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Nd:YAG 激光在牙周炎治疗中作为龈下刮治和根面平整的辅助手段的短期评估。

A short-term evaluation of Nd:YAG laser as an adjunct to scaling and root planing in the treatment of periodontal inflammation.

机构信息

Division of Periodontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.

出版信息

J Periodontol. 2010 Aug;81(8):1161-6. doi: 10.1902/jop.2010.090700.

Abstract

BACKGROUND

This split-mouth, single-masked, randomized, controlled clinical trial compares the short-term outcomes of a combined treatment with scaling and root planing (SRP) and neodymium-doped:yttrium, aluminum, and garnet (Nd:YAG)-laser irradiation with treatment with SRP alone.

METHODS

Thirty patients were recruited. The mandibular left or right side was randomly assigned as the test side (SRP with laser treatment) or control side (SRP alone). The water-cooled Nd:YAG laser was used at 4 W, 80 mJ/pulse, 50 Hz, and with a pulse width of 350 micros. At baseline, gingival crevicular fluid (GCF) samples were taken from the test and control sides, and levels of matrix metalloproteinase (MMP)-8 and interleukin (IL)-1beta, -4, -6, and -8 were measured using standard techniques. The plaque index (PI), gingival index (GI), and probing depth (PD) were measured by calibrated examiners.

RESULTS

At the 1-week follow-up, PD (P <0.001), PI (P <0.05), and GCF volume (P <0.001) showed significant improvement on test sides compared to control sides. At the 3-month follow-up, PD (P <0.01), PI (P <0.01), GI (P <0.01), and GCF volume (P <0.05) also showed significant improvement on test sides compared to control sides. At the 1-week follow up, IL-1beta and MMP-8 levels were significantly reduced on test sides compared to control sides. The 3-month follow-up confirmed that the improvements on test sites had been sustained compared to the treatment outcomes of control sites.

CONCLUSION

In the short-term, SRP in combination with a single application of a water-cooled Nd:YAG laser significantly improves clinical signs associated with periodontal inflammation compared to treatment with SRP alone.

摘要

背景

本研究采用随机对照临床试验,比较了龈下刮治和根面平整(SRP)联合与单纯 SRP 治疗的短期疗效,前者联合应用了掺钕钇铝石榴石(Nd:YAG)激光。

方法

共纳入 30 例患者,下颌左侧或右侧随机设为试验侧(SRP 联合激光治疗)或对照侧(单纯 SRP 治疗)。Nd:YAG 激光采用水冷式,设定参数为 4 W、80 mJ/pulse、50 Hz、350 微秒脉冲宽度。于基线时,分别采集试验侧和对照侧龈沟液(GCF)样本,采用酶联免疫吸附法检测基质金属蛋白酶(MMP)-8 和白细胞介素(IL)-1β、-4、-6、-8 水平。由经过校准的检查者测量菌斑指数(PI)、龈炎指数(GI)和探诊深度(PD)。

结果

治疗后 1 周时,与对照侧相比,试验侧的 PD(P <0.001)、PI(P <0.05)和 GCF 量(P <0.001)均显著改善。治疗后 3 个月时,试验侧的 PD(P <0.01)、PI(P <0.01)、GI(P <0.01)和 GCF 量(P <0.05)仍显著优于对照侧。治疗后 1 周时,与对照侧相比,试验侧的 IL-1β和 MMP-8 水平显著降低。3 个月时的随访结果显示,与对照侧相比,试验侧的改善得以持续。

结论

短期内,与单纯 SRP 治疗相比,SRP 联合单次应用水冷式 Nd:YAG 激光可显著改善与牙周炎症相关的临床指标。

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