【摘要】 目的探讨Er:YAG激光在重度牙周炎患者牙周翻瓣术的应用效果,旨在为临床提供参考。方法将2016年1月至2018年12月医院收治的拟进行牙周翻瓣术的60例重度牙周炎患者纳入研究,根据患者治疗意愿分为观察组(n=30)和对照组(n=30)。对照组患者采用单纯牙周翻瓣术治疗,观察组在对照组基础上以Er:YAG激光辅助治疗。比较两组患者临床疗效,术前、术后3、6和12个月牙周临床指标,术前、术后24 h和72 h炎症因子水平。利用视觉模拟评分(VAS)和匹兹堡睡眠质量指数(PSQI)评估两组患者术前、术后24 h和72 h牙痛症状和睡眠质量,观察术后并发症发生情况。结果观察组临床总有效率高于对照组(P<0.05);两组患者术后3、6和12个月探诊深度(PD)、临床附着丧失(CAL)较术前减小,菌斑指数(PLI)、牙龈指数(GI)和龈沟出血指数(SBI)较术前降低,观察组变化明显(P<0.05);两组患者术后24 h和72 h白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)水平明显低于术前,观察组变化明显(P<0.05);两组患者术后24 h和72 hVAS评分和PSQI指数明显低于术前,观察组变化明显(P<0.05);研究期间观察组患者未出现因激光治疗引起的牙槽骨高度及骨密度降低和骨结构改变。结论 Er:YAG激光可促进重度牙周炎患者牙龈附着水平恢复提高牙周组织与压根面贴合,同时能改善牙龈附着水平缓解牙龈炎症,值得临床推广应用。更多还原

【Abstract】 Objective To explore the effect of Er:YAG laser in the treatment of severe periodontitis patients with periodontal flap.Methods 60 patients with severe periodontitis who were admitted to the hospital from January 2016 to December 2018 for periodontal flap surgery were included in the study,and they were divided into observation group(n=30) and control group(n=30) according to their treatment wishes.The control group were treated with simple periodontal flap turnover,while the observation group were treated with Er:YAG laser on the basis of the control group.The clinical effect,the periodontal clinical indexes,the levels of inflammatory factors in 24 hours and 72 hours before and after operation were compared.The visual analogue scale(VAS) and Pittsburgh sleep quality index(PSQI) were used to evaluate the toothache symptoms and sleep quality of the two groups before,24 hours and 72 hours after operation,and to observe the postoperative complications.Results The total clinical effective rate of the observation group was higher than that of the control group(P <0.05).The depth of probing(PD) and clinical attachment loss(C.AL) at 3,6 and 12 months after operation in the two groups were lower than those before operation,plaque index(PLI),gingival index(GI) and Sulcus bleeding index(SBI)were lower than those before operation,and the changes in the observation group were significant(P <0.05).The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) and C-reactive protein(CRP) at 24 and 72 hours after operation in the two groups were significantly lower than those before operation,and the changes in the observation group were significant(P <0.05).The VAS score and PSQI index at 24 hours and 72 hours after operation in the two groups were significantly lower than those before operation,with significant changes in the observation group(P <0.05).During the study period,the patients in the observation group did not have any decrease in alveolar bone height,bone density and bone structure changes caused by laser treatment.Conclusion Er:YAG laser can promote the restoration of gingival adhesion level in patients with severe periodontitis,improve the adhesion between periodontal tissue and root surface,and at the same time improve the gingival adhesion level to relieve gingival inflammation,which is worthy of clinical application.更多还原