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比较 Bur 磨除法和 CO2 激光治疗牙龈色素沉着:6 个月随访。

Comparison of Bur Abrasion and CO2 Laser in Treatment of Gingival Pigmentation: 6 Months Follow-Up.

出版信息

Oral Health Prev Dent. 2021 Jun 1;19:321-326. doi: 10.3290/j.ohpd.b1492771.

Abstract

PURPOSE

Pigmentation of gingiva is an aesthetic problem. Until now, various methods have been introduced for removal of gingival pigmentation. The purpose of this study was to compare bur abrasion and CO2 laser methods in removing gingival pigmentation.

MATERIALS AND METHODS

Twelve patients aged 20-40 years old with the chief complaint of physiologic gingival pigmentation participated in this study. For these patients, gingival depigmentation was performed using two treatment modalities including bur abrasion and CO2 laser in a split-mouth design. Gingival depigmentation was performed in the right half of the anterior maxillary and mandibular sextants using bur abrasion method by means of diamond bur on a high-speed headpiece with vigorous water irrigation and the left half of the anterior maxillary and mandibular sextants using a CO2 laser. CO2 laser was set at: peak power 252 watts, repeat time 20 ms and pulse duration 200 microsecond which was used in a non-contact position. The area of pigmentation was calculated via gridlines in the Microsoft Paint software 1 and 6 months after the procedure. Gingival recession was also determined before, and at 1 and 6 months after the procedure.

RESULTS

The area of gingival pigmentation was not statistically significantly different between the two treatment modalities before the procedure (p = 0.452), 1 month (p = 0.443) and 6 months after the procedure (p = 0.202). There was no statistically significant difference in the variance of pigmented area at different times in the two methods. In both CO2 laser and bur abrasion methods, the mean area of pigmentation was statistically significantly different in the follow-up period (p < 0/001), in a way that the change in the area of pigmentation was statistically significant 1 month after treatment (p <0.001) and also 6 months after treatment (p < 0.001) compared to before. The change in the area of pigmentation between 1 and 6 months after treatment was not statistically significant in both CO2 laser (p = 0.157) and bur abrasion method (p = 0.150). No increase in gingival recession was observed in any of the patients.

CONCLUSION

Both treatment modalities can effectively treat gingival pigmentation. No increase in gingival recession was observed. Conventional method and CO2 laser were not statistically significantly different during a follow-up period of 1 and 6 months.

摘要

目的

牙龈着色是一个美学问题。到目前为止,已经介绍了各种去除牙龈色素沉着的方法。本研究的目的是比较喷砂洁牙和 CO2 激光两种方法去除牙龈色素沉着的效果。

材料和方法

本研究纳入了 12 名年龄在 20-40 岁之间、主诉为生理性牙龈色素沉着的患者。这些患者采用两种治疗方法中的一种进行牙龈脱色治疗,治疗部位为上前牙和下颌前牙的左右半口,治疗方法分别为喷砂洁牙和 CO2 激光。采用金刚砂车针对高速机头进行喷砂洁牙,以强水流冲洗,用钻石车针对上前牙和下颌前牙的左右半口进行 CO2 激光治疗。CO2 激光参数设置为:峰值功率 252 瓦,重复时间 20 毫秒,脉冲持续时间 200 微秒,采用非接触式位置。在 Microsoft Paint 软件中通过网格线计算色素沉着区域,并在治疗后 1 个月和 6 个月进行评估。在治疗前、治疗后 1 个月和 6 个月还分别测量了牙龈退缩情况。

结果

治疗前(p = 0.452)、治疗后 1 个月(p = 0.443)和 6 个月(p = 0.202),两种治疗方法的牙龈色素沉着面积无统计学差异。两种方法不同时间点色素沉着面积的方差无统计学差异。在 CO2 激光和喷砂洁牙两种方法中,随访期间平均色素沉着面积均有统计学差异(p < 0.001),治疗后 1 个月(p <0.001)和 6 个月(p < 0.001)与治疗前相比,色素沉着面积的变化均有统计学意义。CO2 激光(p = 0.157)和喷砂洁牙(p = 0.150)两种方法治疗后 1 个月至 6 个月之间色素沉着面积的变化无统计学差异。治疗后,所有患者的牙龈退缩均无增加。

结论

两种治疗方法均可有效治疗牙龈色素沉着,且均无牙龈退缩增加。在 1 个月和 6 个月的随访期内,CO2 激光与传统方法的疗效无统计学差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dbf/11641478/6dc551306da7/ohpd-19-321-g001.jpg

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