纯机械刮治组	41.82±10.36	7	10	5.11±0.98	3.54±0.57	5.75±0.77
盐酸米诺环素组	39.91±11.43	8	9	5.18±0.97	3.50±0.59	5.78±0.70
生物抗菌多肽组	42.27±9.75	8	9	5.16±1.02	3.59±0.58	5.72±0.78
P	0.727	0.924		0.970	0.872	0.964

组别	PD/mm		BI		AL/mm
组别	基线	治疗后90 d	基线	治疗后90 d	基线	治疗后90 d
单纯机械刮治组	3.45±0.54	2.28±0.53^*	3.14±0.51	1.52±0.34^*	3.78±0.37	2.58±0.32^*
盐酸米诺环素组	3.41±0.57	2.21±0.57^*	3.12±0.47	1.49±0.37^*	3.72±0.31	2.51±0.33^*
生物抗菌多肽组	3.53±0.54	2.27±0.61^*	3.17±0.43	1.50±0.40^*	3.84±0.39	2.55±0.38^*

组别	PD/mm		BI		AL/mm
组别	基线	治疗后90 d	基线	治疗后90 d	基线	治疗后90 d
单纯机械刮治组	6.82±0.78	5.12±1.21^a	3.73±0.35	2.66±0.60^a	7.18±0.73	5.59±0.71^a
盐酸米诺环素组	6.80±0.79	4.34±1.22^ab	3.71±0.30	2.23±0.55 ab	7.12±0.70	5.18±0.68^ab
生物抗菌多肽组	6.75±0.74	4.28±1.32^ab	3.73±0.32	2.25±0.54^ab	7.20±0.77	5.15±0.74^ab

组别	TNF-α/(pg/mL)			IL-1β/(pg/mL)
组别	基线	治疗后7 d	治疗后90 d	基线	治疗后7 d	治疗后90 d
单纯机械刮治组	127.23±20.71	62.15±10.26^*	32.17±6.52^*	158.71±32.42	77.13±22.22^*	44.26±8.65^*
盐酸米诺环素组	134.41±18.39	61.32±13.67^*	30.37±7.53^*	161.56±35.37	74.19±25.54^*	46.32±7.74^*
生物抗菌多肽组	131.77±18.24	59.44±11.21^*	29.38±5.43^*	165.23±29.40	73.83±19.77^*	43.69±8.55^*

组别	TNF-α/(pg/mL)			IL-1β/(pg/mL)
组别	基线	治疗后7 d	治疗后90 d	基线	治疗后7 d	治疗后90 d
单纯机械刮治组	167.42±23.54	78.54±12.36^a	54.78±15.43^a	188.72±25.52	122.53±15.61^a	88.64±7.50^a
盐酸米诺环素组	175.67±25.39	65.44±16.04^ab	39.89±12.23^ab	195.63±23.32	99.05±17.83^ab	53.52±11.20^ab
生物抗菌多肽组	172.54±22.63	63.03±13.79^ab	40.02±9.55^ab	190.51±24.06	101.20±15.43^ab	54.43±12.77^ab