陈星羽　薛雅琴　刘 玉

[關键词]激光;牙周炎;牙龈;牙菌斑;牙周袋

[中图分类号]R781.4+2    [文献标志码]A    [文章编号]1008-6455（2021）12-0136-04

Clinical Effect of Er：YAG Laser on Periodontitis and Its Effect on Periodontal Index and Inflammatory Factors

CHEN Xing-yu，XUE Ya-qin，LIU Yu

（Department of Senior Expert Diagnosis and Treatment， Nanjing Stomatological Hospital，Medical School of Nanjing University，Nanjing 210008，Jiangsu，China）

Abstract： Objective  To explore the effect of Er：YAG laser on periodontal indicators， inflammatory factors of periodontitis. Methods  A retrospective analysis of the data of 120 patients with chronic periodontitis who visited Nanjing Stomatological Hospital from June 2017 to June 2020. All patients were divided into the control group and the observation group according to the differences in the treatment methods they received， with 60 cases in the control group and 60 cases in the observation group. The control group was treated with conventional basic treatment， and the observation group was treated with Er：YAG laser based on the treatment method of the control group （removal of subgingival stones and sterilization in the periodontal pocket）. Compare the treatment effects of the two groups， periodontal indicators [gingival index （GI）， dental plaque index （PLI）， degree of alveolar bone resorption， periodontal pocket depth （PD）]， gingival crevicular fluid inflammatory factor indicators [leukocytosis IL-6 （IL-6）， interleukin-8 （IL-8）， soluble intercellular adhesion molecule-1 （sICAM-1）]， serum oxidative stress indicators [malondialdehyde （MDA）， superoxide Dismutase （SOD）]， adverse reactions. Results The effective rate of treatment in the observation group was 100.00%， which was higher than 90.00% in the control group （P<0.05）. Three months after treatment， the observation group's GI， PLI， alveolar bone absorption， PD， and gingival crevicular fluid IL-6， IL-8， sICAM-1， MDA， were all lower than those of the control group. The observation group's SOD， The aesthetic effect index scores were higher than those of the control group （P<0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups during treatment （P>0.05）. Conclusion  In the treatment of patients with chronic periodontitis， the use of Er：YAG laser combined with conventional basic methods to complete the treatment can improve the treatment effect and various periodontal indicators， and reduce local inflammatory reactions and oxidative stress reactions ， has good safety.

Key words： laser; periodontitis; gum; dental plaque; periodontal pocket

牙周炎是人群中较为高发的一类口腔疾病，其中又以慢性牙周炎的占比最高[1]。罹患牙周炎的患者以中老年人为主，其病程漫长，具有牙龈出血，牙齿松动以及难以根治的口腔异味等若干临床表现，随着病情的逐步进展，会发生牙齿脱落导致患者牙列缺损，影响食物咀嚼以及容貌美观[2-3]。以往的研究结果显示，多种因素均可以引起牙周炎的发病风险增高，其中已经确认的有长期吸烟，糖尿病，不良的牙齿清洁习惯及精神压力等[4]。牙周炎的病程极为漫长，绝大部分患者在病变早期易忽视相应症状或不及时治疗，病情进入中晚期后发生牙齿移位、牙周袋等，治疗困难增高。当下针对慢性牙周炎患者，大多以基础治疗为主，虽然去除牙菌斑具有良好的效果，但是牙周袋深部的菌斑去除难度较大[5]。Er：YAG是近些年兴起的一种水动力生物激光技术，该种激光的运用在口腔疾病治疗过程中，可以对牙体硬组织完成切割操作，同时也可以通过照射对牙周致病微生物进行杀灭或抑制功效。Er：YAG激光属于低强度激光，操作过程中对周围正常组织的损伤风险小，能量也容易被水吸收，患者在操作过程中的舒适感较好[6]。筆者医院运用Er：YAG激光技术完成若干牙周炎患者的治疗，取得良好的效果，现对部分患者的数据进行回顾性分析，探讨Er：YAG激光对牙周炎的牙周指标、炎性因子及美学效果的改善效果，现将结果报道如下。……