目的:探讨激光联合牙周基础治疗对牙周指数的影响。龈下菌群,脂联素,牙周炎患者的基质金属蛋白酶-13(MMP-13)和白细胞介素-1β(IL-1β)。
方法:对2022年12月至2023年7月衡水市人民医院诊治的100例牙周炎患者进行回顾性分析。根据治疗方法,将患者分为对照组(n=51)和实验组(n=49)。对照组接受牙周基础治疗,实验组在对照组的基础上接受激光治疗。牙周指数,龈下微生物,脂联素,比较两组治疗前后龈沟液中MMP-13、IL-1β及骨代谢因子,以及临床治疗效果。采用SPSS22.0软件包进行统计学分析。
结果:治疗后,探测深度(PD),探查出血(BOP),实验组牙龈指数(GI)和菌斑指数(PLI)均低于治疗前(P<0.05),PD,对照组BOP、PLI较治疗前降低(P<0.05),还有PD,防喷器,实验组GI和PLI明显低于对照组(P<0.05).治疗后,乳酸菌,两组梭菌和拟杆菌均较治疗前显著降低(P<0.05)。且实验组明显低于对照组(P<0.05)。治疗后,与治疗前比较,两组龈沟液中脂联素水平均升高(P<0.05),与治疗前比较,两组龈沟液中MMP-13和IL-1β均降低(P<0.05),实验组龈沟液中脂联素水平明显高于对照组(P<0.05),实验组MMP-13和IL-1β明显高于对照组(P<0.05).治疗后,原胶原Ⅰ型N末端肽(PINP),Ⅰ型胶原交联C端肽(CXT)和骨膜蛋白(BGP)均明显高于治疗前(P<0.05),且实验组明显高于对照组(P<0.05)。试验组总有效率明显高于对照组(P<0.05).
结论:激光联合牙周基础治疗能有效改善牙周指数,减少龈下菌群,增加龈沟液中脂联素和骨代谢因子的水平,降低龈沟液中MMP-13和IL-1β的水平,提高牙周炎患者的临床治疗效果。
OBJECTIVE: To investigate the effects of laser combined with periodontal basic treatment on periodontal indices, subgingival flora, adiponectin, matrix metalloproteinase-13 (MMP-13) and interleukin-1β (IL-1β) in patients with periodontitis.
METHODS: A retrospective analysis was performed on 100 patients with periodontitis diagnosed and treated in Hengshui People\'s Hospital from December 2022 to July 2023. According to treatment methods, the patients were divided into control group (n=51) and experimental group (n=49). The control group received periodontal basic treatment, and the experimental group received laser treatment on the basis of the control group. The periodontal indexes, subgingival microflora, adiponectin, MMP-13, IL-1β and bone metabolic factors of gingival crevicular fluid before and after treatment were compared between the two groups, as well as the clinical therapeutic effect. Statistical analysis was performed with SPSS 22.0 software package.
RESULTS: After treatment, probing depth(PD), bleeding on probing(BOP), gingival index(GI) and plaque index (PLI) in the experimental group were lower than before treatment (P<0.05), PD, BOP and PLI in the control group were lower than before treatment (P<0.05), and PD, BOP, GI and PLI in the experimental group were significantly lower than those in control group (P<0.05). After treatment, Lactobacillus, Clostridium and Bacteroides in both groups were significantly lower than before treatment (P<0.05), and the experimental group was significantly lower than the control group(P<0.05). After treatment, adiponectin in gingival crevicular fluid increased in both groups compared with before treatment(P<0.05), and MMP-13 and IL-1β in gingival crevicular fluid decreased in both groups compared with before treatment (P<0.05), and adiponectin in gingival crevicular fluid in the experimental group was significantly higher than that in the control group (P<0.05), MMP-13 and IL-1β in the experimental group were significantly higher than that in the control group (P<0.05). After treatment, procollagenⅠtype N-terminal peptide (PINP), cross linked C-telopeptide of type Ⅰ collagen(CXT) and bone glaprotein (BGP) were significantly higher than those before treatment (P<0.05), and the experimental group was significantly higher than the control group (P<0.05). The total effective rate of the experimental group was significantly higher than that of the control group (P<0.05).
CONCLUSIONS: Laser combined with periodontal basic treatment can effectively improve periodontal indexes, reduce subgingival flora, increase the levels of adiponectin and bone metabolic factor in gingival crevicular fluid, reduce the levels of MMP-13 and IL-1β in gingival crevicular fluid, and improve the clinical therapeutic effect in patients with periodontitis.