摘要： 目的 通过比较内窥镜下龈下刮治和根面平整（SRP）和单纯SRP治疗慢性牙周炎的疗效以及龈沟液中碱性磷酸酶（ALP）的表达水平，为牙周炎的临床治疗提供理论指导。方法 选择30例符合牙周炎新分类Ⅲ期和Ⅳ期的患者，选取中切牙和第一磨牙作为指数牙，全口洁治后随机分为2组，对照组（15例患者，112颗指数牙）采用单纯SRP治疗，实验组（15例患者，116颗指数牙）采用内窥镜下SRP治疗，评估治疗前和治疗后3个月指数牙的牙周状况，并检测治疗前后龈沟液中ALP活性水平的变化。结果 与治疗前相比，治疗后3个月对照组和实验组菌斑指数、龈沟出血指数、牙周探诊深度、附着丧失均明显下降（均P < 0.05）；治疗后3个月，实验组菌斑指数、龈沟出血指数、牙周探诊深度、附着丧失低于对照组，但差异无统计学意义（P > 0.05）。治疗后3个月，2组中切牙和第一磨牙龈沟液ALP水平均明显低于治疗前，且实验组ALP水平明显低于对照组，差异均有统计学意义（均P < 0.05）。结论 传统牙周基础治疗和内窥镜下牙周基础治疗均可有效治疗重度慢性牙周炎，内窥镜辅助下治疗更适用于有全身系统性疾病或对手术极度恐惧而不能进行牙周手术治疗的患者。另外，内窥镜辅助下牙周基础治疗可能通过减轻炎症导致的组织细胞破坏而获得更好的远期效果。

内窥镜下龈下刮治和根面平整治疗慢性牙周炎的疗效

薛筱霏, 方芷昱, 荆志慧, 李欣, 王宏岩, 潘春玲

中国医科大学口腔医学院·附属口腔医院牙周科, 辽宁省口腔疾病重点实验室, 沈阳 110002

收稿日期:2021-03-22出版日期:2021-11-30发布日期:2021-11-04
通讯作者:潘春玲E-mail:chunlingpan@163.com
作者简介:薛筱霏(1995-),女,硕士研究生.
基金资助:国家自然科学基金青年基金（81800974）；辽宁省博士启动基金（2018054009）


关键词: 牙周炎, 牙周内窥镜, 龈下刮治
Abstract: Objective To compare the clinical efficacy of endoscopic scaling and root planning (SRP) with SRP alone in treating severe chronic periodontitis and the changes in the activity of alkaline phosphatase (ALP) in gingival crevicular fluid, and thus to provide theoretical guidance for the clinical treatment of periodontitis. Methods We selected 30 patients with stage Ⅲ and stage Ⅳ periodontitis according to the new classification of periodontitis, used the central incisors and the first molars as index teeth, and divided them into the control (SRP alone) and experimental (endoscopic SRP) groups after full scaling. The periodontal status of index teeth was evaluated before and 3 months after treatment, and the activity of ALP in gingival crevicular fluid was assessed. Results Three months after treatment, the plaque index, sulcus bleeding index, probing depth, and attachment level (AL) significantly decreased in both groups (P < 0.05);those in the experimental group were lower than those in the control group, although the difference was not statistically significant (P > 0.05). Three months after treatment, the ALP levels in gingival crevicular fluid in the two groups were significantly lower than those before treatment, and the ALP levels in the experimental group were significantly lower (P < 0.05). Conclusion Traditional periodontal basic treatment and endoscopic periodontal basic treatment can effectively be used in severe chronic periodontitis. Endoscope-assisted treatment is more suitable for patients with systemic diseases or extreme fear of surgery who cannot undergo periodontal surgery. In addition, endoscope-assisted periodontal basic treatment might have a better long-term effect by reducing the cellular destruction caused by inflammation.
Key words: periodontitis, periodontal endoscope, scaling and root planning
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