【摘要】 目的 探讨低强度激光治疗联合引导组织再生术(GTR)对慢性牙周炎患者炎症因子调控及临床疗效的协同作用。方法 94例慢性牙周炎患者以随机数字表法分为对照组和观察组各47例,对照组行GTR,观察组在此基础上加以低强度激光治疗,疗程7天。比较两组疗程结束后3个月疗效、治疗前及术前24 h,术后1、3、7 d疼痛评分(VAS)、治疗前及治疗后牙周袋深度、菌斑指数、临床附着水平(CAL)、牙龈出血指数(BI)、治疗前及治疗后白细胞介素(IL)-6、IL-8、肿瘤坏死因子α(TNF-α)及出院时满意度。结果 观察组总有效率显著高于对照组(P<0.05)。GTR前24 h两组VAS均较入组时明显下降(P<0.05),对照组术后1 d VAS得分与GTR前24 h无显著改变(P>0.05),术后3、7 d均显著低于GTR术前24 h;观察组术后1、3、7 d均显著低于术前24 h,且术后1、3、7 d观察组VAS得分均低于对照组(P<0.05)。两组治疗后牙周袋深度、菌斑指数得分、CAL、BI、IL-6、IL-8及TNF-α水平均较治疗前降低,且观察组低于对照组(P<0.05)。观察组主观满意度得分更高(P<0.05),两组不良反应比较,差异无统计学意义(P>0.05)。结论 低强度激光治疗联合GTR通过抑制炎症因子及促进组织再生,显著提高慢性牙周炎疗效,兼具局部抗炎与改善患者满意度潜力。更多还原

【Abstract】 Objective To investigate the synergistic effects of low-level laser therapy(LLLT) combined with guided tissue regeneration(GTR) on the regulation of inflammatory factors and clinical efficacy in patients with chronic periodontitis.Methods Ninety-four patients with chronic periodontitis were divided into a control group and an observation group using a random number table method, 47 in each group. The control group received guided tissue regeneration(GTR). The observation group received additional lowlevel laser therapy(LLLT) based on GTR. The treatment course was 7 days. The efficacy after 3 months of the treatment, pain scores(VAS) before treatment, 24 hours before surgery, and after 1, 3 and 7 days of surgery, periodontal indicators such as periodontal pocket depth, plaque index, clinical attachment level(CAL), and gingival bleeding index(BI) before and after treatment, and inflammatory factors such as IL-6, IL-8 and TNF-α before and after treatment were compared between the two groups. Satisfaction degree at discharge were also compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group(P<0. 05). The VAS scores of both groups were decreased significantly in the first 24 hours of GTR compared to the time of enrollment(P<0. 05). In the control group, the VAS score on postoperative day 1 showed no significant change compared to 24 hours before GTR(P>0. 05). The scores on postoperative days 3 and 7 were significantly lower than those 24 hours before GTR. In the observation group, the VAS scores on postoperative days 1, 3 and 7 were all significantly lower than the score 24 hours before surgery, and the VAS scores in the observation group on postoperative days 1, 3 and 7 were all lower than those in the control group(P<0. 05). After treatment, the periodontal pocket depth, plaque index score, CAL, BI, and the levels of IL-6, IL-8, and TNF-α were all lower than before treatment, and these indexes in the observation group were lower than those in the control group(P<0. 05). The subjective satisfaction score was higher in the observation group(P<0. 05). There was no statistically significant difference in adverse reactions between the two groups(P>0. 05).Conclusions LLLT combined with guided tissue regeneration significantly improves the efficacy of chronic periodontitis by inhibiting inflammatory factors and promoting tissue regeneration. It has a potential for local anti-inflammatory. It also improves the patient satisfaction.更多还原