钕钇铝石榴石激光和二氧化碳激光治疗以及超声洁治对慢性牙周炎患者牙周袋的影响。

Effects of Nd:YAG and CO2 laser treatment and ultrasonic scaling on periodontal pockets of chronic periodontitis patients.

作者信息

Miyazaki Akira, Yamaguchi Toshikazu, Nishikata Jun, Okuda Kazuhiro, Suda Satoru, Orima Kazuko, Kobayashi Tetsuo, Yamazaki Kazuhisa, Yoshikawa Eiji, Yoshie Hiromasa

机构信息

Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

J Periodontol. 2003 Feb;74(2):175-80. doi: 10.1902/jop.2003.74.2.175.

DOI:10.1902/jop.2003.74.2.175

PMID:12666705

Abstract

BACKGROUND

The aim of the present study was to compare the effectiveness of Nd:YAG and CO2 laser treatment to that of ultrasonic scaling used as monotherapies by examining clinical parameters, subgingival microflora, and interleukin-1 beta (IL-1beta) in gingival crevicular fluid (GCF).

METHODS

Eighteen patients, each of whom had 2 or more sites with probing depth measuring > 5 mm, were included this clinical trial. The 41 sites were randomly assigned treatment with either Nd:YAG laser alone (n = 14, 100 mj, 20 pps, 2.0 W, 120 seconds), CO2 laser alone (n = 13, 2.0 W, 120 seconds), or ultrasonic scaling alone (n = 14, maximum power, 120 seconds). At baseline and at 1, 4, and 12 weeks, clinical measurements (plaque index, PI; gingival index, GI; probing depth, PD; clinical attachment level, CAL; and bleeding on probing, BOP) were performed and subgingival plaque and GCF sampled. A quantitative analysis of Porphyromonas gingivalis was carried out using real-time polymerase chain reaction (PCR) procedures. The amounts of IL-1beta were estimated by an enzyme-linked immunosorbent assay (ELISA).

RESULTS

Decreased inflammation and PD were observed in all 3 groups after treatment. A microbiological analysis indicated significant decreases in P. gingivalis in the Nd:YAG and scaling groups at 1, 4, and 12 weeks compared to baseline (P < 0.05). The amount of GCF significantly decreased in the Nd:YAG and scaling groups at 12 weeks. The amount of IL-1beta increased in the CO2 group from baseline to 1 week (P < 0.05). The Nd:YAG group tended to show a decrease in IL-1beta from 1 to 12 weeks, although these data were not statistically significant.

CONCLUSIONS

Our data suggest that Nd:YAG laser and ultrasonic scaling treatments showed significant improvements regarding the clinical parameters and subgingival microflora compared to the baseline, but no significant difference was observed between the 3 groups.

摘要

背景

本研究的目的是通过检查临床参数、龈下微生物群以及龈沟液（GCF）中的白细胞介素-1β（IL-1β），比较钕钇铝石榴石（Nd:YAG）激光和二氧化碳（CO2）激光治疗与超声龈上洁治作为单一疗法的有效性。

方法

18名患者纳入本临床试验，每名患者有2个或更多探诊深度>5mm的部位。41个部位被随机分配接受以下治疗：单独使用Nd:YAG激光（n = 14，100 mj，20脉冲每秒，2.0 W，120秒）、单独使用CO2激光（n = 13，2.0 W，120秒）或单独使用超声龈上洁治（n = 14，最大功率，120秒）。在基线以及第1、4和12周时，进行临床测量（菌斑指数，PI；牙龈指数，GI；探诊深度，PD；临床附着水平，CAL；探诊出血，BOP）并采集龈下菌斑和GCF。使用实时聚合酶链反应（PCR）程序对牙龈卟啉单胞菌进行定量分析。通过酶联免疫吸附测定（ELISA）估计IL-1β的量。

结果

治疗后所有3组均观察到炎症减轻和PD降低。微生物学分析表明，与基线相比，Nd:YAG激光组和龈上洁治组在第1、4和12周时牙龈卟啉单胞菌显著减少（P < 0.05）。在第12周时，Nd:YAG激光组和龈上洁治组的GCF量显著减少。从基线到第1周，CO2激光组的IL-1β量增加（P < 0.05）。Nd:YAG激光组从第1周到第12周IL-1β呈下降趋势，尽管这些数据无统计学意义。