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用荧光控制的铒:钇铝石榴石激光辐射治疗慢性牙周炎时的白细胞介素-1β、肿瘤坏死因子-α、总抗氧化状态及微生物学结果

IL-1beta, TNF-alpha, total antioxidative status and microbiological findings in chronic periodontitis treated with fluorescence-controlled Er:YAG laser radiation.

作者信息

Domínguez Arantza, Gómez Clara, García-Kass Ana Isabel, García-Nuñez Juan Antonio

机构信息

Departamento de Química Láser, Instituto de Química Física Rocasolano, CSIC, Madrid 28006, Spain.

出版信息

Lasers Surg Med. 2010 Jan;42(1):24-31. doi: 10.1002/lsm.20873.

Abstract

BACKGROUND AND OBJECTIVE

Although some studies have attempted to elucidate the possible advantages of the use of Er:YAG laser radiation as a coadjuvant of scaling and root planing (SRP), the results have often been contradictory. A new possibility to improve the results of the laser therapy is the control of the laser radiation by a feedback system that selectively detects subgingival calculus. This study compared the effects of fluorescence-controlled Er:YAG radiation after SRP with SRP alone on the treatment of chronic periodontitis.

STUDY DESIGN/MATERIALS AND METHODS: Thirty patients with chronic periodontitis were randomly distributed into two groups of 15 patients to receive: SRP or SRP followed by fluorescence controlled Er:YAG laser (SRP+ERL). Clinical parameters including probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PI) were recorded and samples of gingival crevicular fluid (GCF) and subgingival plaque were taken at baseline, 4 and 8 weeks postoperatively. The laser therapy was performed 1 day after the SRP procedure. The GCF samples were analyzed for interleukin-1beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha) and total antioxidative status (TAS). Subgingival plaque was examined by culture for 10 bacteria.

RESULTS

During the observation periods (4 and 8 weeks postoperatively), no statistically significant differences were detected for clinical, microbiological variables and TAS of GCF between SRP and SRP+ERL groups. However, the amount of IL-1beta and TNF-alpha in GCF was increased after SRP procedure in contrast to a slight decrease of their levels after SRP+ERL treatment, where in addition the process of recolonization seems to be more delayed.

CONCLUSION

SRP+ERL allowed a decrease of the levels of proinflammatory cytokines and prevented a fast process of recolonization.

摘要

背景与目的

尽管一些研究试图阐明使用铒激光辐射作为龈下刮治术和根面平整术(SRP)辅助手段的潜在优势,但结果往往相互矛盾。通过反馈系统控制激光辐射以选择性检测龈下牙石是提高激光治疗效果的一种新方法。本研究比较了SRP联合荧光控制铒激光辐射(SRP + ERL)与单纯SRP治疗慢性牙周炎的效果。

研究设计/材料与方法:30例慢性牙周炎患者随机分为两组,每组15例,分别接受:SRP或SRP后进行荧光控制铒激光治疗(SRP + ERL)。记录包括探诊深度(PPD)、探诊出血(BOP)和菌斑指数(PI)在内的临床参数,并在基线、术后4周和8周采集龈沟液(GCF)和龈下菌斑样本。激光治疗在SRP术后1天进行。对GCF样本进行白细胞介素-1β(IL - 1β)、肿瘤坏死因子-α(TNF - α)和总抗氧化状态(TAS)分析。通过培养检测龈下菌斑中的10种细菌。

结果

在观察期(术后4周和8周),SRP组和SRP + ERL组在临床、微生物学变量及GCF的TAS方面未检测到统计学显著差异。然而,SRP术后GCF中IL - 1β和TNF - α的含量增加,而SRP + ERL治疗后其水平略有下降,此外再定植过程似乎也延迟得更多。

结论

SRP + ERL可降低促炎细胞因子水平并防止快速的再定植过程。

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