亚甲基蓝/光化学法辅助治疗慢性牙周炎对牙龈卟啉单胞菌的影响

目的研究亚甲基蓝/光化学法辅助治疗慢性牙周炎对牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)检出率的变化。方法经伦理委员会同意后,本研究拟筛选出45例慢性牙周炎患者(每位患者经过详细牙周检查及X线检查后确认为牙周炎,有4个以上≥5 mm的牙周袋并分布在2个以上口腔区域),随机分3组:其中A组在SRP之后接受1次PERIOWAVE光化学治疗,B组在SRP后接受1次PERIOWAVE治疗以及在6周后再一次接受光化学治疗,而SRP组仅接受SRP治疗,各组患者取治疗前后相同4个位点龈下菌斑,聚合酶链式反应(Poly-merase chain reaction,PCR)检测Pg,观察Pg菌的检出率,采用卡方检验,并计算χ2值。结果 SRP组、A组、B组3组各组治疗后均较治疗前检出率降低(P<0.001),A组与SRP组治疗后比较差异无统计学意义A组:40%(24/60),SRP组:45%(27/60),χ2=1.4815,P>0.05],B组与SRP治疗后比较检出率降低SRP组:45%(27/60),B组:20%(12/60)χ2=8.547,P<0.01];B组与A组治疗后比较检出率降低A组:40%(24/60),B组:20%(12/60),χ2=5.7143,P<0.05]。结论亚甲基蓝/光化学法辅助治疗慢性牙周炎后牙龈卟啉单胞菌的检出率较治疗前降低;结合临床试验结果,尚可认为2次激光疗效较1次激光好。

Therapeutical effect of photochemical treatment on chronic preiodontitis by Porphyromonas gingivalis detection rate

Objective To detect Porphyromonas gingivalis（Pg） in periodontal pocket of chronic periodontitis patients after the photochemical treatment by polymerase chain reaction method.Method 45 subjects qualified with more than 4 sites of periodontal pocket depth（PD,≥5 mm in ≥2 quadrants） were selected.After baseline examination,all patients were subjected to scaling and root planning（SRP） and randomly assigned to three groups： Group A received PERIOWAVE photochemical treatment instantly;Group B received PERIOWAVE photochemical treatment immediately after SRP and repeat after 6 weeks;Group SRP received nothing as control.Pg in subgingival plaque and gingival sulcus were detected by PCR.The detection rate of Pg was statistically analyzed by chi-square test,and χ2 values were compared（P〈0.05）.Result The Pg detection rate of all groups reduced significantly after treatment（P〈0.001）.As for the detection rate after treatment,there was no statistic difference between Group A and Group SRP（P〉0.05）;however the rate of Group B was much lower than both Group A（P〈0.05）and Group SRP（P〈0.01）.Conclusion The detection rate of Porphyromonas gingivalis reduces after the photochemical treatment.Two times PERIOWAVE photochemical treatment after regular SRP can be an effective accessory choice to chronic periodontal patients.