Uysal Özge, Ustaoğlu Gülbahar, Behçet Mustafa, Albayrak Önder, Tunalı Mustafa
Department of Periodontology, Dentistry Faculty, Bolu Abant Izzet Baysal University, Bolu, Turkey.
Department of Medical Microbiology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey.
J Periodontal Implant Sci. 2022 Apr;52(2):116-126. doi: 10.5051/jpis.2102080104.
This study evaluated the efficacy of treating periodontitis using subgingival nano-hydroxyapatite powder with an air abrasion device (NHAPA) combined with scaling and root planing (SRP).
A total of 28 patients with stage III periodontitis (grade B) were included in this study, although 1 was lost during follow-up and 3 used antibiotics. The patients were divided into a test group and a control group. All patients first received whole-mouth SRP using hand instruments, and a split-mouth approach was used for the second treatment. In the test group, the teeth were treated with NHAPA for 15 seconds at 70% power per pocket. Subgingival plaque samples were obtained from the 2 deepest pockets at the test and control sites before treatment (baseline) and 3 months after treatment. The full-mouth plaque index (PI), gingival index (GI), papillary bleeding index (PBI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and at 1- and 3-month post-treatment. Real-time polymerase chain reaction was used to determine the colonisation of (), (), and in the subgingival plaque.
From baseline to the first month, the test group showed significantly larger changes in BOP and CAL (43.705%±27.495% and 1.160±0.747 mm, respectively) than the control group (36.311%±27.599% and 0.947±0.635 mm, respectively). Periodontal parameters had improved in both groups at 3 months. The reductions of PI, GI, BOP, PD, and CAL in the test group at 3 months were greater and statistically significant. The total bacterial count and and species had decreased significantly by the third month in both groups (<0.05).
Applying NHAPA in addition to SRP improves clinical periodontal parameters more than SRP alone. Subgingival NHAPA may encourage clot adhesion to tooth surfaces by increasing surface wettability.
本研究评估了使用空气喷砂装置配合龈下纳米羟基磷灰石粉末(NHAPA)联合龈上洁治和根面平整术(SRP)治疗牙周炎的疗效。
本研究共纳入28例III期牙周炎(B级)患者,尽管1例在随访期间失访,3例使用了抗生素。将患者分为试验组和对照组。所有患者首先使用手工器械进行全口SRP治疗,第二次治疗采用分口对照法。试验组中,每个牙周袋以70%的功率用NHAPA治疗15秒。在治疗前(基线)和治疗后3个月,从试验组和对照组部位最深的2个牙周袋中获取龈下菌斑样本。在基线以及治疗后1个月和3个月时记录全口菌斑指数(PI)、牙龈指数(GI)、龈乳头出血指数(PBI)、探诊出血(BOP)、探诊深度(PD)和临床附着水平(CAL)。采用实时聚合酶链反应测定龈下菌斑中()、()和()的定植情况。
从基线到第1个月,试验组的BOP和CAL变化(分别为43.705%±27.495%和1.160±0.747 mm)显著大于对照组(分别为36.311%±27.599%和0.947±0.635 mm)。两组在3个月时牙周参数均有所改善。试验组在3个月时PI、GI、BOP、PD和CAL的降低幅度更大且具有统计学意义。到第3个月时,两组的总细菌计数以及()和()菌属均显著减少(<0.05)。
除SRP外应用NHAPA比单独使用SRP能更有效地改善临床牙周参数。龈下NHAPA可能通过增加表面润湿性促进血凝块附着于牙面。