光动力疗法联合龈下刮治和根面平整术治疗重度慢性牙周炎的疗效观察

目的 比较光动力疗法（photodynamic therapy,PDT）辅助龈下刮治术及根面平整术（scaling and root planing,SRP）和单独使用SRP治疗重度慢性牙周炎的临床疗效.方法 对34例重度慢性牙周炎患者做自身对照,每个病人选取PD≥7 mm的位点,一共300个,随机分为实验组（SRP/PDT）和对照组（SRP）.实验组在龈下刮治术及根面平整术后做一次光动力治疗（光敏剂为26.7 mmol·L-1亚甲基蓝,660 nm激光）,对照组仅行SRP.术前、术后1个月、3个月检查实验组及对照组的牙周探诊深度（probing depth,PD）和探诊出血（bleeding on probing,BOP）.结果 实验组和对照组术前PD和BOP差异无统计学意义（P〉0.05）,术后1个月和3个月的结果显示,两组PD和BOP较术前均有改善,且实验组的PD和BOP改善效果均优于对照组,差异具有统计学意义（P〈0.05）.结论 对重度慢性牙周炎患者应用PDT辅助SRP治疗较单独使用SRP效果更佳.

A clinical observation of photodynamic therapy as an adjunctive to scaling and root planing in treatment of severe chronic periodontitis

Objective To compare the efficacy between photodynamic therapy （PDT） as an adjunctive treatment of severe chronic peri- odontitis with scaling and root planing in patients and treatment of SRP. Methods This is a split-mouth, randomized controlled clinical trial. A total of 300 sites, in which probing depth was not less than 7 mm, were selected from 34patients with severe chronic periodontitis. These sites were randomly assigned to SRP plus PDT using a laser source with a wavelength of 660 nm associated with 26.7 mmol · L- 1 methylene blue as the photosensitizer after SRP （test group） and the contra-lateral teeth were assigned to SRP only （control group）. Pro- bing depth （PD） and bleeding on probing （BOP） were recorded at baseline, 1 and 3 months after SRP. Results There was no statisti- cally significant difference in PD and BOP before periodontal treatment in both groups （ P 〉 0.05 ）. Clinical parameters improved signifi- cantly after both therapies,whereas higher reduction of PD and BOP were observed in the test group 1 and 3 months after SRP （P 〈 O. 05）. Conclusions Photodynamic therapy has an additional benefit to scaling and root planing when treating patients affected with se- vere chronic periodontitis.