慢性牙周炎患者种植修复后临床疗效及对龈沟液炎性因子和基质金属蛋白酶水平的影响
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摘要
目的:探讨种植修复术对慢性牙周炎患者的临床疗效及对龈沟液炎性因子和基质金属蛋白酶水平的影响。方法:选取我院收治的66例慢性牙周炎合并牙列缺损患者为观察组,并以同期收治的66例牙周健康合并牙列缺损患者为对照组;所有患者均行口腔种植修复术。比较两组患者术后6个月及术后1年边缘骨吸收量、牙周探诊深度(periodontal probing depth,PD)、改良龈沟出血指数(modified sulcus bleeding index,mSBI)、改良菌斑指数(modified plaque index,mPLI)、龈沟液炎性因子(IL-1β、IL-6、IL-8)、基质金属蛋白酶(MMP-2、MMP-8、MMP-9)水平变化情况及术后1年两组患者种植体脱落情况。结果::术后6个月,两组患者在边缘骨吸收量、PD、mSBI及mPLI上比较无统计学差异(P>0.05);术后1年,观察组各指标水平均显著上升(P<0.05),对照组边缘骨吸收量及mPLI水平显著上升(P<0.05),而PD及mSBI水平无明显变化(P>0.05),且观察组PD及mSBI水平显著高于对照组(P<0.05)。术后6个月,观察组龈沟液IL-1β、IL-6、IL-8、MMP-2、MMP-8、MMP-9水平显著高于对照组;术后1年,对照组IL-1β、IL-6及MMP-9水平显著上升(P<0.05),而IL-8、MMP-2及MMP-8水平无明显变化(P>0.05),观察组龈沟液各指标水平均显著上升,且高于对照组(P<0.05)。术后1年两组患者种植体留存率比较无显著性差异(观察组97.03%vs对照组95.74%)。结论:慢性牙周炎患者通过种植修复术可获得较好的疗效,但也存在患种植体周围炎的风险,而MMP-2、MMP-8、MMP-9水平与种植体周围炎存在一定联系。
Objective:To investigate the clinical efficacy of implant restoration in patients with chronic periodontitis and the effects of inflammatory factors and matrix metalloproteinase levels in gingival crevicular fluid.Methods:Sixty-six patients with chronic periodontitis complicated with dentition defect were enrolled in our hospital,and 66 patients with periodontal health and dentition defect were treated as the control group.All patients underwent oral implant restoration.The marginal bone resorption,periodontal probing depth(PD),modified sulcus bleeding index(mSBI),modified plaque index(mPLI),gingival crevicular inflammation were compared between the two groups at 6 months and 1 year after operation.The levels of factors(IL-1β,IL-6,IL-8),matrix metalloproteinases(MMP-2,MMP-8,MMP-9)and the loss of implants in the two groups after 1 year.Results:At 6 months after operation,there was no significant difference in marginal bone resorption,PD,mSBI and mPLI between the two groups(P>0.05).After 1 year,the indicators in the observation group increased significantly(P<0.05).The bone resorption and mPLI levels in the control group increased significantly(P<0.05),while the PD and mSBI levels did not change significantly(P>0.05),and the PD and mSBI levels in the observation group were significantly higher than those in the control group(P<0.05).At 6 months after operation,the levels of IL-1β,IL-6,IL-8,MMP-2,MMP-8 and MMP-9 in the gingival crevicular fluid of the observation group were significantly higher than those in the control group,and 1 year after operation,the control group IL-The levels of 1β,IL-6 and MMP-9 increased significantly(P<0.05),while the levels of IL-8,MMP-2 and MMP-8 did not change significantly(P>0.05).It rose and was higher than the control group(P<0.05).There was no significant difference in implant retention rates between the two groups(observation group 97.03% vs control group 95.74%)in 1 year after operation.Conclusion:Patients with chronic periodontitis can achieve better results through implant restoration,but there is also a risk of inflammation around the implant.MMP-2,MMP-8,MMP-9 levels are associated with peri-implantitis.
Objective:To investigate the clinical efficacy of implant restoration in patients with chronic periodontitis and the effects of inflammatory factors and matrix metalloproteinase levels in gingival crevicular fluid.Methods:Sixty-six patients with chronic periodontitis complicated with dentition defect were enrolled in our hospital,and 66 patients with periodontal health and dentition defect were treated as the control group.All patients underwent oral implant restoration.The marginal bone resorption,periodontal probing depth(PD),modified sulcus bleeding index(mSBI),modified plaque index(mPLI),gingival crevicular inflammation were compared between the two groups at 6 months and 1 year after operation.The levels of factors(IL-1β,IL-6,IL-8),matrix metalloproteinases(MMP-2,MMP-8,MMP-9)and the loss of implants in the two groups after 1 year.Results:At 6 months after operation,there was no significant difference in marginal bone resorption,PD,mSBI and mPLI between the two groups(P>0.05).After 1 year,the indicators in the observation group increased significantly(P<0.05).The bone resorption and mPLI levels in the control group increased significantly(P<0.05),while the PD and mSBI levels did not change significantly(P>0.05),and the PD and mSBI levels in the observation group were significantly higher than those in the control group(P<0.05).At 6 months after operation,the levels of IL-1β,IL-6,IL-8,MMP-2,MMP-8 and MMP-9 in the gingival crevicular fluid of the observation group were significantly higher than those in the control group,and 1 year after operation,the control group IL-The levels of 1β,IL-6 and MMP-9 increased significantly(P<0.05),while the levels of IL-8,MMP-2 and MMP-8 did not change significantly(P>0.05).It rose and was higher than the control group(P<0.05).There was no significant difference in implant retention rates between the two groups(observation group 97.03% vs control group 95.74%)in 1 year after operation.Conclusion:Patients with chronic periodontitis can achieve better results through implant restoration,but there is also a risk of inflammation around the implant.MMP-2,MMP-8,MMP-9 levels are associated with peri-implantitis.
引文
[1]陈琳,陈昕.慢性牙周炎基础治疗前后龈沟液ET-1水平变化及其与牙周临床指标的关系[J].临床口腔医学杂志,2018,34(3):174-177.
[2]Gurol C,Kazazoglu E,Dabakoglu B,et al.A comparative study of the role of cytokine polymorphisms interleukin-10 and tumor necrosis factor alpha in susceptibility to implant failure and chronic periodontitis[J].Int J Oral Maxillofac Implants,2011,26(5):955-960.
[3]王林虎,施斌,叶明福,等.慢性牙周炎与种植牙相关性的Meta分析[J].中华口腔医学研究杂志(电子版),2014,8(1):28-32.
[4]Petkovi c'-Curcin A,Mati c'S,Vojvodi c'D,et al.Cytokines in pathogenesis of peri-implantitis[J].Vojnosanit Pregl,2011,68(5):435-440.
[5]Boyce BF,Li P,Yao Z,et al.TNF-alpha and pathologic bone resorption[J].Keio J Med,2005,54(3):127-131.
[6]孟焕新.牙周病学[M].3版,北京:人民卫生出版社,2008:120-124.
[7]De Boever AL,Quirynen M,Coucke W,et al.Clinical and radiographic study of implant treatment outcome in periodontally susceptible and non-susceptible patients:a prospective long-term study[J].Clin Oral Implants Res,2009,20(12):1341-1350.
[8]刘磊,吕东达.口腔种植修复技术对慢性牙周炎患者种植体松动度、PD及SBI指数影响研究[J].陕西医学杂志,2018,47(3):305-307.
[9]谢也斯,孟焕新,韩劼,等.牙周炎患者种植修复体机械并发症及菌斑控制的相关性分析[J].中华口腔医学杂志,2016,51(2):69-75.
[10]van Steenberghe D,Klinge B,Lindén U,et al.Periodontal indices around natural and titanium abutments:a longitudinal multicenter study[J].JPeriodontol,1993,64(6):538-541.
[11]Lavu V,Venkatesan V,Venkata,Kameswara Subrahmanya Lakkakula B,et al.Polymorphic regions in the interleukin-1 gene and susceptibility to chronic periodontitis:a genetic association study[J].Genet Test Mol Biomarkers,2015,19(4):175-181.
[12]Ferreira CF,Buttendorf AR,de Souza JG,et al.Prevalence of peri-implant diseases:analyses of associated factors[J].Eur J Prosthodont Restor Dent,2015,23(4):199-206.
[13]Kim GY,Lee CH.Antimicrobial susceptibility and pathogenic genes of Staphylococcus aureus isolated from the oral cavity of patients with periodontitis[J].J Periodontal Implant Sci,2015,45(6):223-228.
[14]张旭,祁胜财,唐小山,等.牙周炎患者牙龈组织中IL-21表达的研究[J].临床口腔医学杂志,2016,32(6):338-341.
[15]刘璐,张巧红,朱洪光,等.白细胞介素-1β与种植体周围炎的相关性实验研究[J].中国口腔种植学杂志,2013,18(1):15-17.
[16]赵靓,曹远.牙周基础治疗对牙周炎患者龈沟液和血清IL-6、IL-8和PAF水平的影响[J].实用临床医药杂志,2015,19(19):67-69,85.
[17]Giannobile WV.Host-response therapeutics for periodontal diseases[J].J Periodontol,2008,79(8):1592-1600.
[18]Kuula H,Salo T,Pirila E,et al.Local and systemic responses in matrix metalloproteinase 8-deficient mice during Porphyromonas gingivalis-induced periodontitis[J].Infect Immun,2009,77(2):850-859.
[19]Arakawa H,Uehara J,Hara ES,et al.Matrix metalloproteinase-8 is the major potential collagenase in active peri-implantitis[J].J Prosthodont Res,2012,56(4):249-255.
[20]Soell M,Elkaim R,Tenenbaum H.The Psinc,matrix metalloproteinases and their tissue inhibitors in gingival and gingival crevicular fluid from periodont it is-affected patients[J].Dent Res,2002,81(1):174-178.
[2]Gurol C,Kazazoglu E,Dabakoglu B,et al.A comparative study of the role of cytokine polymorphisms interleukin-10 and tumor necrosis factor alpha in susceptibility to implant failure and chronic periodontitis[J].Int J Oral Maxillofac Implants,2011,26(5):955-960.
[3]王林虎,施斌,叶明福,等.慢性牙周炎与种植牙相关性的Meta分析[J].中华口腔医学研究杂志(电子版),2014,8(1):28-32.
[4]Petkovi c'-Curcin A,Mati c'S,Vojvodi c'D,et al.Cytokines in pathogenesis of peri-implantitis[J].Vojnosanit Pregl,2011,68(5):435-440.
[5]Boyce BF,Li P,Yao Z,et al.TNF-alpha and pathologic bone resorption[J].Keio J Med,2005,54(3):127-131.
[6]孟焕新.牙周病学[M].3版,北京:人民卫生出版社,2008:120-124.
[7]De Boever AL,Quirynen M,Coucke W,et al.Clinical and radiographic study of implant treatment outcome in periodontally susceptible and non-susceptible patients:a prospective long-term study[J].Clin Oral Implants Res,2009,20(12):1341-1350.
[8]刘磊,吕东达.口腔种植修复技术对慢性牙周炎患者种植体松动度、PD及SBI指数影响研究[J].陕西医学杂志,2018,47(3):305-307.
[9]谢也斯,孟焕新,韩劼,等.牙周炎患者种植修复体机械并发症及菌斑控制的相关性分析[J].中华口腔医学杂志,2016,51(2):69-75.
[10]van Steenberghe D,Klinge B,Lindén U,et al.Periodontal indices around natural and titanium abutments:a longitudinal multicenter study[J].JPeriodontol,1993,64(6):538-541.
[11]Lavu V,Venkatesan V,Venkata,Kameswara Subrahmanya Lakkakula B,et al.Polymorphic regions in the interleukin-1 gene and susceptibility to chronic periodontitis:a genetic association study[J].Genet Test Mol Biomarkers,2015,19(4):175-181.
[12]Ferreira CF,Buttendorf AR,de Souza JG,et al.Prevalence of peri-implant diseases:analyses of associated factors[J].Eur J Prosthodont Restor Dent,2015,23(4):199-206.
[13]Kim GY,Lee CH.Antimicrobial susceptibility and pathogenic genes of Staphylococcus aureus isolated from the oral cavity of patients with periodontitis[J].J Periodontal Implant Sci,2015,45(6):223-228.
[14]张旭,祁胜财,唐小山,等.牙周炎患者牙龈组织中IL-21表达的研究[J].临床口腔医学杂志,2016,32(6):338-341.
[15]刘璐,张巧红,朱洪光,等.白细胞介素-1β与种植体周围炎的相关性实验研究[J].中国口腔种植学杂志,2013,18(1):15-17.
[16]赵靓,曹远.牙周基础治疗对牙周炎患者龈沟液和血清IL-6、IL-8和PAF水平的影响[J].实用临床医药杂志,2015,19(19):67-69,85.
[17]Giannobile WV.Host-response therapeutics for periodontal diseases[J].J Periodontol,2008,79(8):1592-1600.
[18]Kuula H,Salo T,Pirila E,et al.Local and systemic responses in matrix metalloproteinase 8-deficient mice during Porphyromonas gingivalis-induced periodontitis[J].Infect Immun,2009,77(2):850-859.
[19]Arakawa H,Uehara J,Hara ES,et al.Matrix metalloproteinase-8 is the major potential collagenase in active peri-implantitis[J].J Prosthodont Res,2012,56(4):249-255.
[20]Soell M,Elkaim R,Tenenbaum H.The Psinc,matrix metalloproteinases and their tissue inhibitors in gingival and gingival crevicular fluid from periodont it is-affected patients[J].Dent Res,2002,81(1):174-178.