Er∶YAG激光治疗Ⅱ度根分叉病变牙周炎患者的临床疗效评价

目的 观察并评价Er:YAG（Erbium-doped yttrium aluminium garnet lase, 掺铒钇铝石榴石）激光治疗Ⅱ度根分叉病变牙周炎患者的临床疗效。方法 纳入30例慢性牙周炎出现Ⅱ度根分叉病变患者（60颗患牙）,采取左右半口对照研究。以超声龈上洁治1周后作为基线,随机分为实验组：超声波及手用器械行龈下刮治、根面平整+Er:YAG激光牙周袋内照射,对照组：单纯使用超声波及手用器械行龈下刮治、根面平整治疗对侧同名牙。治疗后12周、20周后比较2组牙龈指数（gingival index, GI）、牙周袋深度（pocket depth, PD）、水平探诊深度 (horizontal probing depth, HPD)、附着丧失 (attachment loss, AL)的变化。采用 SPSS 20.0软件包进行统计学处理。结果 实验组和对照组各牙周临床指标（GI、PD、HPD、AL）在治疗后12周、20周与基线时相比,均显著下降（P<0.05）。治疗后12周和20周,实验组PD分别为 (4.03±0.48) 和 (3.43±0.45) mm,对照组为 (4.82±0.55) 和 (4.27±0.36) mm。经配对样本t检验,实验组PD减小量显著高于对照组（P<0.05）。治疗后12周,2组间HPD无显著差异;术后20周复查HPD发现,实验组为 （3.01±0.34） mm,对照组为（3.78±0.29） mm,实验组HPD降低但仍显著大于对照组（P<0.05）。12周和20周时,实验组GI和AL值较对照组低,但差异无统计学意义。结论 Er:YAG激光对慢性牙周炎Ⅱ度根分叉患者的治疗安全有效,临床应用价值显著。

Clinical evaluation of Er:YAG laser in the treatment of grade Ⅱ periodontitis with bifurcation lesions

PURPOSE: To evaluate the clinical efficacy of erbium-doped yttrium aluminium garnet (Er: YAG) laser in the treatment of degree II bifurcation periodontitis. METHODS: Thirty patients(60 teeth) with grade II bifurcation lesions of chronic periodontitis were enrolled in this study. One week after supergingival scaling with ultrasound, the patients were randomly divided into experimental group: subgingival scaling with ultrasound and hand instruments + Er: YAG laser irradiation in periodontal pocket; control group: the contralateral homonymous teeth were treated with subgingival scaling with ultrasound and hand instruments alone. The changes of gingival index(GI), pocket depth(PD), horizontal probing depth (HPD) and attachment loss(AL) were compared between the two groups 12 and 20 weeks after treatment. SPSS 20.0 software package was used for statistical analysis. RESULTS: Periodontal clinical indexes(GI, PD, HPD, AL) of the experimental group and control group were significantly reduced compared with baseline at 12 and 20 weeks after treatment(P<0.05). At 12 and 20 weeks after treatment, PD in the experimental group was (4.03±0.48) mm and (3.43±0.45) mm, (4.82±0.55) mm and (4.27±0.36) mm in the control group, respectively. The reduction of PD in the experimental group was significantly greater than that in the control group (P<0.05). There was no significant difference in HPD between the two groups at 12 weeks after treatment. Twenty weeks after operation, HPD in the experimental group was found to be (3.01±0.34) mm and (3.78±0.29) mm in the control group. The decrease of HPD in the experimental group was significantly greater than that in the control group (P<0.05). GI and AL of the experimental group at 12 and 20 weeks were lower than those of the control group, but the difference was not statistically significant. CONCLUSIONS: Er: YAG laser is safe and effective in the treatment of chronic periodontitis patients with grade II root bifurcation lesions with significant clinical value.