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1.
目的 探讨甘氨酸龈下喷砂辅助龈下刮治及根面平整术在慢性牙周炎患者中的应用。方法 选取 2021年3月-2022年3月我院收治的92例慢性牙周炎患者作为研究对象,采用随机数字表法分为对照组及观 察组,各46例。对照组在龈下刮治及根面平整术后实施空气冲洗,观察组在龈下刮治及根面平整术后采用 甘氨酸龈下喷砂辅助治疗。比较两组临床疗效、MMP-3、TIMP-1水平以及牙周临床指标。结果 观察组 治疗总有效率高于对照组(P<0.05);两组治疗后MMP-3、TIMP-1水平均低于治疗前,且观察组低于 对照组(P<0.05);两组治疗后牙周各项指标均低于治疗前,且观察组低于对照组(P<0.05)。结论 甘 氨酸龈下喷砂辅助龈下刮治及根面平整术治疗慢性牙周炎患者不仅可以提高临床疗效,还可降低GCF中 MMP-3、TIMP-1水平,值得临床运用。  相似文献   

2.
Scaling and root planing are one of the most commonly used procedures for the treatment of periodontal diseases. Removal of calculus using conventional hand instruments is incomplete and rather time-consuming. In search for more efficient and less difficult instrumentation, investigators have proposed lasers as alternatives or adjuncts for scaling and root planing. The aim of the present study was to compare the effectiveness of subgingival scaling and root planing with erbium: yttrium, aluminium, garnet (Er:YAG) laser and hand instrumentation in vitro. The mesial and distal surfaces of 15 periodontal loosed extracted teeth were treated randomly either by hand instrumentation or by Er:YAG laser irradiation. After choosing the “very long pulse mode” (pulse duration of about 700 μs), the output energy of 160 mJ with 920-μm beam diameter (RO7 Perio tip, Fidelis, Fotona, Slovenia) and frequency of 12 Hz were selected, both according to the best results of past studies. In addition, air water spray was used during the procedures. The morphology of the root surface was evaluated by three observers with a scanning electron microscopy in magnifications of 50× and 400×. The result of this setting showed that the rate of remained roughness on treated root surfaces in two groups of hand instruments and Er:YAG laser had a meaningful difference: The surface roughness in Er:YAG laser group was more than in hand instruments group. The present study could demonstrate the in vitro capability of the Er:YAG laser for scaling and root planing in periodontitis, although the effectiveness of this setting did not reach that achieved by hand instrumentation. It could be concluded that lower frequency and long pulse duration maybe more suitable for the micro-morphology of root surface after treatment. This theory is going to be tested with the same laser instrument in the next study.  相似文献   

3.
BACKGROUND AND OBJECTIVES: The aim of the in vitro study was to examine the clinical efficacy of semiconductor laser periodontal pocket irradiation as an adjunct to conventional scaling and root planing. MATERIALS AND METHODS: Twenty-two healthy patients with a need of periodontal treatment (15 women, 7 men, mean age 45.0 +/- 10.8 years) with at least four teeth in all quadrants, were included. All of them underwent a conventional periodontal treatment including scaling and root planing. Using a split mouth design, two randomly chosen quadrants (one upper and the corresponding lower one) were subsequently treated with an 809 nm GaAlAs laser operated at a power output of 1.0 Watt using a 0.6 mm optical fiber. The teeth in the control quadrants were rinsed with saline. The clinical outcome was evaluated by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), sulcus fluid flow rate (SFFR), Periotest (PT), probing pocket depth (PPD), and clinical attachment loss (CAL) at baseline and at 3 months after treatment. A total of 492 teeth in both groups were evaluated and differences between the laser and the control teeth were analyzed using the Wilcoxon test (P < 0.05). RESULTS: Teeth treated with the laser revealed a significantly higher reduction in tooth mobility, pocket depth, and clinical attachment loss. Twelve percent of the teeth in the laser group showed an attachment gain of 3 mm or more, compared to 7% in the control group. An attachment gain of 2-3 mm was found in 24% of the teeth in the laser group and 18% in the control group. No significant group differences, however, could be detected for the plaque index, gingival index, bleeding on probing, and the sulcus fluid flow rate. CONCLUSIONS: The higher reduction in tooth mobility and probing depths is probably not predominantly related to bacterial reduction in the periodontal pockets but to the de-epithelization of the periodontal pockets leading to an enhanced connective tissue attachment. The application of the diode laser in the treatment of inflammatory periodontitis at the irradiation parameters described above is a safe clinical procedure and can be recommended as an adjunct to conventional scaling and root planing.  相似文献   

4.
The objective of this study was to evaluate the microbiological and clinical outcomes following nonsurgical treatment by either scaling and root planing, combination of Nd:YAG and Er:YAG lasers, or by Er:YAG laser treatment alone. The study involved 60 patients with generalized chronic periodontitis, randomly assigned into one of three treatment groups of 20 patients. The first group received scaling and root planing by hand instruments (SRP group), the second group received Er:YAG laser treatment alone (Er group), and the third group received combined treatment with Nd:YAG and Er:YAG lasers (NdErNd group). Microbiological samples, taken from the periodontal pockets at baseline and 6 months after treatments, were assessed with PET Plus tests. The combined NdErNd laser (93.0%), followed closely by Er:YAG laser (84.9%), treatment resulted in the highest reduction of all bacteria count after 6 months, whereas SRP (46.2%) failed to reduce Treponema denticola, Peptostreptococcus micros, and Capnocytophaga gingivalis. Full-mouth plaque and bleeding on probing scores dropped after 6 months and were the lowest in both laser groups. The combination of NdErNd resulted in higher probing pocket depth reduction and gain of clinical attachment level (1.99?±?0.23 mm) compared to SRP (0.86?±?0.13 mm) or Er:YAG laser alone (0.93?±?0.20 mm) in 4–6 mm-deep pockets. Within their limits, the present results provide support for the combination of Nd:YAG and Er:YAG lasers to additionally improve the microbiological and clinical outcomes of nonsurgical periodontal therapy in patients with moderate to severe chronic periodontitis.  相似文献   

5.
目的:评价派丽奥配合牙周基础治疗对慢性牙周炎的临床疗效。方法:选择20例确诊为慢性牙周炎患者,并筛选出80颗患牙,分为药物组(派丽奥辅助牙周基础治疗)和空白组(牙周基础治疗),各40颗;记录药物组及空白组的基线、第6、12周的牙龈指数、牙周探诊深度及附着丧失。结果:试验前两组基线资料具有可比性(P>0.05);第6、12周,两试验组牙周各指标均小于基线(P<0.05);药物组的牙周探度及附着丧失均小于空白组(P<0.05)。结论:使用派丽奥配合牙周基础治疗具有较好的临床疗效。  相似文献   

6.
The high intensity diode laser has been studied in periodontics for the reduction of subgingival bacteria in non-surgical treatment. Our study evaluated the bacterial effect as well as changes in periodontal clinical parameters promoted by root scaling and planing associated with this wavelength. Twenty-seven patients randomly assigned in two groups underwent root scaling and planing on the tested sites, and only the experimental group received the diode laser irradiation. Among the clinical parameters studied, the clinical probing depth (CPD) and the clinical attachment level (CAL) resulted in significant enhancement in the control group when compared with the experimental group (P = 0.014 and P = 0.039, respectively). The results were similar for both groups regarding the plaque index (PI) and bleeding on probing (BP). No significant difference in the microbiological parameters was observed between the control and experimental groups. It was possible to conclude that the high power diode laser adjunct to the non-surgical periodontal treatment did not promote additional effects to the conventional periodontal treatment.  相似文献   

7.
BACKGROUND AND OBJECTIVE: The incidence of cervical dentinal hypersensitivity is related to the high number of non-carious cervical lesions. This clinical research was developed in order to evaluate the Nd:YAG laser treatment of cervical dentin hypersensitivity after attempting the removal and control of etiologic factor after two different stimuli. STUDY DESIGN/MATERIALS AND METHODS: Twenty patients participated in this study in a total of 145 teeth, where 104 received the Nd:YAG laser treatment and 41 remained as control. RESULTS: The results showed that there was statistically significant reduction of hypersensitivity as for the groups that received the treatment with Nd:YAG laser, as for the control teeth. However, the reduction of cervical dentinal hypersensitivity was statistically greater when there was the association of the removal of etiologic factors with the application of Nd:YAG laser. CONCLUSIONS: We concluded that the laser irradiation was effective in the treatment of cervical dentin hypersensitivity after 6 months.  相似文献   

8.
Tooth hypersensitivity is a frequent condition that causes discomfort and sometimes severe pain. It is caused by exposure of spots of dentinal tubules to the oral environment. Conventional desensitizing agents (professional pastes, toothpastes, mouthwashes) aim to obliterate the exposed dentinal tubules. Laser desensitization was introduced as an alternative efficient tool for the immediate treatment of tooth hypersensitivity. We explored in vitro the microscopical occluding effects of the Er:YAG laser on exposed dentinal tubules. The clinical application of this technique is also described.  相似文献   

9.
Dental hypersensitivity is a commonly seen complaint in dental clinics. It is caused by thermal, chemical or mechanical stimulation of exposed dentine, and may be so severe that it affects mastication. Conservative treatments using topically applied medicines have not achieved good results. Over a period of more than one year, 105 patients suffering from dental hypersensitivity were treated using the Nd-YAG laser. Whilst the effectiveness of this treatment was rated as 90%, the incidence of associated thermal damage to dental pulp was not studied. Other experimental investigations have shown that the thermal effect of the laser can cause damage to dental pulp (1).In this study, histopathological changes to molars of rats and humans have been investigated following irradiation with the Nd-YAG laser. The irradiation dose used was based upon data from a study on changes of pulp after laser irradiation for caries prevention in our hospital (2, 3).  相似文献   

10.
研究对牙体牙髓病患者采用一次性根管治疗的美观效果及安全性。方法 选取2022年 1月-2023年1月我院收治的90例牙体牙髓病患者为研究对象,随机分为对照组和研究组,各45例。对照组 采用多次性根管治疗,研究组采用一次性根管治疗,比较两组临床疗效、美观度、疼痛程度及并发症发 生情况。结果 研究组治疗总有效率为95.56%,高于对照组的77.78%(P <0.05);研究组治疗后美观 度评分高于对照组,VAS评分低于对照组(P <0.05);研究组并发症发生率为4.44%,低于对照组的 17.78%(P <0.05)。结论 一次性根管治疗在牙体牙髓病患者中的应用效果确切,可以提升患者的牙齿美 观度,有利于减轻疼痛,且治疗后并发症较少,具有较高的安全性。  相似文献   

11.
Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.  相似文献   

12.
Yu  Shuchen  Zhao  Xiaodan  Zhang  Yuchen  Liu  Yujiao  Li  Ang  Pei  Dandan 《Lasers in medical science》2022,37(2):759-769
Lasers in Medical Science - This review aims to evaluate the adjunctive clinical effectiveness of diode laser (DL) to scaling and root planing (SRP) in the treatment of periodontitis, and identify...  相似文献   

13.
The aim of this study was to compare low-level laser therapy (LLLT) as adjuvant treatment for induced periodontitis with scaling and root planing (SRP) in dexamethasone-treated rats. One-hundred twenty rats were divided into groups: D group (n = 60), treated with dexamethasone; ND group (n = 60) treated with saline solution. In both groups, periodontal disease was induced by ligature at the left first mandibular molar. After 7 days, the ligature was removed and all animals were subjected to SRP and were divided according to the following treatments: SRP, irrigation with saline solution (SS); SRP + LLLT, SS and laser irradiation (660 nm; 24 J; 0.428 W/cm2). Ten animals in each treatment were killed after 7 days, 15 days and 30 days. The radiographic and histometric values were statistically analyzed. In all groups radiographic and histometric analysis showed less bone loss (P < 0.05) in animals treated with SRP + LLLT in all experimental periods. SRP + LLLT was an effective adjuvant conventional treatment for periodontitis in rats treated with dexamethasone.  相似文献   

14.
BACKGROUND AND OBJECTIVES: Lasers can be used to modify the chemical composition of dental enamel to increase the bond strength to restorative materials and to render the mineral phase more resistant to acid dissolution. Previous studies have suggested a synergistic relationship between CO(2) laser irradiation and fluoride treatment on increased resistance to acid dissolution. In this study a near-UV laser operating with lambda = 355-nm laser pulses of 3-5 nanoseconds duration was used to modify the surface morphology of dental enamel to increase the bond strength to restorative materials and increase the uptake of topical fluoride to render the surface more resistant to acid dissolution. We hypothesize that the short UV laser pulses are primarily absorbed by protein and lipid localized between the enamel prisms resulting in removal of intact mineral effectively etching the surface without thermal modification of the mineral phase. Such modification is likely to increase the permeability of the enamel surface and the subsequent absorption of fluoride. In addition, there is an increase in surface roughness without the formation of a layer of loosely adherent, thermally modified enamel that increases the bond strength to composite restorative materials. STUDY DESIGN/MATERIALS AND METHODS: The surfaces of blocks of bovine enamel, 5 x 5 mm(2), were uniformly irradiated by 355-nm laser pulses and subsequently bonded to composite. The shear bond test was used to assess the bond strength of non-irradiated blocks (negative control), acid etched blocks (positive control), and laser irradiated blocks. The resistance to acid dissolution was evaluated using controlled surface dissolution experiments on irradiated samples, irradiated samples exposed to topical fluoride, and non-irradiated control samples with and without fluoride. RESULTS: The laser surface treatments significantly increased the shear-bond strength of enamel to composite, to a level exceeding 20 MPa which was significantly more than the non-irradiated control samples and significantly less than the acid etch. Laser irradiation alone and topical fluoride application alone did not significantly increase the resistance to acid dissolution. The laser treatment followed by topical application of fluoride significantly increased the resistance to acid dissolution to a level of over 50% versus the control samples. CONCLUSIONS: We present a novel method for increasing bond strength to restorative materials and enhancing fluoride delivery to enamel surfaces and shed some light on the underlying mechanisms of caries inhibition via laser treatment and topical application of fluoride.  相似文献   

15.
The aim of this study was to investigate if coherence length is of importance in laser phototherapy. Twenty patients with moderate periodontitis were selected. After oral hygiene instructions, scaling and root planing (SRP), one side of the upper jaw was randomly selected for HeNe (632.8 nm, 3 mW) or InGaAlP (650 nm, 3 mW) laser irradiation. One week after SRP, the following parameters were measured: pocket depth, gingival index, plaque index, gingival crevicular fluid volume, matrix metalloproteinase (MMP-8), interleukin (IL-8) and subgingival microflora. The irradiation (180 s per point, energy 0.54 J) was then performed once a week for 6 weeks. At the follow up examination, all clinical parameters had improved significantly in both groups. A more pronounced decrease of clinical inflammation was observed after HeNe treatment. MMP-8 levels were considerably reduced on the HeNe side, while there was no difference for IL-8 or microflora. Coherence length appears to be an important factor in laser phototherapy.  相似文献   

16.
目的:探讨308nm准分子激光联合他卡西醇软膏治疗儿童面部白癜风的疗效。方法:治疗组儿童面部白癜风患者采用Xt rac颠峰准分子激光联合他卡西醇软膏治疗,对照组仅用Xt rac颠峰准分子激光,为期3月,治疗结束后3天进行疗效评价。结果:治疗组显效率77.3%,对照组显效率52.5%,两组差异有统计学意义(χ2=5.69,P<0.05)。结论:308nm准分子激光联合他卡西醇软膏治疗儿童面部白癜风疗效好、副作用小。  相似文献   

17.
Adjunctive treatments to scaling and root planing (SRP) such as lasers, have been utilized in the treatment of chronic periodontitis, mainly aiming to suppress and eliminate the bacteria, as well as enhancing the healing response. Eighty gingival papilla biopsy samples were obtained from 60 patients diagnosed with chronic advanced periodontitis; randomly assigned to three treatment groups (n = 20), as well as 20 subjects with no periodontal disease [group A]. Group B received SRP on a single quadrant/day for four consecutive days. On day 5, all quadrants were rescaled. Groups C and D received the same treatment as group B plus laser application with the low-level diode laser (630-670 nm, 1.875 J/cm2) for five and ten consecutive days, respectively. Papilla biopsies were obtained from subjects and evaluated by RT-PCR for expression of COX-2. The values in the control group were 0.028 0.014 and baseline values for the examined groups were 0.16 0.18. Significantly decreased level of COX-2 expression for groups C and D was found after treatment, while lowest average expression was found in the group that had the 10 laser treatments supplemental to SRP (0,035 0,014). The results of this study show suppression of COX-2 in gingival tissue after low-level laser treatment as adjunct to SRP.  相似文献   

18.
BACKGROUND AND OBJECTIVES: The aim of the present histologic study was to compare the in vivo and in vitro effects of an erbium: yttrium, aluminum, and garnet (Er:YAG) laser (ERL), combined with a fluorescent calculus detection system, a diode laser (DL) and scaling and root planing (SRP) on periodontally diseased root surfaces. STUDY DESIGN/MATERIALS AND METHODS: Twenty-four single rooted teeth, considered for extraction due to severe periodontal destruction, were included in the study. Prior to extraction all mesial root surfaces were randomly assigned to the following treatment groups: (1) ERL combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP DL radiation (160 mJ/pulse and 10 pulses/second under water irrigation) (ERL), or (2) GaAlAs DL (1.8 W, pulse/pause relation 1:10), or (3) SRP using hand instruments. Immediately after extraction, all distal root surfaces were treated with the same instruments under standardized conditions. For light microscopic investigation, a plastic embedding technique was used to cut the undecalcified roots into 30 microm thick crossections. The following parameters were recorded by on blind examiner: remaining debris, root surface morphology, and thermal side effects. RESULTS: Root surfaces instrumented with both, ERL in vivo and DL in vitro exhibited no detectable surface alterations. In contrast, ERL scaling in vitro and SRP in vivo/in vitro produced superficial microchanges in root cementum. However, irradiation with DL in vivo caused severe damages to the root surface (i.e., crater formation). There were no signs of thermal side effects in all laser treated groups. ERL provided subgingival calculus removal on a level equivalent to that provided by SRP. DL was unsuitable for calculus removal, since macroscopic inspection revealed the presence of large amounts of subgingival calculus. CONCLUSIONS: The present in vivo results showed that (i) ERL, combined with a fluorescent calculus detection system, provided a selective subgingival calculus removal on a level equivalent to that provided by SRP, and (ii) DL, using this power output, was unsuitable for calculus removal and altered the root surface in an undesirable manner.  相似文献   

19.
Recent preclinical and clinical data have suggested the potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, currently, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of the present study was to evaluate the clinical and microbiological effects of the adjunctive use of PDT in non-surgical periodontal treatment in patients receiving supportive periodontal therapy. Twenty-four patients receiving regularly supportive periodontal therapy were randomly treated with either subgingival scaling and root planing followed by a single episode of PDT (test) or subgingival scaling and root planing alone (control). The following parameters were evaluated at baseline and at 3 months and 6 months after therapy: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), bleeding on probing (BOP) at experimental sites, probing pocket depth (PPD), gingival recession (REC), and clinical attachment level (CAL). Primary outcome variables were changes in PPD and CAL. Microbiological evaluation of Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythensis (T.f.), Treponema denticola (T.d.), Peptostreptococcus micros (P.m.), Fusobacterium nucleatum (F.n.), Campylobacter rectus (C.r.), Eubacterium nodatum (E.n.), Eikenella corrodens (E.c.), and Capnocytophaga species (C.s.) was also performed at baseline and at 3 months and 6 months after therapy, using a commercially available polymerase chain reaction test. No differences in any of the investigated parameters were observed at baseline between the two groups. At 3 months and 6 months after treatment, there were no statistically significant differences between the groups in terms of PPD, CAL and FMPS. At 3 months and 6 months, a statistically significantly higher improvement of BOP was found in the test group. At 3 months after therapy, the microbiological analysis showed a statistically significant reduction of F.n. and E.n. in the test group. At 6 months, statistically significantly higher numbers of E.c. and C.s. were detected in the test group. The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PPD reduction and CAL gain, but it resulted in significantly higher reduction of bleeding scores than following scaling and root planing alone.  相似文献   

20.
This meta-analysis was conducted to investigate the efficacy and safety of antimicrobial photodynamic therapy used alone or adjunctive to scaling root planing in patients with chronic periodontitis. The meta-analysis was conducted according to the QUOROM statement and recommendations of the Cochrane Collaboration. An extensive literature search was performed on seven databases, followed by a manual search. Weighted mean differences and 95% confidence intervals were calculated for clinical attachment level, probing depth and gingival recession. The I2 test was used for inter-study heterogeneity; visual asymmetry inspection of the funnel plot, Egger’s regression test and the trim-and-fill method were used to investigate publication bias. At 3 months, significant differences in clinical attachment level (p?=?0.006) and probing depth reduction (p?=?0.02) were observed for scaling root planing with antimicrobial photodynamic therapy, while no significant differences were retrieved for antimicrobial photodynamic therapy used alone; at 6 months no significant differences were observed for any investigated outcome. Neither heterogeneity nor publication bias was detected. The use of antimicrobial photodynamic therapy adjunctive to conventional treatment provides short-term benefits, but microbiological outcomes are contradictory. There is no evidence of effectiveness for the use of antimicrobial photodynamic therapy as alternative to scaling root planing. Long-term randomized controlled clinical trials reporting data on microbiological changes and costs are needed to support the long-term efficacy of adjunctive antimicrobial photodynamic therapy and the reliability of antimicrobial photodynamic therapy as alternative treatment to scaling root planing.  相似文献   

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