【作者】 张宁；

【导师】 李秋红；

【作者基本信息】 大连医科大学 ， 口腔医学（专业学位）， 2021， 硕士

【摘要】 目的:本研究使用啄木鸟PT5超声牙周治疗仪和Hu-Friedy Gracey手动刮治器对慢性牙周炎患者进行龈下刮治术和根面平整术,比较和观察治疗前后各项临床牙周指标和疼痛程度以及一些主观评价指标的变化。方法:试验分组:随机将每位受试患者的左右半口(以中线为基准)分为PT5区和Gracey区,又选取左右半口中病情相似的前牙、前磨牙、磨牙各一颗分为前牙组、前磨牙组、磨牙组。选取2019年11月-2021年1月就诊于大连医科大学附属第一医院口腔门诊的慢性牙周炎患者50例,PT5区使用啄木鸟PT5牙周治疗仪治疗,Gracey区使用Hu-Friedy Gracey手动刮治器治疗,分别记录治疗前(基线)及治疗后1、3、6个月复诊时入选位点的各项临床指标:探诊深度(PD)、附着丧失(AL)、菌斑指数(PLI)、出血指数(BI)、龈沟出血指数(SBI)及探诊出血(BOP)等。并在每次治疗结束后,请受试患者立即填写视觉模拟评分量表(VAS)和刮治后调查问卷,记录治疗时间。结果:1.PT5区与Gracey区在牙周基础治疗中的临床效果相同,两区患者的各项临床指标较治疗前均有改善(P<0.05)。2.基线、治疗后1、3、6月PT5区和Gracey区两区之间比较:牙周指标PD、AL、PLI、BI、SBI和BOP的变化无统计学差异(P>0.05)。3.治疗后1、3、6月PT5区和Gracey区每个区分别比较:牙周指标AL的差异无统计学意义(P>0.05);牙周指标PD、PLI、BI、SBI、BOP在基线与治疗后1、3、6月之间的差异有统计学意义(P<0.05),1月与3月之间的差异有统计学意义(P<0.05),3月与6月之间的差异无统计学意义(P>0.05)。4.PT5区和Gracey区的前牙组、前磨牙组和磨牙组之间比较:基线时牙周指标PD、AL、PLI、BI、SBI、BOP的差异无统计学意义(P>0.05),治疗后1、3、6月的牙周指标PD、AL、PLI、BI、SBI、BOP的差异均有统计学意义(P<0.05);治疗后1月、3月、6月时每个区的三组之间比较:前牙组与磨牙组的牙周指标PD、AL、PLI、BI、SBI、BOP的变化之间有统计学差异(P<0.05),前牙组与前磨牙组、前磨牙组与磨牙组之间无统计学差异(P>0.05)。5.两种治疗方法的治疗时间之间有统计学差异(P<0.05),PT5牙周治疗仪更省时。6.两种治疗方法的VAS差异无统计学意义(P>0.05)。7.问卷调查结果:两种治疗方法的疼痛程度差异无统计学意义(P>0.05)。14例(28%)受试患者愿意接受使用啄木鸟PT5牙周治疗仪进行再次牙周治疗,17例(34%)受试患者愿意接受使用Hu-Friedy Gracey手动刮治器进行维护期的牙周治疗,19例(38%)受试患者认为两种治疗方法都可以。结论:啄木鸟PT5牙周治疗仪与Hu-Friedy Gracey手动刮治器在慢性牙周炎患者的龈下刮治术和根面平整术中均能达到良好的临床效果,且二者疗效相当。Hu-Friedy Gracey手动刮治器在慢性牙周炎的根面平整术中仍然有着不可替代的作用。PT5牙周治疗仪操作方法简便,工作效率高,在临床工作中更省时间,值得临床推广。更多还原

【Abstract】 Objective: In this study,we performed subgingival scaling and root planing on patients with chronic periodontitis using Woodpecker PT5 periodontal ultrasonic therapy instrument and Hu-Friedy Gracey manual instrument,as well as compared and observed the changes of various clinical periodontal indexes,pain degree and some subjective evaluation indexes before and after treatment.Methods: The experimental groups were divided into PT5 area and Gracey area at random method(Take the midline as the benchmark).And the anterior teeth,premolars and molars with similar conditions in the left and right halves were divided into anterior tooth group,premolar group and molar group.We selected 50 cases of patients with chronic periodontitis from November 2019 to January 2021 in The First Affiliated Hospital of Dalian Medical University,using Woodpecker PT5 periodontal ultrasonic therapy instrument for therapy in PT5 area and using Hu-Friedy Gracey manual instrument for therapy in Gracey area.A doctor respectively recorded clinical indicators of selected sites before treatment(baseline)and after treatment month1,3,6 as follow-up:probing depth(PD),attachment loss(AL),plaque index(PLI),bleeding index(BI),sulcus bleeding index(SBI)and bleeding on probing(BOP).After each treatment,the patients were asked to fill in the visual analogue scale(VAS)and the post-subgingival scaling and root planing questionnaire immediately,and the treatment time was recorded.Results: 1.The clinical therapeutic effect of PT5 area and Gracey area in periodontal initial therapy was the same,and the clinical indicators of patients in both areas were improved compared with that before treatment(P < 0.05).2.There was no significant difference in PD,AL,PLI,BI,SBI and BOP between PT5 area and Gracey area at baseline and month1,3 and 6 after treatment(P > 0.05).3.Respective comparison of PT5 area and Gracey area at month1,3 and 6 after treatment: there was no statistical significance in AL(P > 0.05);PD,PLI,BI,SBI and BOP showed statistically significant differences between baseline and month1,3 and 6(P<0.05),and there was statistically significant difference between month1 and month3(P<0.05),but no statistically significant difference between month3 and month6(P>0.05).4.Comparison between PT5 area and Gracey area among anterior tooth group,premolar group and molar group:there were no statistically significant differences in PD,AL,PLI,BI,SBI and BOP at baseline(P>0.05),but there were statistically significant differences in PD,AL,PLI,BI,SBI and BOP at month1,3 and 6(P<0.05).At month1,3 and 6 after treatment,the three groups in each area showed statistically significant differences in PD,AL,PLI,BI,SBI and BOP between the anterior tooth group and the molar group(P<0.05),while there was no statistically significant difference between the anterior tooth group and the premolar group,or between the premolar group and the molar group(P > 0.05).5.The difference of period of treatment between the two instruments was statistical significance(P < 0.05),and PT5 periodontal instrument was time-saving.6.There was no statistically significant difference in VAS between the two instruments(P > 0.05).7.Questionnaire results: there was no statistical significance in VAS between the two instruments(P > 0.05).14 patients(28%)were willing to use the Woodpecker PT5 periodontal ultrasonic therapy instrument for the second periodontal initial therapy,17patients(34%)were willing to use the Hu-Friedy Gracey manual instrument for periodontal maintenance,and 19 patients(38%)thought both instruments were acceptable.Conclusion: Both woodpecker PT5 periodontal ultrasonic therapy instrument and Hu-Friedy Gracey manual instrument can achieve good clinical effect in subgingival scaling and root planing on patients with chronic periodontitis,in addition,they have the same therapeutic effect.Hu-Friedy Gracey manual instrument still plays an necessary role in periodontal initial therapy.PT5 periodontal ultrasonic therapy instrument has the advantages of simple operation,high working efficiency and time saving in clinical work,which is worthy of clinical promotion.更多还原