何颖 武明轩 杨冬茹

[摘要]目的：探討Er：YAG激光结合牙周翻瓣术治疗重度牙周炎的临床效果。方法：选取2018年6月-2020年2月河北医科大学口腔医院牙周二科收治的60例重度牙周炎患者为研究对象，随机分为两组。对照组采用翻瓣术进行治疗，研究组在对照组的基础上采用Er：YAG激光辅助治疗，两组术后均随访6个月。比较两组术后6个月的临床疗效;对比两组术前、术后6个月的牙齿松动度及牙周指标，术后3d的疼痛程度及睡眠质量。结果：术后6个月，研究组总有效率高于对照组（90.00% vs 66.67%，P<0.05）;两组术前、术后6个月的牙齿松动度比较，差异均无统计学意义（P>0.05）。与术前比较，术后6个月，两组PD、PLI、SBI均降低，且研究组均低于对照组（P<0.05）;术后3d，研究组VAS、PSQI评分均低于对照组（P<0.05）。结论：Er：YAG激光结合牙周翻瓣术可明显改善重度牙周炎患者的牙周指标，促进组织愈合，减轻术后疼痛，提高睡眠质量，进而有助于提高临床疗效，且对牙齿松动度的影响较小。

[关键词]牙周炎;重度;Er：YAG激光;牙周翻瓣术;临床疗效

[中图分类号]R781.4+2    [文献标志码]A    [文章编号]1008-6455（2021）06-0118-04

The Clinical Research of Er： YAG Laser Combined with Periodontal Flap Surgery in Patients with Severe Periodontitis

HE Ying， WU Ming-xuan， YANG Dong-ru

[Department of Periodontology（Department of Laser Medicine），School

and Hospital of Stomatology Hebei Medical University，Hebei Key Laboratory of Stomatology，Hebei Clinical Research Center for Oral Diseases，Shijiazhuang 050017， Hebei，China]

Abstract：Objective  To investigate the clinical research of Er： YAG laser combined with periodontal flap surgery  in patients with severe periodontitis. Methods  Between June 2018 and February 2020， 60 patients with severe periodontitis admitted to the department of oral dentistry， Stomatological Hospital of Hebei Medical University were selected as the research objects. They were divided into the study group and the control group through a random number table， with 30 cases in each group. The control group was treated with periodontal flap surgery ， and the study group was treated with Er： YAG laser on the basis of the control group. Both groups were followed up for 6 months after surgery. The clinical efficacy at 6 months after surgery was compared between the two groups， the teeth looseness and periodontal indicators before and 6 months after surgery， the pain degree and the quality of sleep 3 d after surgery were compared between the two groups. Results   At 6 months after surgery， the total effective rate in the study group was higher than the control group （90.00% vs 66.67%， P<0.05）. There was no significant difference in teeth looseness between the two groups before and 6 months after surgery （P>0.05）. Compared with before surgery， at 6 months after surgery， the PD， PLI， and SBI in the two groups decreased， and the study group were lower than the control group （P<0.05）. At 3 d after surgery， the VAS and PSQI scores in the two groups decreased， and the study group were lower than the control group （P<0.05）. Conclusion  Er：YAG laser combined with periodontal flap surgery  could significantly improve the periodontal indicators of patients with severe periodontitis， promote tissue healing， reduce postoperative pain， improve sleep quality， and thus help improve the clinical efficacy， and has little effect on teeth looseness.

Key words：periodontitis; severe; Er： YAG laser; periodontal flap surgery ; clinical efficacy

牙周炎是口腔科常见疾病，该疾病若未进行有效救治，易进一步发展为重度，严重影响患者口腔健康及生活质量[1-2]。目前，临床治疗重度牙周炎常采用牙周翻瓣术和牙周引导骨组织再生术，可在一定程度上促使牙周袋变浅，控制病情进一步恶化，但临床有关研究证实[3]，单纯依靠牙周翻瓣术易导致牙石及牙菌斑清除不彻底，影响预后，从而使牙周引导骨组织再生手术成功率降低。近年来，激光手术广泛应用于治疗牙周疾病，其中Er：YAG激光作为新一代牙科激光，可在精确切割软硬组织的同时对患病组织进行有效清创[4]。本研究选取60例重度牙周炎患者进行随机对照研究，以期为临床治疗重度牙周炎提供指导。

1  资料和方法

1.1 一般资料：经河北医科大学口腔医院医学伦理委员会审核并批准后，选取2018年6月-2020年2月河北医科大学口腔医院牙周二科收治的60例重度牙周炎患者作为研究对象，均符合《牙周病学》[5]中关于重度牙周炎的相关诊断标准。……