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臭氧疗法与光动力疗法在慢性牙周炎非手术治疗中的效果比较评估:一项双侧对照纵向研究。

Comparative evaluation of the effect of Ozone therapy and Photodynamic therapy in non-surgical management of Chronic periodontitis: A split mouth longitudinal study.

作者信息

Ameyaroy Divyasree Kochilat, Ramabhadran Biniraj Kannanganatt, Emmatty Rishi, Paul Tony Pallipurathukaran, Jose Priya

机构信息

Department of Clinical Periodontology and Oral Implantology, Royal Dental College, Palakkad, Kerala, India.

出版信息

J Indian Soc Periodontol. 2020 Sep-Oct;24(5):447-453. doi: 10.4103/jisp.jisp_381_19. Epub 2020 Jun 2.

Abstract

BACKGROUND

A split-mouth longitudinal study was conducted to compare and evaluate the effect of ozonated water and photodynamic therapy (PDT) in nonsurgical management of chronic periodontitis, along with mechanical debridement procedure.

MATERIALS AND METHODS

Twenty-two patients diagnosed with chronic generalized periodontitis were subjected to the study. Following the assessment of gingival index, periodontal pocket depth, and clinical attachment loss, all patients underwent full-mouth scaling and root planing. Upper right and left quadrants of each patient were considered as sample sites in the study. Among these split-mouth sites, upper right quadrant of each patient was subjected to ozonated water irrigation with a 22-gauge needle and left upper quadrant was treated with PDT, which involved sulcus irrigation with indocyanine green dye (0.05 mg/ml) followed by low-level diode laser light application at 0.5 W and 810 nm (AMD Picasso) through a fiber-optic tip of 10 mm length, default angle of 60°, and fiber core diameter of 400 μm in noncontact continuous wave mode. Patients were recalled at the 2 and 4 months regularly, and the therapy was repeated at the same sites in the same manner. Clinical parameters recorded before the study were assessed again at the end of the 2- and 6-month period.

RESULTS

A statistically significant reduction ( < 0.05) was observed in gingival index scores within both the study groups at all intervals of the study. In Ozone therapy (OT) group, a statistically significant difference was noted for total periodontal pocket depth values between baseline and 2 month ( = 0.000), baseline and 6 month ( = 0.000), and between 2 month and 6 month ( = 0.029). In the PDT group, on contrary, a statistically significant difference was noticed in total periodontal pocket probing depth values between baseline and 2 month ( = 0.000) and baseline to 6 month ( = 0.000), but a similar significant difference was not noticed between 2-month and 6-month periods ( = 0.269). In group OT, a statistically significant difference was noted for total clinical attachment loss between baseline and 2 month ( = 0.000), baseline and 6 months ( = 0.000), and 2 month and 6 month ( = 0.019). In group PDT, a statistically significant difference in terms of its improvement was noted at intervals between baseline and 2 months ( = 0.000) and from baseline to 6 months ( = 0.000) but not between 2 month and 6 month ( = 0.129).

CONCLUSION

Results of the study showed that sub-gingival OT and PDT equally improved the clinical outcomes of treatment drastically following mechanical debridement at the end of first 2 months. Thereafter, it was shown to improve steadily throughout the study period, with slightly better results with OT compared with PDT.

摘要

背景

进行了一项半口纵向研究,以比较和评估臭氧水和光动力疗法(PDT)在慢性牙周炎非手术治疗中的效果,并结合机械清创术。

材料与方法

22例被诊断为慢性广泛性牙周炎的患者纳入本研究。在评估牙龈指数、牙周袋深度和临床附着丧失后,所有患者均接受全口洁治和根面平整。每位患者的右上和左上象限被视为研究中的样本部位。在这些半口部位中,每位患者的右上象限用22号针头进行臭氧水冲洗,左上象限接受PDT治疗,包括用吲哚菁绿染料(0.05mg/ml)进行龈沟冲洗,然后通过长度为10mm、默认角度为60°、光纤芯直径为400μm的光纤尖端,以0.5W和810nm(AMD Picasso)的低水平二极管激光在非接触连续波模式下照射。患者在第2个月和第4个月定期复诊,并在相同部位以相同方式重复治疗。在研究结束时,再次评估研究前记录的临床参数。

结果

在研究的所有时间间隔内,两个研究组的牙龈指数评分均有统计学意义的降低(<0.05)。在臭氧治疗(OT)组中,基线与2个月(=0.000)、基线与6个月(=0.000)以及2个月与6个月之间(=0.029)的总牙周袋深度值存在统计学意义的差异。相反,在PDT组中,基线与2个月(=0.000)以及基线至6个月(=0.000)之间的总牙周袋探诊深度值存在统计学意义的差异,但在2个月和6个月之间未观察到类似的显著差异(=0.269)。在OT组中,基线与2个月(=0.000)、基线与6个月(=0.000)以及2个月与6个月之间(=0.019)的总临床附着丧失存在统计学意义的差异。在PDT组中,在基线与2个月之间(=0.000)以及从基线到6个月之间(=0.000)的改善方面存在统计学意义的差异,但在2个月和6个月之间未观察到(=0.129)。

结论

研究结果表明,龈下OT和PDT在最初2个月结束时机械清创后均能显著改善治疗的临床效果。此后,在整个研究期间均显示出稳步改善,OT的效果略优于PDT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d44/7592624/b6490b669371/JISP-24-447-g002.jpg

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