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低强度二极管激光光动力疗法在种植体周围炎非手术治疗中的疗效评估

Evaluation of Effectiveness of Photodynamic Therapy With Low-level Diode Laser in Nonsurgical Treatment of Peri-implantitis.

作者信息

Birang Ehsan, Talebi Ardekani Mohammad Reza, Rajabzadeh Mahboobeh, Sarmadi Gloria, Birang Reza, Gutknecht Norbert

机构信息

School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Lasers Med Sci. 2017 Summer;8(3):136-142. doi: 10.15171/jlms.2017.25. Epub 2017 Jun 27.

Abstract

Side effects related to antibiotic therapy for peri-implantitis are rare in laser therapy (LT); therefore, the aim of this study was to evaluate the effectiveness of LT and photodynamic therapy (PDT) on patients with primary peri-implantitis. In this randomized clinical trial, 40 implants presenting primary peri-implantitis in 20 patients with a mean age of 52.6 years old were included using the simple sampling technique. Periodontal treatment comprising scaling and root planing (SRP) was accomplished for the whole mouth while mechanical debridement with titanium curettes and air polishing with sodium bicarbonate powder was accomplished around the implants. The implants were randomly divided into two groups and treated with LT (control) and PDT (test). The clinical indices were measured at baseline, 6 weeks and 3 months after treatment. Real-time polymerase chain reaction (PCR) was used for analysis of microbial samples at baseline and 3-month follow-up. Data were analyzed with SPSS 20, using repeated-measures analysis of variance (ANOVA) and Friedman's and Mann-Whitney tests (α = 0.05). Both groups showed statistically significant improvements in terms of bleeding on probing ( < 0.001), probing pocket depth (PPD) ( = 0.006) and modified plaque index ( < 0.001), with no significant differences between the 2 groups ( > 0.05). The number of Aggregatibacter actinomycetemcomitans ( = 0.022), Tannerella forsythia ( = 0.038) and Porphyromonas gingivalis (P = 0.05) in the test group and Porphyromonas gingivalis ( = 0.015) in the control group significantly decreased. The results suggested that LT and PDT have significant short-term benefits in the treatment of primary peri-implantitis.

摘要

在激光治疗(LT)中,与种植体周围炎抗生素治疗相关的副作用很少见;因此,本研究的目的是评估LT和光动力疗法(PDT)对原发性种植体周围炎患者的有效性。在这项随机临床试验中,采用简单抽样技术纳入了20名平均年龄为52.6岁的患者的40颗出现原发性种植体周围炎的种植体。对全口进行了包括龈下刮治和根面平整(SRP)在内的牙周治疗,同时在种植体周围用钛刮治器进行机械清创并用碳酸氢钠粉末进行空气抛光。将种植体随机分为两组,分别用LT(对照组)和PDT(试验组)进行治疗。在治疗前、治疗后6周和3个月测量临床指标。在基线和3个月随访时,采用实时聚合酶链反应(PCR)分析微生物样本。使用SPSS 20软件进行数据分析,采用重复测量方差分析(ANOVA)以及Friedman检验和Mann-Whitney检验(α = 0.05)。两组在探诊出血(< 0.001)、探诊袋深度(PPD)( = 0.006)和改良菌斑指数(< 0.001)方面均显示出统计学上的显著改善,两组之间无显著差异(> 0.05)。试验组中伴放线聚集杆菌( = 0.022)、福赛坦纳菌( = 0.038)和牙龈卟啉单胞菌(P = 0.05)以及对照组中牙龈卟啉单胞菌( = 0.015)的数量均显著减少。结果表明,LT和PDT在治疗原发性种植体周围炎方面具有显著的短期益处。

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