Yanli Yin, Chunmei Xu, Yafei Wu, Lei Zhao
Dept. of Periodontics, Stomatological Hospital of Xiangyang, Xiangyang 441000, China;State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2017 Dec 1;35(6):618-624. doi: 10.7518/hxkq.2017.06.011.
Our research aimed to detect the efficacy of non-surgical periodontal treatment with Nd: YAG laser and scaling and root planning (SRP) for chronic periodontitis.
We recruited chronic periodontitis patients who have more than four teeth with clinical pocket depth of 4-8 mm. These teeth were distributed in four different zones within the oral cavity. Moreover, the teeth were single root teeth and not adjacent to each other. The subordinated teeth were randomized into four groups, as follows: no treatment (C group), simple SRP (SRP group), Nd: YAG laser after SRP treatment (SRP+L group), and SRP after Nd: YAG laser treatment (L+SRP group). The four experimental observation points were as follows: before treatment (baseline) and 1 week, 1 month, and 3 months after treatment. We measured clinical indicators and collected subgingival deposits in the four time points to analyze changes of red complex in periodontitis.
The clinical indicators were better in all treatment groups than in the control group. Comparison among treatment groups indicated that the value of bleeding on probing, periodontal probing depth, and clinical attachment loss showed no difference. However, the value of plaque index in SRP+L and L+SRP presented a significant reduction at 3 months after treatment. The percentages of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola in all treatment groups decreased after clinical treatment, and differences were observed among the treatment groups at different time points.
Non-surgical periodontal treatment with SRP and Nd: YAG laser is not more effective than SRP monotherapy. The sequence of laser treatment and SRP has no significant effect on the treatment. However, SRP with Nd: YAG laser was beneficial for plaque control. Non-surgical periodontal treatment with Nd: YAG laser may be used as an alternative to reduce and control the proliferation of microorganisms in persistent periodontitis, but it still needs further verification.
本研究旨在检测钕钇铝石榴石（Nd:YAG）激光联合龈下刮治术和根面平整术（SRP）治疗慢性牙周炎的疗效。
招募临床牙周袋深度为4-8mm且患牙超过四颗的慢性牙周炎患者。这些牙齿分布在口腔内四个不同区域。此外，这些牙齿均为单根牙且彼此不相邻。将患牙随机分为四组，如下：不治疗组（C组）、单纯SRP组（SRP组）、SRP治疗后行Nd:YAG激光治疗组（SRP+L组）、Nd:YAG激光治疗后行SRP组（L+SRP组）。四个实验观察点如下：治疗前（基线）以及治疗后1周、1个月和3个月。在这四个时间点测量临床指标并收集龈下沉积物，以分析牙周炎中红色复合体的变化。
所有治疗组的临床指标均优于对照组。治疗组之间的比较表明，探诊出血值、牙周探诊深度和临床附着丧失值无差异。然而，SRP+L组和L+SRP组的菌斑指数在治疗后3个月时显著降低。临床治疗后，所有治疗组中牙龈卟啉单胞菌、福赛坦氏菌和具核梭杆菌的百分比均下降，且在不同时间点各治疗组之间存在差异。
SRP联合Nd:YAG激光进行非手术牙周治疗并不比单纯SRP治疗更有效。激光治疗和SRP的顺序对治疗无显著影响。然而，SRP联合Nd:YAG激光有利于菌斑控制。用Nd:YAG激光进行非手术牙周治疗可作为减少和控制持续性牙周炎中微生物增殖的一种替代方法，但仍需进一步验证。
