董婷婷 张德梅 解用江 刘玲珍 潘多

[摘要] 目的 分析YAG激光聯合牙周基础治疗对牙周炎的临床治疗效果。 方法 采取单双数球抽签的方式将我院在2016年7月～2017年7月期间收治的24例牙周炎患者分为两组，对照组（牙周基础治疗，12例患者44颗牙）与实验组（YAG激光联合牙周基础治疗，12例患者45颗牙），分别对两组牙周炎患者的临床治疗效果进行分析并比较。 结果 实验组治疗后第4周sICAM-1的含量（149.32±22.54）ng/mL明显低于对照组（189.69±31.23）ng/mL，差异具有统计学意义（P<0.05）；实验组与对照组的临床附着丧失比较，差异无统计学意义（P>0.05），实验组的牙周探诊深度（3.51±0.62）mm均明显优于对照组（4.31±1.13）mm，差异具有统计学意义（P<0.05）；且实验组治疗后3个月（1.33±0.98）、6个月（1.12±0.82）的出血指数均低于对照组（2.43±1.04）、（2.23±1.03），差异具有统计学意义（P<0.05）；另外，实验组治疗6个月后牙槽骨骨密度改善优于对照组，差异具有统计学意义（P<0.05）。 结论 对于牙周炎患者而言，采取YAG激光联合牙周基础治疗的临床应用效果显著，能有效减少龈沟液中sICAM-1的表达，同时能改善牙龈出血症状，促进患者的牙周组织恢复健康状态，临床应用价值显著。

[关键词] YAG激光；牙周基础治疗；牙周炎；出血指数

[中图分类号] R248.1 [文献标识码] B [文章编号] 1673-9701（2018）30-0061-03

[Abstract] Objective To analyze the clinical effect of YAG laser combined with periodontal basic therapy on periodontitis. Methods 24 patients with periodontitis admitted in our hospital from July 2016 to July 2017 were divided into two groups according to single-dual ball drawing， including the control group （periodontal basic treatment， 12 patients with 44 teeth） and the experimental group（YAG laser combined with periodontal basic treatment， 12 patients with 45 teeth）. The clinical treatment effects of the two groups of patients with periodontitis were analyzed and compared. Results The content of sICAM-1（149.32±22.54） ng/mL in the experimental group was significantly lower than that in the control group （189.69±31.23）ng/mL at 4 weeks after treatment， which was statistically significant（P<0.05）. There was not statistically significant difference in the clinical attachment loss between the experimental group and the control group（P>0.05）. The depth of periodontal probing （3.51±0.62） mm in the experimental group was significantly better than that in the control group（4.31±1.13） mm， which was statistically significant（P<0.05）. And the bleeding index at 3 months （1.33±0.98） and 6 months after treatment （1.12±0.82） in the experimental group was gradually lower than （2.43±1.04） and （2.23±1.03） of the control group， with statistically significant difference（P<0.05）. In addition， the improvement of alveolar bone mineral density in the experimental group was better than that in the control group after 6 months of treatment（P<0.05）. Conclusion For patients with periodontitis， the clinical application of YAG laser combined with periodontal basic treatment is effective， which can effectively reduce the expression of sICAM-1 in gingival crevicular fluid， improve the symptoms of gingival bleeding and promote the recovery health status of periodontal tissue. And the clinical application value is significant.

[Key words] YAG laser； Periodontal basic therapy； Periodontitis； Bleeding index

慢性牙周炎的治疗方法为去除牙石、菌斑，目前临床常用的根面清创治疗方法为手工刮治或超声刮治，其中手工刮治方法敏感性高，不易到达根面凹陷的生理解剖部位；而超声刮治方法较易产生气溶胶，对空气的污染较严重，两种治疗方法均无法获取良好的治疗效果[1]。近年来激光逐渐进入牙周治疗的领域中，YAG激光被认为是治疗牙周炎最有效的激光治疗方法，YAG激光是固体脉冲激光，较易被水与羟磷灰石吸收而形成微爆破，从而将牙周中的软组织清除，不会引起热损伤[2]。大量研究表明，YAG激光治疗能有效清除病变牙骨质，不会产生玷污层，并且具有良好的杀菌效果与抑菌效果。本文主要对我院收治的24例牙周炎患者采取YAG激光联合牙周基础治疗，取得良好的临床治疗效果，现报道如下。……