光动力疗法辅助治疗Ⅲ期、Ⅳ期牙周炎的临床效果评价

目的: 探讨光动力疗法（photodynamic therapy,PDT）辅助龈下刮治术（subgingival scaling and root planning,SRP）在Ⅲ、Ⅳ期牙周炎治疗中的临床效果。方法: 根据2018年牙周病新分类,选择Ⅲ期和Ⅳ期牙周炎患者,经龈上洁治1周后,记录牙周探诊深度（probing depth, PD）、牙龈指数（gingival index, GI）和探诊出血（bleeding on probing,BOP）为基线。将患者分为3组,SRP组进行SRP治疗;PDT1组在SRP后即刻对口内所有PD≥5 mm的位点进行PDT;PDT2组在SRP+PDT后6周,对原位点再进行1次PDT。基线治疗后3、6个月复查,比较PD、GI和BOP阳性率的变化。采用SPSS 22.0软件包对数据进行统计学分析。结果: 共纳入30例患者、1 289个位点。SRP组、PDT1组和PDT2组各10例患者,位点数分别为476个（36.9%）、384个（29.8%）和429个（33.3%）。3组治疗后3个月、6个月复查时,PD、GI、BOP阳性率较基线均显著降低（P<0.05）; 6个月与3个月的复查结果无显著差异。PD≥5 mm的位点,PDT1组和PDT2组可以显著降低患牙的GI和BOP阳性率（P<0.05）;PD≥7 mm时,PDT2组PD显著降低（P<0.05）。结论: 对于Ⅲ、Ⅳ期牙周炎,PDT辅助SRP治疗可以获得比单纯SRP更好的临床效果。

Effectiveness of adjunctive photodynamic therapy in the treatment of stage Ⅲ, Ⅳ periodontitis

PURPOSE: To explore the clinical effect of subgingival scaling and root planning (SRP) with adjunctive photodynamic therapy (PDT) in the treatment of stage Ⅲ and Ⅳ periodontitis. METHODS: According to 2018 Classification of Periodontitis, patients diagnosed as stage Ⅲ and Ⅳ periodontitis were recruited. One week after supragingival scaling, probing depth (PD), bleeding on probing (BOP) and gingival index (GI) were recorded as the baseline. All patients were divided into 3 groups, SRP group received whole mouth SRP treatment; PDT1 group: PDT at all sites with PD≥5 mm immediately after SRP; PDT2 group received another PDT at the test sites 6 weeks after full mouth SRP+PDT. PD, GI and the positive rates of BOP were compared 3 months and 6 months after treatment. SPSS 22.0 software package was used for data analysis. RESULTS: Thirty patients and 1 289 test sites were included in this trial. There were 10 patients in group SRP, PDT1 and PDT2, and the number of tests sites were 476, 36.9%, 384, 29.8% and 429 33.3%, respectively. The PD, GI and the positive rates of BOP in the three groups were reduced at 3-months and 6-months of follow-up (P<0.05), there was no significant difference between 3-months and 6-months of follow-up. At the site of PD≥5 mm, group PDT1 and PDT2 could significantly reduce GI and the positive rates of BOP at the test sites(P<0.05). When PD≥7 mm, significant PD reduction was observed in group PDT2(P<0.05). CONCLUSIONS: In the treatment of stage Ⅲ and Ⅳ periodontitis, PDT assisted with SRP therapy can achieve better clinical effect than SRP alone.