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980nm 半导体激光作为非手术牙周治疗辅助手段对心肌梗死后牙周状况和炎症标志物的影响:一项随机对照试验。

Effects of a 980 nm Diode Laser as an Adjunct to Nonsurgical Periodontal Therapy on Periodontal Status and Inflammatory Markers in Patients After Myocardial Infarction: A Randomized Controlled Trial.

机构信息

Department of Periodontology, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland.

Department of Medical Analytics, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland.

出版信息

Photobiomodul Photomed Laser Surg. 2022 Aug;40(8):532-542. doi: 10.1089/photob.2021.0112. Epub 2022 Jul 29.

DOI:10.1089/photob.2021.0112
PMID:35904950
Abstract

The aim of this study was to evaluate the efficacy of diode laser (DL) therapy as an adjunct to nonsurgical periodontal therapy in the treatment of periodontitis in patients after myocardial infarction (MI). After given permission by Ethics Commission of the Pomeranian Medical University (KB-0012/06/12), 36 patients <65 years of age (mean: 56.3 ± 7.9) with periodontitis, 6 weeks to 6 months after MI were enrolled for the study. The control group ( = 18) received nonsurgical periodontal therapy, whereas the test group ( = 18) received nonsurgical periodontal therapy followed by laser therapy of the periodontal pockets with 980 nm DL, 1 W, continuous wave mode, and 20 sec per tooth side. Procedures were repeated twice at 5-7 day intervals. Clinical periodontal parameters and inflammatory markers in gingival crevicular fluid (GCF) [elastase, aspartate transaminase (AST), alanine transaminase (ALT) and interleukin (IL)-6, proteins], bloodstream [fibrinogen, high-sensitivity CRP (hs-CRP), IL-6, AST and ALT], and lipid fractions (triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol) were measured before treatment, 2 weeks, and 3 months after treatment. The difference between groups in the reduction of periodontal pocket depth (PPD) in pockets ≥7 mm was found to be significant in the test group ( < 0.05). There was also a statistically significant reduction in the volume of GCF and hs-CRP concentration in blood 2 weeks after the completion of treatment in the test group ( < 0.05). Within the limits of this study, it can be concluded that in the nonsurgical treatment of periodontitis with patients after MI, the additional use of DL enables greater reduction of PPD in pockets ≥7 mm. In addition, a faster reduction of GCF volume and hs-CRP was noted in the laser group.

摘要

本研究旨在评估二极管激光(DL)治疗作为心肌梗死后(MI)牙周炎非手术治疗辅助手段的疗效。在获得波美拉尼亚医科大学伦理委员会的许可(KB-0012/06/12)后,纳入了 36 名年龄在 65 岁以下(平均:56.3 ± 7.9 岁)、MI 后 6 周至 6 个月的牙周炎患者进行本研究。对照组(n = 18)接受非手术牙周治疗,而实验组(n = 18)接受非手术牙周治疗后,用 980nmDL 激光治疗牙周袋,1W,连续波模式,每侧牙 20 秒。两次间隔 5-7 天重复进行。治疗前、治疗后 2 周和 3 个月,测量临床牙周参数和龈沟液(GCF)中的炎症标志物[弹性蛋白酶、天门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和白细胞介素(IL)-6、蛋白]、血液[纤维蛋白原、高敏 C 反应蛋白(hs-CRP)、IL-6、AST 和 ALT]和脂质分数(甘油三酯、高密度脂蛋白、低密度脂蛋白和总胆固醇)。发现实验组牙周袋深度(PPD)≥7mm 的减小在组间有显著差异(P < 0.05)。实验组治疗结束后 2 周,GCF 体积和 hs-CRP 浓度也有统计学显著降低(P < 0.05)。在本研究范围内,可以得出结论,在 MI 后牙周炎的非手术治疗中,额外使用 DL 可以更大程度地减小 PPD≥7mm。此外,激光组还观察到 GCF 体积和 hs-CRP 更快的降低。

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