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牙髓牙周联合治疗与传统单纯牙周治疗作为重度牙周炎治疗方式的比较。

Comparison of dental pulp periodontal therapy and conventional simple periodontal therapy as treatment modalities for severe periodontitis.

作者信息

Li Lu, Chen Hong-Jie, Lian Yi, Wang Tuo

机构信息

Department of Stomatology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.

Department of Stomatology, Wuhou District People's Hospital of Chengdu, Chengdu 610041, Sichuan Province, China.

出版信息

World J Clin Cases. 2021 Nov 26;9(33):10098-10105. doi: 10.12998/wjcc.v9.i33.10098.

Abstract

BACKGROUND

Severe periodontitis is a major oral health concern today as it can lead to loss of teeth. Conventional periodontal therapy has numerous pitfalls as it does not address the pulp-periodontal complex in its entirety.

AIM

To investigate the effect of dental pulp periodontal therapy on the levels of interleukin-1β (IL-1β) and IL-10 in gingival crevicular fluid (GCF) in patients with severe periodontitis.

METHODS

Eighty-six patients with severe periodontitis were randomly divided into a research group ( = 43) and a control group ( = 43). The control group was treated with simple periodontal therapy, and the research group was treated with dental pulp periodontal therapy. The total effective rates of the treatments; periodontal status before and after treatment through the measurement of the periodontal pocket probing depth (PPD), gingival sulcus bleeding index (SBI), mobility (MD), and plaque index (PLI); the levels of inflammatory factors IL-1β and IL-10 in the GCF; and the incidence of complications were calculated for both groups and compared using the Student's test and the test.

RESULTS

The total effective rate of treatment in the study group (93.02%) was higher than that in the control group (76.74%; < 0.05). While before treatment, there was no significant difference in the PLI, MD, SBI, or PPD between the two groups, the post-treatment values of PLI, MD, SBI, and PPD (4.71 ± 0.16 mm, 0.61 ± 0.09 mm, 0.96 ± 0.17 mm, and 0.76 ± 0.26 mm, respectively) were significantly lower ( < 0.05) in the research group than in the control group (5.35 ± 0.24 mm, 0.93 ± 0.15 mm, 1.35 ± 0.30 mm, and 1.04 ± 0.41 mm, respectively). There was no significant difference in the level of IL-1β or IL-10 in the GCF before treatment between the two groups; after treatment, the IL-1β level in the research group (139.04 ± 15.54 pg/mL) was significantly lower than that in the control group (156.35 ± 18.10 pg/mL), and the level of IL-10 in the research group (7.98 ± 1.01 ug/L) was higher than that in the control group (5.56 ± 0.96 ug/L) ( < 0.05). The incidence of complications in the study group (4.65%) was significantly lower than that of the control group (18.60%; < 0.05).

CONCLUSION

Endodontic therapy and periodontal treatment for patients with severe periodontitis can effectively reduce the levels of inflammatory factors in the GCF and the inflammatory reaction. In addition, it can improve the periodontal condition and the overall treatment effect, reduce the risk of complications, and ensure the safety of treatment.

摘要

背景

重度牙周炎是当今主要的口腔健康问题,因为它会导致牙齿脱落。传统的牙周治疗存在诸多缺陷,因为它没有全面解决牙髓 - 牙周复合体问题。

目的

探讨牙髓牙周联合治疗对重度牙周炎患者龈沟液(GCF)中白细胞介素 - 1β(IL - 1β)和IL - 10水平的影响。

方法

86例重度牙周炎患者随机分为研究组(n = 43)和对照组(n = 43)。对照组采用单纯牙周治疗,研究组采用牙髓牙周联合治疗。计算两组治疗的总有效率;通过测量牙周袋探诊深度(PPD)、龈沟出血指数(SBI)、牙齿松动度(MD)和菌斑指数(PLI)评估治疗前后的牙周状况;检测GCF中炎症因子IL - 1β和IL - 10的水平;计算并发症发生率,并采用t检验和χ²检验进行比较。

结果

研究组治疗总有效率(93.02%)高于对照组(76.74%;P < 0.05)。治疗前,两组的PLI、MD、SBI或PPD无显著差异,但治疗后,研究组的PLI、MD、SBI和PPD值(分别为4.71±0.16mm、0.61±0.09mm、0.96±0.17mm和0.76±0.26mm)显著低于对照组(分别为5.35±0.24mm、0.93±0.15mm、1.35±0.30mm和1.04±0.41mm)(P < 0.05)。两组治疗前GCF中IL - 1β或IL - 10水平无显著差异;治疗后,研究组的IL - 1β水平(139.04±15.54pg/mL)显著低于对照组(156.35±18.10pg/mL),研究组的IL - 10水平(7.98±1.01μg/L)高于对照组(5.56±0.96μg/L)(P < 0.05)。研究组并发症发生率(4.65%)显著低于对照组(18.60%;P < 0.05)。

结论

重度牙周炎患者进行牙髓治疗和牙周治疗可有效降低GCF中炎症因子水平及炎症反应。此外,还可改善牙周状况和整体治疗效果,降低并发症风险,确保治疗安全。

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