牙周牙髓联合病变激光与药物辅助治疗观察及菌群分析

目的:探讨双波长激光对比盐酸米诺环素治疗牙周牙髓联合病变的差别及牙周袋菌群分析。方法:收集牙周牙髓联合病变患者60颗患牙,随机分为2组:实验组Nd:YAG消毒根管一次性充填根管+Er: YAG处理牙周袋;对照组碘伏消毒根管一次性根管充填+盐酸米诺环素牙周袋上药。按视觉模拟评分法(visual analogue scale,VAS)观察两组治疗后1 d疼痛差异,对比两组治疗1周、2周、3周、3月、6月、1年的牙周袋深度(the depth of periodontal pocket,PD)、牙周附着水平(clinical periodontal attachment level,CAL),探诊出血指数(bleeding on probing,BOP),评价疗效。抽取两组病例各4例,并定期采集患牙牙周袋菌斑行高通量测序。结果:实验组与对照组治疗1 d疼痛有差异;不同时间点间PD、CAL静息状态下VAS评分有差别;BOP阳性位点发生率有差别。2组牙周袋菌斑多样性差异不大,以韦荣氏菌、变性链球菌、卟啉单胞菌、消化链球菌为主。结论:双波长激光联合辅助治疗牙周牙髓联合病变的效果优于盐酸米诺环素,具有较好的临床应用前景。

Comparison of Therapeutic Effects between Dual-wavelength Laser and Minocycline Hydrochloride on Combined Periodontal-endodontic Lesions.

Objective: To compare the therapeutic effects between dual-wavelength laser and minocycline hydrochloride on combined periodontal-endodontic lesions. Methods: Sixty teeth with combined periodontal-endodontic lesions were randomly divided into 2 groups, the experiment group (Nd: YAG disinfection after Root canal preparation + Er: YAG laser irradiation periodontal pocket) and the control group ( Iodine volts disinfection after Root canal preparation+ Minocycline hydrochloride in periodontal pocket). The difference in pain after 1 day between two groups was evaluated by visual analog scale (VAS). Periodontal pocket depth (PD), periodontal attachment level (CAL), and bleeding on probing (BOP) were compared between two groups after 1 week, 2 weeks, 3 weeks, 3 months, 6 months, and 1 year. Results: There were statistically significant difference in PD, CAL, and BOP between two groups. The experimental group was better than the control group. The bacteria were mainly Veillonellaceae, Streptococcaceae, Porphyromonadaceae, and Peptostreptococcaceae. Conclusion: Combination of Er: YAG laser and Nd: YAG laser is better than minocycline hydrochloride in treating combined periodontal-endodontic lesions.