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牙周内窥镜下刮治和根面平整术治疗慢性牙周炎残余牙周袋的疗效:一项随机对照临床试验

Efficacy of scaling and root planning with periodontal endoscopy for residual pockets in the treatment of chronic periodontitis: a randomized controlled clinical trial.

作者信息

Wu Juan, Lin Liangyuan, Xiao Jianping, Zhao Jie, Wang Ningxiang, Zhao Xingxing, Tan Baochun

机构信息

Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, 30 Zhongyang Road, Xuanwu District, Nanjing, 210008, Jiangsu, China.

Department of Stomatology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

出版信息

Clin Oral Investig. 2022 Jan;26(1):513-521. doi: 10.1007/s00784-021-04029-w. Epub 2021 Jun 18.

Abstract

OBJECTIVES

Residual pockets are a risk factor of periodontitis progression. This study evaluated the efficacy of periodontal endoscopy (PE) during scaling and root planning (SRP) of residual pockets in chronic periodontitis patients after initial periodontal treatment.

MATERIALS AND METHODS

A single-blinded, randomized controlled clinical trial was conducted in systemically healthy subjects presenting at least three residual pockets with a probing depth (PD) ≥ 5 mm in each quadrant. Subjects were randomly allocated to one of two trial groups using a computer-generated program: SRP + PE (test group) or SRP alone (control group). Clinical parameters (PD, clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PLI)) were then measured at baseline, 3-, and 6-month follow-up.

RESULTS

A total of 1629 sites in 37 patients were examined. Both treatments significantly improved all clinical outcomes (PD, CAL, BOP, and PLI) from baseline to 6 months (P < 0.05), although greater reductions in PD and PLI were observed in the test group at both 3- (PD: 3.45 ± 0.56 vs. 4.14 ± 0.59 mm; PLI: 0.55 ± 0.23 vs. 0.73 ± 0.27) and 6-month follow-up (PD: 3.12 ± 0.63 vs. 4.0 ± 0.68 mm; PLI: 0.49 ± 0.21 vs. 0.72 ± 0.28, respectively; P = 0.001 for PD and P = 0.021 for PLI). No significant differences in CAL or BOP were observed.

CONCLUSIONS

SRP + PE resulted in significant reductions in PD and PLI compared to SRP alone in residual pockets with a PD ≥ 5 mm.

CLINICAL RELEVANCE

The findings highlight the benefits of SRP + PE, supporting use as an alternative strategy in nonsurgical periodontal treatment.

摘要

目的

残余牙周袋是牙周炎进展的危险因素。本研究评估了牙周内窥镜检查(PE)在慢性牙周炎患者初始牙周治疗后残余牙周袋的龈下刮治和根面平整(SRP)过程中的疗效。

材料与方法

在全身健康的受试者中进行了一项单盲随机对照临床试验,这些受试者每个象限至少有三个探诊深度(PD)≥5mm的残余牙周袋。使用计算机生成程序将受试者随机分配到两个试验组之一:SRP + PE(试验组)或仅SRP(对照组)。然后在基线、3个月和6个月随访时测量临床参数(PD、临床附着水平(CAL)、探诊出血(BOP)和菌斑指数(PLI))。

结果

共检查了37例患者的1629个位点。两种治疗方法均使所有临床指标(PD、CAL、BOP和PLI)从基线到6个月均有显著改善(P < 0.05),尽管试验组在3个月(PD:3.45±0.56 vs. 4.14±0.59mm;PLI:0.55±0.23 vs. 0.73±0.27)和6个月随访时(PD:3.12±0.63 vs. 4.0±0.68mm;PLI:0.49±0.21 vs. 0.72±0.28,PD的P = 0.001,PLI的P = 0.021)观察到PD和PLI有更大程度的降低。CAL或BOP未观察到显著差异。

结论

与仅进行SRP相比,SRP + PE在PD≥5mm的残余牙周袋中可显著降低PD和PLI。

临床意义

研究结果突出了SRP + PE的益处,支持其作为非手术牙周治疗的替代策略使用。

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