Effects of subgingival glycine powder air polishing on molar class Ⅱ furcation involvement
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摘要: 目的 观察联合使用超声龈下刮治和甘氨酸龈下喷砂治疗磨牙Ⅱ度根分叉病变的临床疗效。 方法 选取安徽医科大学附属口腔医院牙周黏膜科2017年5月—2018年5月期间就诊的32例慢性牙周炎患者,共有64颗Ⅱ度根分叉病变的磨牙。以龈上洁治疗后1周的各项指标为基线,自身随机对照研究,一侧为试验组,行超声龈下刮治和甘氨酸龈下喷砂;另一侧为对照组,采用超声龈下刮治。治疗4周、12周后复查,通过牙周临床指标、龈沟液炎性因子水平测定和苯甲酰精氨酸萘酰胺(BANA)试验评价2种治疗方式的临床疗效。 结果 2组牙周临床指标基线时差异无统计学意义(均P>0.05);治疗后4周、12周除临床附着丧失以外2组的牙周临床指标均下降且均与基线值比较差异有统计学意义(均P<0.05);肿瘤坏死因子-α和白细胞介素-6较基线值均显著下降,差异具有统计学意义(均P<0.05);BANA试验结果表明治疗4周后致病菌总体数量均下降,2组治疗前后差异均有统计学意义(均P<0.05);治疗12周后试验组仍低于对照组,2组差异有统计学意义(P<0.01)。 结论 在12周的观察期内,甘氨酸龈下喷砂联合超声龈下刮治可有效改善磨牙Ⅱ度根分叉病变的临床症状和炎症水平,相较于单独超声龈下刮治更利于治疗效果的长期保持。Abstract: Objective To evaluate the clinical effect of subgingival ultrasonic scaling and subgingival glycine powder air polishing in the treatment of class Ⅱ furcation involvement. Methods Sixty-four class Ⅱ furcation involvement molars from thirty-two severe chronic periodontitis patients in Stomatological Hospital of Anhui Medical University from May 2017 to May 2018 were selected. Everyone had two class Ⅱ furcation involvement molars at least. One week after the supragingival scaling, the clinical index were taken as the baseline data. The principle of oral control design was adopted. One side of the same patient's teeth was randomly designed as experimental group, subgingival scaling and subgingival glycine powder air polishing was performed, the other side as control group, subgingival scaling was performed. After 4 weeks and 12 weeks, the periodontal clinical indicators, inflammatory factor from gingival crevicular fluid and BANA test were reviewed to evaluate the clinical effects. Results The differences between the two groups in baseline were not significant (all P>0.05). The data of 4 weeks and 12 weeks after the treatment were analyzed using repeat measurement test, except CAL, the other observed periodontal clinical index were all significantly improved after the treatment (all P<0.05). The level of tumor necrosis factor-α and interleukin-6 were all lower as compared with those at baseline. BANA results showed that the overall quantity of pathogens decreased in both groups after 4 weeks of treatment (all P<0.05). Twelve week later, the overall quantity of pathogens in the experimental group was still lower than that in the control group, and the difference was significant (P<0.01). Conclusion During 12 weeks of follow-up, subgingival ultrasonic scaling combine subgingival glycine powder air polishing can effectively improve the clinical symptoms and inflammatory response of class Ⅱ furcation involvement, which can maintain the long-term therapeutic effect when compared with subgingival scaling only.
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