脉冲Nd:YAG激光与超声洁刮治联合治疗牙周炎的效果观察

目的　观察Nd:YAG激光与超声洁刮治联合治疗牙周炎的临床效果。方法　选择牙周袋4~7 mm的 26颗同颌对称同名的慢性牙周炎患牙,随机分为实验组(激光加洁刮治)和对照组(洁刮治)。比较两组患牙治疗前后牙周袋内细菌检出总数和主要细菌组成比。结果　实验组患牙激光照射后即刻,细菌检出总数较治疗前显著降低(P<0·05)。完成治疗后两组患牙牙周袋内细菌检出总数较治疗前显著降低(P<0·05);但两组间差异无显著性。两组患牙治疗后牙周袋内G+球菌升高、G-杆菌下降,与治疗前有显著性差异;治疗后1周实验组牙周袋内球杆菌比例与对照组比较差异有显著性。结论　参数为2 W、20 Hz、100 mJ的脉冲Nd:YAG激光牙周袋内照射可明显减少牙周袋内细菌总量;激光与超声洁刮治联合治疗能短期内显著改善龈下微生态环境。

The Effect of Pulsed Nd:YAG Laser Used as an Adjunct to Subgingival Scaling and Root Planning

Objective This study was to observe and compare the microbiological effects of laser therapy combined with ultrasonic subgingival scaling and root planning (SRP) versus SRP alone.Methods 26 contra lateral teeth were randomly assigned to the test group (laser+SRP) or the control group (SRP alone). Subgingival microbial samples were collected,cultured and analyzed at baseline, then repeated immediately after laser treatment at week 1,week 2 and week 4.Results Although both groups had significant increase in G++/G+- ratio (P<0.01), the changes of G++ and G+- were more obvious in the test group till week 1(P<0.05). The total CFU of test group diminished significantly just after laser irradiation (P<0.05). That revealed the laser therapy followed by SRP appeared to have a stronger effect on converting the subgingival micro-ecosystem to healthy status.Conclusion Laser appeared to have a stronger bactericidal action in vivo,especially on the dark-pigmented G+- rods associated with periodontal disease.