缓释氯己定凝胶在慢性牙周炎治疗中的应用

目的:观察龈上洁治术、龈下刮治术和根面平整术(scaling and root planing,SRP)结合缓释氯己定凝胶(chlorhexidine,CHX)对慢性牙周炎的治疗作用。方法:选择35～65岁的慢性牙周炎患者36例,将后牙区牙周袋数目较多的单颌设定为实验组,对颌为对照组。实验组采取SRP+CHX治疗,对照组采取SRP治疗。分别于牙周治疗前、中、后3个阶段,记录每个受试牙近颊、颊侧、远颊、近舌、舌侧和远舌位点的牙龈指数(GI)、探诊出血(BOP)、探诊深度(PD)、临床附着水平(CAL)、探诊出血指数(SBI)。结果:BOP、SBI、PD、GI四项指标在治疗后1个月,实验组与对照组之间有显著差异(P<0.05),4个月后则无显著性差异(P>0.05)。CAL在治疗后1个月,两组间无显著(P>0.05),而4个月后差异显著性差异(P<0.05)。无论是实验组还是对照组,治疗前后各项牙周指标后牙区位点对治疗的反应明显不如前牙区,但无显著性差异(P>0.05)。PD>7 mm的深牙周袋,SRP+CHX组与SRP组之间4个月后仍有显著性差异。结论:在慢性牙周炎治疗过程中,SRP+CHX治疗能够改善牙周临床指标,尤其对PD>7 mm的深牙周袋有更好的治疗作用。

Clinical application of sustained-release chlorhexidine gel in the treatment of chronic periodontitis

AIM: To investigate the effect of scaling and root planing(SRP) combined with sustained-release chlorhexidine gel(CHX) in the treatment of chronic periodontitis.METHODS: Thirty-six patients with chronic periodontitis were included.According to the number of periodontal pockets in the posterior region,the side with more pockets received SRP+CHX treatment,and the contralateral side received SRP treatment only.Gingival index(GI),bleeding on probing(BOP),pocket depth(PD),clinical attachment level(CAL) and SBI in the misal-buccal,buccal,distal-buccal,misal-lingual,lingual,distal-lingual site of the tested teeth were recorded before,during and after periodontal treatment.RESULTS: Significant difference was observed in BOP,SBI,PD and GI between SRP + CHX group and SRP group one month after periodontal treatment.However,there was no significant difference between the two groups four months after periodontal treatment.For teeth with PD≥7mm,significant difference in PD was observer between the two groups.No significant difference was observed in CAL between SRP+CHX group and SRP group one month after periodontal treatment.However,there was significant difference between the two groups four months after periodontal treatment.In the anterior teeth,all periodontal indices showed more improvement than those in the posterior teeth although the difference was not significant.CONCLUSION: Sustained-release chlorhexidine showed adjunct effects in the treatment of chronic periodontitis,especially for the teeth with pocket depth deeper than 7 mm.