Pei X Y, Yang W, Ouyang X Y, Sun F
First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100034, China.
Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Aug 18;55(4):716-720. doi: 10.19723/j.issn.1671-167X.2023.04.024.
To compare the clinical effects of periodontal endoscopy aiding subgingival debridement with periodontal flap surgery on residual deep pockets of chronic periodontitis.
In the single-blind randomized control clinical study, residual deep pockets of periodontitis patients were still existing when re-evaluation after receiving initial periodontal treatment.The pockets which were necessary for bone surgery or guided tissue regeneration surgery were excluded.The sites were divided into test group and control group randomly.Test group sites underwent periodontal endoscopy aiding debridement and control group sites had periodontal flap surgery.At the baseline and 3 months later, parameters, such as plaque index (PLI), bleeding index (BI), probing depth (PD), attachment loss (AL) were examined.Bone height was measured by parallelly digital X-ray dental film.Meanwhile, treatment time and comfort scale (visual analogue scale, VAS) were also recorded.
At baseline, 41 proximal sites with residual deep pockets were enrolled (test sites=21, control sites=20).All the parameters were not significantly different between the two groups.PD decreased by (1.67±0.91) mm from (5.62±0.86) mm to (3.95±0.74) mm in test group and by (2.25±1.12) mm from (5.95±1.19) mm to (3.70±0.73) mm in control group significantly ( < 0.05).The difference between the two groups was not significant.The PD of all the sites decreased lower than 5 mm, meanwhile, 76% was lower than 4 mm in test group and 85% was lower than 4 mm in control group.The BI decreased by 0.81±0.93 in test group and 0.65±0.99 in control group significantly ( < 0.05).The difference between the two groups was not significant.The PLI showed a tendency of decrease more in test group and bone height showed a trend of decrease more in control group, however, the difference was not significant.The treatment time was almost the same.The patients felt more comfortable in the test group (VAS was 0.60±0.89) than the control group (VAS was 1.20±1.64), however, the difference was not significant.
Periodontal endoscopy aiding subgingival debridement could improve periodontal status by reducing the PD and BI significantly in short term.The effect was almost the same with periodontal surgery and endoscopy treatment may decrease the necessity of surgery.Meanwhile, periodontal endoscopy has more comfortable treatment experience than flap surgery and does not need extra treatment time.
比较牙周内窥镜辅助龈下刮治术与牙周翻瓣术治疗慢性牙周炎残余深牙周袋的临床效果。
在单盲随机对照临床研究中，牙周炎患者在接受初始牙周治疗后复查时仍存在残余深牙周袋。排除需要骨手术或引导组织再生手术的牙周袋部位。将这些部位随机分为试验组和对照组。试验组部位采用牙周内窥镜辅助刮治，对照组部位采用牙周翻瓣术。在基线和3个月后，检查菌斑指数（PLI）、出血指数（BI）、探诊深度（PD）、附着丧失（AL）等参数。通过平行数字化牙科X线片测量骨高度。同时，记录治疗时间和舒适度量表（视觉模拟量表，VAS）。
基线时，纳入41个有残余深牙周袋的邻面部位（试验部位=21个，对照部位=20个）。两组所有参数差异均无统计学意义。试验组PD从（5.62±0.86）mm降至（3.95±0.74）mm，下降了（1.67±0.91）mm，对照组PD从（5.95±1.19）mm降至（3.70±0.73）mm，下降了（2.25±1.12）mm，差异有统计学意义（<0.05）。两组间差异无统计学意义。所有部位的PD均降至5mm以下，试验组76%低于4mm，对照组85%低于4mm。试验组BI显著下降0.81±0.93，对照组显著下降0.65±0.99（<0.05）。两组间差异无统计学意义。PLI在试验组下降趋势更明显，骨高度在对照组下降趋势更明显，但差异均无统计学意义。治疗时间基本相同。试验组患者感觉比对照组更舒适（VAS为0.60±0.89），而对照组VAS为1.20±1.64，但差异无统计学意义。
牙周内窥镜辅助龈下刮治术可在短期内通过显著降低PD和BI改善牙周状况。其效果与牙周手术基本相同，且内窥镜治疗可能减少手术必要性。同时，牙周内窥镜治疗体验比翻瓣术更舒适，且无需额外治疗时间。
