铒钕双波长激光辅助吸烟牙周炎患者非手术治疗的临床效果评价

doi:10.13591/j.cnki.kqyx.2025.12.006

摘要/Abstract

摘要：

目的探讨并比较Er:YAG激光联合Nd:YAG激光辅助吸烟和非吸烟Ⅲ期C级牙周炎患者非手术治疗的临床效果。方法选取2023年3月—2024年5月在临沂市人民医院牙周病科就诊的52例Ⅲ期C级牙周炎患者,共208颗患牙,分为吸烟对照组(SP组)、吸烟试验组(ST组)、非吸烟对照组(NSP组)、非吸烟试验组(NST组)。所有对照组采用常规龈下刮治和根面平整术治疗,所有试验组在此基础上给予铒钕双波长激光(Er:YAG激光联合Nd:YAG激光)辅助治疗。记录基线、治疗后1个月和治疗后6个月菌斑指数(plaque index,PLI)、牙龈指数(gingival index,GI)、探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)。每例患者在治疗后3 h采用视觉模拟量表(visual analog scale,VAS)对治疗过程中的不适程度进行评估。结果治疗后1、6个月,所有牙周指数较基线时均显著降低(P<0.05);各组间PLI、GI无显著性差异(P>0.05);ST组、NST组PD、AL分别明显低于SP组、NSP组(P<0.05),NSP组、NST组PD、AL分别明显低于SP组、ST组(P<0.05)。治疗后3 h各组间VAS无显著性差异(P>0.05)。结论铒钕双波长激光可作为吸烟牙周炎患者基础治疗的有效辅助方法,有利于该类患者非手术治疗后的组织愈合。

关键词: Er:YAG激光, Nd:YAG激光, Ⅲ期C级牙周炎, 吸烟, 牙周指数

Abstract:

Objective To explore and compare the clinical effects of Er: YAG laser combined with Nd: YAG laser assisted non-surgical treatment of smoking and non-smoking patients with Stage Ⅲ Grade C periodontitis. Methods A total of 52 patients with Stage Ⅲ Grade C periodontitis who visited the Periodontology Department of Linyi People’s Hospital from March 2023 to May 2024 were selected. A total of 208 teeth were collected. The subjects were divided into four groups: smoker control group (SP group), smoker experimental group (ST group), non-smoker control group (NSP group), non-smoker experimental group (NST group). The control groups were treated with subgingival scaling and root planing, while the experimental groups were treated with Er: YAG laser combined with Nd: YAG laser assisted therapy on the basis of subgingival scaling and root planing. The plaque index (PLI), gingival index (GI), probing depth (PD) and attachment loss (AL) were recorded at baseline, 1 month, and 6 months after treatment. Three hours after treatment, each patient used the visual analogue scale (VAS) to assess the level of discomfort experienced during the treatments. Results After 1 and 6 months of treatment, all periodontal indices were significantly reduced compared to those before treatment (P<0.05). There were no significant differences in PLI, GI changes among the groups (P>0.05). The PD and AL in the ST group and NST group were significantly lower than those in the SP group and NSP group, respectively (P<0.05), and the PD and AL in the NSP group and NST group were significantly lower than those in the SP group and ST group, respectively (P<0.05). After 3 h of treatment, there was no significant difference in VAS scores among the groups (P>0.05). Conclusion Erbium-neodymium dual-wavelength laser can serve as an adjunctive method for the basic treatment of smoking-related periodontitis patients, potentially facilitating the healing response in those patients after non-surgical treatment.

Key words: Er:YAG laser, Nd:YAG laser, Stage Ⅲ Grade C periodontitis, smoking, periodontal index

中图分类号:

R781.4

赛云涛, 王智, 耿淳, 赵宁, 朱超. 铒钕双波长激光辅助吸烟牙周炎患者非手术治疗的临床效果评价[J]. 口腔医学, 2025, 45(12): 914-918.

SAI Yuntao, WANG Zhi, GENG Chun, ZHAO Ning, ZHU Chao. Clinical effect evaluation of Er:YAG and Nd:YAG dual-wavelength laser assisted non-surgical treatment for smoking periodontitis patients[J]. Stomatology, 2025, 45(12): 914-918.

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时间	SP组	ST组	NSP组	NST组
基线	2.80(2.60,3.18)	2.82(2.63,3.10)	2.82(2.60,3.08)	2.79(2.62,3.09)
治疗后1个月	0.91(0.80,1.10)^*	0.90(0.78,1.05)^*	0.88(0.73,1.03)^*	0.90(0.81,1.08)^*
治疗后6个月	0.90(0.83,1.10)^*	0.89(0.80,1.02)^*	0.90(0.78,1.11)^*	0.88(0.80,1.10)^*

时间	SP组	ST组	NSP组	NST组
基线	1.51(1.42,1.53)	1.49(1.40,1.50)	1.80(1.82,1.90)^b	1.79(1.71,1.92)^c
治疗后1个月	0.78(0.70,0.90)^a	0.82(0.70,0.89)^a	0.80(0.73,0.90)^a	0.80(0.72,0.88)^a
治疗后6个月	0.81(0.70,0.91)^a	0.80(0.70,0.90)^a	0.79(0.73,0.93)^a	0.80(0.75,1.00)^a

时间	SP组	ST组	NSP组	NST组
基线	5.70(5.50,6.01)	5.75(5.33,6.03)	5.72(5.40,5.98)	5.60(5.33,5.95)
治疗后1个月	4.20(4.06,4.47)^a	3.50(3.43,3.68)^ab	3.52(3.43,3.70)^ad	3.11(2.97,3.19)^ace
治疗后6个月	4.33(4.18,4.51)^a	3.51(3.43,3.71)^ab	3.51(3.40,3.55)^ad	3.10(2.90,3.21)^ace

时间	SP组	ST组	NSP组	NST组
基线	5.75(5.52,6.08)	5.72(5.30,5.88)	5.80(5.64,6.05)	5.76(5.51,5.93)
治疗后1个月	4.32(4.15,4.50)^a	3.45(3.20,3.66)^ab	3.57(3.33,3.78)^ad	3.18(2.90,3.27)^ace
治疗后6个月	4.28(4.03,4.47)^a	3.50(3.32,3.73)^ab	3.61(3.42,3.84)^ad	3.20(3.05,3.34)^ace