摘要： 目的 研究铒：钇铝-石榴石（Er：YAG）激光辅助牙周基础治疗前后广泛型Ⅲ期C级牙周炎（GPⅢ-C）患者龈下菌斑的微生物菌群变化。方法 依据牙周病新分类中GPⅢ-C诊断标准，招募GPⅢ-C患者10例，对其治疗前（对照组，G1组）、传统牙周基础治疗后（牙周基础治疗组，G2组）、再行Er：YAG激光辅助治疗后（Er：YAG激光治疗组，G3组）的同位点龈下菌斑进行V3~V4区域的16S rDNA测序和生物信息分析。结果 Er：YAG激光辅助治疗后，菌斑微生物多样性及致病菌相对丰度下降，对梭形杆菌属和二氧化碳嗜纤维菌属等牙周致病菌属，福赛坦氏菌、牙髓卟啉单胞菌和具核梭杆菌等牙周致病菌种有显著清除作用，且有利于龈下菌斑向革兰氏阳性菌占优势的微生物膜转变，但对牙龈卟啉单胞菌作用不显著。结论 在传统牙周基础治疗上，增加Er：YAG激光治疗对清除GPⅢ-C患者具核梭杆菌等牙周致病菌有积极作用。

Er：YAG激光辅助治疗广泛型Ⅲ期C级牙周炎前后龈下菌斑菌群变化

刘铭霄, 吴丽红, 江千舟, 谢微, 王羽仪, 于淼

广州医科大学附属口腔医院牙周病科, 广州市口腔再生医学基础与应用研究重点实验室, 广州 510182

收稿日期:2021-05-24出版日期:2022-04-20发布日期:2022-05-05
通讯作者:于淼E-mail:yu_miaomiao@163.com
作者简介:刘铭霄(2000-),女,本科在读.
基金资助:2021年广东省科技创新战略专项资金 （“攀登计划”专项资金pdjh2021b0413）；广州市卫生健康委项目 （20181A011101）


关键词: 铒：钇铝-石榴石激光, 高通量测序, 具核梭杆菌, 牙周炎, 龈下菌斑
Abstract: Objective To study the microbial structural shifts of subgingival plaque in patients with generalized stage Ⅲ,grade C periodontitis (GPⅢ-C) before and after erbium:yttrium aluminum garnet (Er:YAG) laser adjunctive treatment. Methods We enrolled 10 patients with GPⅢ-C per the new classification of periodontal disease (2018) and collected microbial samples from subgingival plaques at the same sites during therapy:including before treatment (the control group,G1 group),after conventional mechanical treatment (the conventional mechanical treatment group,G2 group),and after Er:YAG laser adjunctive treatment (the laser group,G3 group). V3 to V4 region of 16S rDNA gene sequencing and bioinformatics analysis were performed to unravel the subgingival plaque microbial structure. Results Er:YAG laser adjunctive treatment further reduced the diversity of microorganisms and the relative abundance of pathogenic bacteria in subgingival plaque. It also significantly reduced the relative abundance of periodontal pathogenic genera like Fusobacterium and Capnocytophaga,and periodontal pathogenic species such as Fusobacterium nucleatum,Porphyromonas endodontalis,and Tannerella forsythia,but had no significant effect on Porphyromonas gingivalis. It was also beneficial for transforming subgingival plaque into a microorganism membrane dominated by gram-positive bacteria. Conclusion Er:YAG laser adjunctive treatment in patients with GPⅢ-C has a positive effect on the elimination of periodontitis pathogenic bacteria such as Fusobacterium nucleatum,making it worthy of clinical application.
Key words: erbium：yttrium aluminum garnet laser, high throughput sequencing, Fusobacterium nucleatum, periodontitis, subgingival plaque
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