口腔医学 ›› 2025, Vol. 45 ›› Issue (10): 760-764.doi: 10.13591/j.cnki.kqyx.2025.10.007

• 基础与临床研究 • 上一篇    下一篇

光动力疗法联合甘氨酸龈下喷砂对治疗Ⅲ期牙周炎残留牙周袋的临床疗效研究

许悦, 夏娇娇, 陈玉莲, 陈强()   

  1. 苏州口腔医院牙周病科,江苏苏州(215000)
  • 收稿日期:2024-10-08 出版日期:2025-10-28 发布日期:2025-10-23
  • 通讯作者: 陈 强 Tel:(0512)67770696 E-mail:chenqiang@szkqyy.com

Clinical efficacy of photodynamic therapy combined with subgingival glycine powder air polishing for the management of residual periodontal pocket of stage Ⅲ periodontitis

XU Yue, XIA Jiaojiao, CHEN Yulian, CHEN Qiang()   

  1. Department of Periodontology, Suzhou Stomatological Hospital, Suzhou 215000, China
  • Received:2024-10-08 Online:2025-10-28 Published:2025-10-23

摘要:

目的 探讨光动力疗法(photodynamic therapy,PDT)联合甘氨酸龈下喷砂(subgingival glycine powder air polishing,SubGPAP)辅助龈下刮治,对Ⅲ期牙周炎患者牙周基础治疗后残留牙周袋的临床治疗效果和牙周微环境的影响。方法 选取本院牙周病科就诊的40例Ⅲ期牙周炎患者,以牙周基础治疗后4~6周复查时探诊深度(probing depth,PD)>4 mm伴探诊出血(bleeding on probing,BOP)或PD≥6 mm的残留牙周袋为研究对象,采用自身对照研究,口内一侧进行龈下刮治根面平整(subgingival scaling and root planing,SRP)(对照组),另一侧采用PDT+SubGPAP+SRP(试验组),比较两组在基线、治疗后6周及治疗后3个月临床指标水平变化,包括PD、临床附着丧失(clinical attachment loss,CAL)、出血指数(bleeding index,BI)和菌斑指数(plaque index,PLI)以及龈沟液白细胞介素-6(interleukin 6,IL-6)、白细胞介素-1β(interleukin 1β,IL-1β)和肿瘤坏死因子-α(tumor necrosis factor α,TNF-α)水平变化。结果 与基线比较,两组在治疗后6周和治疗后3个月各项临床指标水平均明显降低(P<0.05);与治疗后6周比较,治疗后3个月时试验组TNF-α水平无明显差异(P>0.05),其余各组各项指标水平均明显降低(P<0.05);试验组治疗后6周和治疗后3个月PD、CAL、BI及IL-6、IL-1β、TNF-α均明显低于对照组(P<0.05),PLI仅在治疗后6周显著低于对照组(P<0.05)。结论 PDT结合SubGPAP有助于改善Ⅲ期牙周炎患者残留牙周袋的临床疗效以及牙周微环境。

关键词: 光动力疗法, 甘氨酸龈下喷砂, Ⅲ期牙周炎, 残留牙周袋

Abstract:

Objective To explore the efficacy and the impact on the periodontal microenvironment of photodynamic therapy (PDT) combined with subgingival glycine powder air polishing (SubGPAP) for patients with stage Ⅲ periodontitis on residual periodontal pockets. Methods Forty patients who visited the Department of Periodontology at our hospital with stage Ⅲ periodontitis were selected. After 4-6 weeks of initial treatment, the residual periodontal pockets of >4 mm depth with bleeding on probing, or ≥6 mm depth were randomly assigned in a split-mouth design, to receive subgingival scaling and root planning (SRP) (control group) or PDT+ SubGPAP + SRP (test group). Indicators including probing depth (PD), clinical attachment loss (CAL), bleeding index (BI), plaque index (PLI), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) at baseline, 6 weeks and 3 months after treatment were measured and compared. Results The clinical indicators showed significant reductions in both groups at 6 weeks and 3 months compared with those at baseline (P<0.05). The TNF-α in test group showed no significant difference at 3 months compared with 6 weeks (P>0.05), while the other indicators in both groups showed significant reductions at 3 months compared with those at 6 weeks (P<0.05). The PD, CAL, BI, TNF-α, IL-6 and IL-1β in test group showed a significant reduction than those in the control group at 6 weeks and 3 months(P<0.05). The PLI in test group showed a significant reduction at 6 weeks (P<0.05). Conclusion PDT combined with SubGPAP assisted SRP for patients with stage Ⅲ periodontitis on residual periodontal pockets is conducive to enhancing the clinical efficacy and improving the microenvironment.

Key words: photodynamic therapy, subgingival glycine powder air polishing, stage Ⅲ periodontitis, residual periodontal pocket

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