不同冲洗消毒方式对牙髓-牙周综合征患者牙周相关指数、龈沟液中细菌变化的影响

目的:探究超声、水激光冲洗消毒对牙髓-牙周综合征患者牙周相关指数、龈沟液细菌的影响。方法:选择2018年2月~2019年9月我院收治的牙髓-牙周综合征患者96例,采用自愿及随机分组原则将患者分为水激光组、超声组及对照组,每组各32例。所有患者均进行常规牙周治疗及根管治疗,水激光组、超声组、对照组患者根管预备后分别采用水激光、超声荡洗及生理盐水冲洗方式冲洗根管。测定根管冲洗前、后根管细菌数量及龈沟液细菌数量,于治疗前、治疗结束时和治疗后3个月时进行牙周检查,收集菌斑指数(plaque index,PLI)、探诊出血指数(bleeding index,BI)、牙周袋探诊深度(periodontal pocket probing depth,PD)、牙龈指数(gingival index,GI)等参数,评价治疗效果。结果:水激光组、超声组和对照组治疗总有效率分别为84.38%、87.50%和81.25%(P>0.05)。与预备消毒前比较,各组患者消毒后根管病菌数量均显著降低(P<0.05),预备消毒后水激光组、超声组根管病菌数量显著低于对照组(P<0.05)。与治疗前比较,各组患者治疗后龈沟液病菌数量均显著降低(P<0.05),治疗后水激光组、超声组病菌数量显著低于对照组(P<0.05)。治疗后3个月水激光组、超声组PLI、BI、PD、GI等牙周指数均显著优于对照组(P<0.05)。结论:与常规根管冲洗比较,水激光、超声荡洗消毒有较好的根管消毒效果,对于牙周细菌的清除、牙周指数的改善具有较大助益。

Effects of different irrigation and disinfection methods on periodontal related indexes and bacterial changes in gingival crevicular fluid of patients with pulp-periodontal syndrome

Objective:To investigate the effects of ultrasonic and waterlaser irrigation and disinfection on periodontal related indexes and bacteria in gingival crevicular fluid of patients with pulp-periodontal syndrome.Methods:Ninety-six patients with pulp-periodontal syndrome treated in the hospital between February 2018 and September 2019 were selected as the research subjects.They were divided into the waterlaser group,the ultrasound group and the control group according to the voluntary and random grouping principles,with 32 patients in each group.All patients underwent conventional periodontal therapy and root canal therapy.The root canals of three groups were irrigated with waterlaser,ultrasound and normal saline respectively.The number of bacteria in the root canal and in the gingival crevicular fluid before and after treatment were measured.Periodontal examinations were performed before,at the end and after 3 months of treatment.The plaque index(PLI),bleeding index(BI)on probing,periodontal pocket probing depth(PD)and gingival index(GI)were used to evaluate the treatment effect.Results:The overall effective rates of treatment in the waterlaser group,ultrasound group and control group were 84.38%,87.50%and 81.25%,respectively(P>0.05).The number of bacteria in root canal of each group was significantly reduced after disinfection(P<0.05),and in the laser group and ultrasound group were significantly smaller than that in the control group after pre-sterilization(P<0.05),also the number of bacteria in gingival crevicular fluid.After 3 months of treatment,periodontal indexes such as PLI,BI,PD and GI in the laser group and the ultrasound group were significantly better than those in the control group respectively(P<0.05).Conclusion:Compared with conventional root canal irrigation measures,laser and ultrasonic irrigation and disinfection is effective in root canal disinfection.It is conductive to removing periodontal bacteria and improving periodontal indexes.