口腔医学 ›› 2024, Vol. 44 ›› Issue (3): 161-167.doi: 10.13591/j.cnki.kqyx.2024.03.001
• 述评 • 下一篇
肖诗梦,刘翼,李茂雪,丁一(
)
收稿日期:2024-01-15
出版日期:2024-03-28
发布日期:2024-03-20
通讯作者:
丁 一 E-mail:作者简介:丁一,四川大学华西口腔医学院牙周科教授、主任医师,博士生导师。现任中华口腔医学会牙周病学专业委员会副主任委员,中华口腔医学会口腔激光医学专业委员会候任主任委员,国际牙医师学院专家组成员(ICD fellow),香港大学牙学院和美国加州大学牙学院(UCSF)访问学者。 基金资助:
XIAO Shimeng,LIU Yi,LI Maoxue,DING Yi()
Received:2024-01-15
Online:2024-03-28
Published:2024-03-20
摘要：
牙周炎与2型糖尿病是一组具有共同危险因素的慢性炎性破坏性疾病,具有明确的双向影响关系。对伴2型糖尿病牙周炎患者的牙周治疗常存在一定的感染风险。激光辅助牙周非手术治疗能够减少细菌积累、减轻局部炎症,有利于伴2型糖尿病牙周炎患者的炎症消退与组织修复,还可能辅助控制血糖指标。该文就当前国内外的激光辅助治疗伴2型糖尿病牙周炎患者的临床研究进行总结评价,以分析激光辅助治疗对伴2型糖尿病牙周炎患者的额外增益,并探讨其潜在机制,旨在为激光辅助临床诊疗提供依据。
中图分类号:
肖诗梦, 刘翼, 李茂雪, 丁一. 激光辅助伴2型糖尿病牙周炎非手术治疗的疗效评价[J]. 口腔医学, 2024, 44(3): 161-167.
XIAO Shimeng, LIU Yi, LI Maoxue, DING Yi. Evaluation of the efficacy of laser-assisted non-surgical treatment of periodontitis with type 2 diabetes mellitus[J]. Stomatology, 2024, 44(3): 161-167.
表1
激光辅助治疗伴T2DM牙周炎患者近5年临床研究文献总结"
| 研究者(发表年份) | 研究类型 | 分组 | 激光类型 | 激光能量参数 | 观察指标 |
|---|---|---|---|---|---|
| Soi等(2021) | 随机对照试验 | SRP组; SRP+DL组 | 940 nm DL | 脉冲模式,平均功率0.8 W,脉宽1 ms,脉冲间隔1 ms,24 J,光纤直径300 μm,单侧15 s | PI、GI、PD、CAL、随机血糖、空腹血糖、HbA1c |
| Feng等 (2022) | 分口随机对照试验 | NSPT组; NSPT+Er:YAG 激光组 | 2 940 nm Er:YAG激光 | 去除结石:脉宽100 μs, 100 mJ/P,10 Hz,平均功率1.0 W,水8档气4档 袋内壁杀菌:脉宽300 μs,60 mJ/P,20 Hz,平均功率1.2 W,水8档气4档,3 min/牙 | BOP、PD、CAL、空腹血糖、HbA1c、hs-CRP |
| Sufaru等 (2022) | 随机对照试验 | SRP组; SRP+aPDT组 | 810 nm DL+ 5 mg/mL吲哚菁绿 | 吲哚菁绿1 mL处理60 s,连续波模式,0.2 W,照射60 s,总能量12 J | PI、BOP、PD、CAL、 HbA1c |
| 李凤等 (2018) | 随机对照试验 | 牙周基础治疗组; 牙周基础治疗+ LLLT组 | 808 nm DL | 连续波模式,平均输出功率0.25 W,光斑面积0.28 cm2,能量密度4 J/cm2,照射时间前牙10 s、后牙20 s | PD、SBI、CAL、HbA1、FPG,龈沟液的TNF-α、IL-1、hs-CRP、LPS及瘦素水平 |
| Dos Santos等 (2019) | 随机对照试验 | 超声治疗组; 超声治疗+PBM组 | 660 nm DL | 连续波模式,0.03 W,能量密度22 J/cm2,功率密度1.1 W/cm2,光斑面积0.028 cm2,总能量0.6 J,光纤直径600 μm,照射时间20 s | CAL、PD、BOP、PI |
| ?zberk等 (2020) | 分口随机对照试验 | NSPT组; NSPT+PBM组 | 980 nm DL | 连续波模式,0.4 W,能量密度0.5 J/cm2,光斑面积0.785 cm2,光纤直径1 cm,照射时间15 s | PD、CAL、PI、GI、龈沟液体积、龈沟液IL-1β水平 |
| Chandra等 (2018) | 随机对照试验 | SRP组; SRP+DL组 | 808 nm DL | 连续波模式,1.5~1.8 W,光纤直径320 nm | PI、GI、CAL、PD、A.actinomycetemcomitans和 P.gingivalis菌落计数 |
| Kocak等 (2020) | 随机对照试验 | SRP组; SRP+DL组 | 940 nm DL | 脉冲模式,峰值功率1.5 W,平均功率0.75 W,脉冲间隔20 ms,脉宽20 ms,平均功率密度1.061 W/cm2,光纤直径300 μm,20 s/牙 | RT-PCR检测P.gingiv-alis、T.denticola和T.forsythia |
| Cláudio等 (2021) | 随机对照试验 | SRP组; SRP+aPDT组 | 660 nm DL+10 mg/mL亚甲蓝 | 亚甲蓝处理60 s,连续波模式,0.1 W,能量密度157 J / cm2,光纤直径0.03 cm,照射50 s | CAL、PD、BOP、PI、牙龈退缩,HbA1c,RT-PCR检测P.gingivalis与P.intermedia |
| Mrasori等 (2021) | 随机对照试验 | 牙周基础治疗组; 牙周基础治疗+LLLT | 660 nm DL | 连续波模式,0.01 W,每天照射8 min | 龈沟液IL-6水平 |
| Mirza等 (2019) | 随机对照试验 | SRP; SRP+aPDT组 | 670 nm DL+ 0.005%亚甲蓝 | 0.005%亚甲蓝处理10 s,连续波模式,0.15 W,能量密度22 J/cm2,功率密度1.1 W/cm2,照射时间60 s | PI、BOP、PD、CAL、HbA1c、龈沟液内AGEs水平 |
| Barbosa等 (2018) | 随机对照试验 | NSPT组; NSPT+aPDT组 | 660 nm DL+10 mg/mL亚甲蓝 | 10 mg/mL亚甲蓝处理5 min,连续波模式,0.04 W,4.8 J/牙,照射时间2 min/牙 | PD、PI、CAL、牙龈探诊出血、HbA1c、果糖胺 |
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