非手术治疗对侵袭性牙周炎不同牙周袋深度位点的影响及可疑致病微生物特性分析
|
摘要
目的:探讨非手术治疗对侵袭性牙周炎不同牙周袋深度位点的影响及可疑致病微生物特性分析。方法:以笔者医院2017年5月-2018年5月收治的30例侵袭性牙周炎患者为对象,均展开非手术治疗,每个象限取1个位点,分析治疗前后不同位点疗效及可疑致病微生物的特性。结果:30例患者,共取120个位点,治疗6个月后牙周袋深度减少>2mm的位点牙周袋深度、邻面附着丧失、出血指数均较牙周袋深度减少≤2mm的位点高,差异有统计学意义(P<0.05),两者菌斑指数对比差异无统计学意义(P>0.05);治疗6个月后,牙周袋深度减少>2mm的位点琥珀酸、乙酸、丙酸、丁酸浓度较牙周袋深度减少≤2mm的位点高,差异有统计学意义(P<0.05),有机酸比较则差异无统计学意义(P>0.05);治疗6个月后,牙周袋深度减少>2mm的位点齿垢密螺旋体检出率较牙周袋深度减少≤2mm的位点高,差异有统计学意义(P<0.05),红色复合体微生物牙龈卟啉单胞菌、福赛坦氏菌、核梭杆菌、中间普氏菌、伴放线聚集杆菌检出率比较,差异无统计学意义(P>0.05)。结论:侵袭性牙周炎疗效受牙周袋深度影响,经非手术治疗后牙周袋较深的位点仍然有感染存在,需持续抗感染治疗。
Objective To investigate the effect of non-surgical treatment on the depth of different periodontal pockets of invasive periodontitis and the characteristics of suspected pathogenic microorganisms. Methods Thirty cases with aggressive periodontitis admitted to our hospital from May 2017 to May 2018 were enrolled.Non-surgical treatment was performed, followed up and reviewed. One site was taken in the quadrant to analyze the efficacy of different sites before and after treatment and the characteristics of suspected pathogenic microorganisms. Results In 30 patients, 120 sites were taken. After 6 months of treatment, the periodontal pocket depth was reduced by>2 mm. The depth of probing exploration, loss of adjacent adhesion, and bleeding index were reduced by less than 2 mm, with statistically significant(P<0.05).There was no significant difference in the plaque index between the two groups(P>0.05).After 6 months of treatment, the concentration of succinic acid, acetic acid, propionic acid and butyric acid in the period of periodontal pocket depth decreased by>2 mm was higher than that of periodontal pocket depth ≤2 mm, with statistically significant(P<0.05). There was no significant difference in organic acid contrast(P >0.05).After 6 months of treatment, the periodontal pocket depth decreased by>2 mm, and the detection rate of tarsal Helicobacter was higher than that of periodontal pocket depth≤ 2 mm,with statistically significant(P<0.05). Red complex microorganisms There was no significant difference in the detection rate of Porphyromonas gingivalis, Fustatin, Fusobacterium nucleatum, Plasmodium mutans and A.faecalis(P>0.05). Conclusion The effect of invasive periodontitis is affected by the depth of periodontal pocket. There is still infection in the deeper periodontal pocket after non-surgical treatment. It is necessary to continue anti-infective treatment.
Objective To investigate the effect of non-surgical treatment on the depth of different periodontal pockets of invasive periodontitis and the characteristics of suspected pathogenic microorganisms. Methods Thirty cases with aggressive periodontitis admitted to our hospital from May 2017 to May 2018 were enrolled.Non-surgical treatment was performed, followed up and reviewed. One site was taken in the quadrant to analyze the efficacy of different sites before and after treatment and the characteristics of suspected pathogenic microorganisms. Results In 30 patients, 120 sites were taken. After 6 months of treatment, the periodontal pocket depth was reduced by>2 mm. The depth of probing exploration, loss of adjacent adhesion, and bleeding index were reduced by less than 2 mm, with statistically significant(P<0.05).There was no significant difference in the plaque index between the two groups(P>0.05).After 6 months of treatment, the concentration of succinic acid, acetic acid, propionic acid and butyric acid in the period of periodontal pocket depth decreased by>2 mm was higher than that of periodontal pocket depth ≤2 mm, with statistically significant(P<0.05). There was no significant difference in organic acid contrast(P >0.05).After 6 months of treatment, the periodontal pocket depth decreased by>2 mm, and the detection rate of tarsal Helicobacter was higher than that of periodontal pocket depth≤ 2 mm,with statistically significant(P<0.05). Red complex microorganisms There was no significant difference in the detection rate of Porphyromonas gingivalis, Fustatin, Fusobacterium nucleatum, Plasmodium mutans and A.faecalis(P>0.05). Conclusion The effect of invasive periodontitis is affected by the depth of periodontal pocket. There is still infection in the deeper periodontal pocket after non-surgical treatment. It is necessary to continue anti-infective treatment.
引文
[1]常静,马钧.局限型和广泛型侵袭性牙周炎的临床特点及预后研究[J].临床与病理杂志,2016,36(5):614-618.
[2]洪润丹,徐全臣.侵袭性牙周炎的治疗研究进展[J].口腔医学,2018,38(3):281-284.
[3]Harrel SK,Nunn M E,Abraham CM,et al.Videoscope Assisted minimally invasive periodontal surgery(vmis):long term outcomes[J].J Periodontol,2017,88(6):1-3.
[4]浩尔.牙周病临床诊治要点[M].北京:人民卫生出版社,2011:242-245.
[5]任颂,潘亚萍.牙周非手术治疗对广泛型侵袭性牙周炎患者咀嚼肌功能影响研究[J].中国实用口腔科杂志,2016,9(1):35-39.
[6]孙晓娟,许春姣.侵袭性牙周炎辅助治疗方法研究进展[J].中国实用口腔科杂志,2017,10(10):630-634.
[7]Th?ne-Mühling M,Kelm D,Mengel R.Width of keratinized mucosa at implant sites in patients treated for generalized aggressive periodontitis:a cohort study[J].Int J Oral Maxillofac Implants,2016,31(2):392.
[8]毕小成,危伊萍,胡文杰,等.罹患重度牙周病变磨牙拔牙后位点保存与自然愈合后种植治疗效果对比研究[J].中国实用口腔科杂志,2017,10(10):598-604.
[9]Happe A,Kunz A.Complex fixed implant-supported restoration in a site compromised by periodontitis:a case report[J].Int J Esthet Dent,2016,11(2):186-202.
[10]刘培成,赵悦,陈晨,等.前牙区重度牙周炎非手术治疗预后影响因素分析[J].中国实用口腔科杂志,2018,11(7):426-430.
[11]胡杉林,秦飞,郑江海,等.IL-4、IL-6和IL-13基因多态性与慢性牙周炎的相关性研究[J].海南医学,2016,27(21):3455-3457.
[12]张秀,潘亚萍.慢性牙周炎患者牙周支持治疗对临床疗效指标的影响[J].中国实用口腔科杂志,2016,9(10):635-638.
[13]Khorsand A,Bayani M,Yaghobee S,et al.Evaluation of salivary leptin levels in healthy subjects and patients with advanced periodontitis[J].J Dent,2016,13(1):1-9.
[14]杨栋,李红梅,刘林花,等.Th17及其相关因子在不同牙周炎症状态龈沟液中的检测[J].口腔医学研究,2017,33(11):1161-1164.
[15]谭葆春,钟泉,闫福华.重度牙周炎的牙髓治疗研究进展[J].中国实用口腔科杂志,2016,9(4):205-208.
[16]赵红,王新林,吕治,等.基于高通量测序技术研究慢性牙周炎患者龈下刮治和根面平整术治疗前后龈下菌群的变化[J].国际口腔医学杂志,2017,44(3):294-300.
[17]张菊梅.牙周炎牙根根面微生物群落结构比较[J].四川大学学报:医学版,2016,47(6):848-851.
[18]徐云龙,于金华.益生菌含片对慢性牙周炎治疗的临床效果及微生物学的影响:一份一年的随访调查报道[J].口腔生物医学,2016,13(2):109.
[19]张光宇,林莉.牙龈卟啉单胞菌诱导的牙周微环境失调引发牙周炎的作用机制研究进展[J].中国实用口腔科杂志,2016,9(9):561-565.
[20]王慧敏,彭舒婷,李连伟,等.牙周炎患者口腔微生物菌群的空间异质性探讨[J].河南科学,2017,35(12):1935-1939.
[2]洪润丹,徐全臣.侵袭性牙周炎的治疗研究进展[J].口腔医学,2018,38(3):281-284.
[3]Harrel SK,Nunn M E,Abraham CM,et al.Videoscope Assisted minimally invasive periodontal surgery(vmis):long term outcomes[J].J Periodontol,2017,88(6):1-3.
[4]浩尔.牙周病临床诊治要点[M].北京:人民卫生出版社,2011:242-245.
[5]任颂,潘亚萍.牙周非手术治疗对广泛型侵袭性牙周炎患者咀嚼肌功能影响研究[J].中国实用口腔科杂志,2016,9(1):35-39.
[6]孙晓娟,许春姣.侵袭性牙周炎辅助治疗方法研究进展[J].中国实用口腔科杂志,2017,10(10):630-634.
[7]Th?ne-Mühling M,Kelm D,Mengel R.Width of keratinized mucosa at implant sites in patients treated for generalized aggressive periodontitis:a cohort study[J].Int J Oral Maxillofac Implants,2016,31(2):392.
[8]毕小成,危伊萍,胡文杰,等.罹患重度牙周病变磨牙拔牙后位点保存与自然愈合后种植治疗效果对比研究[J].中国实用口腔科杂志,2017,10(10):598-604.
[9]Happe A,Kunz A.Complex fixed implant-supported restoration in a site compromised by periodontitis:a case report[J].Int J Esthet Dent,2016,11(2):186-202.
[10]刘培成,赵悦,陈晨,等.前牙区重度牙周炎非手术治疗预后影响因素分析[J].中国实用口腔科杂志,2018,11(7):426-430.
[11]胡杉林,秦飞,郑江海,等.IL-4、IL-6和IL-13基因多态性与慢性牙周炎的相关性研究[J].海南医学,2016,27(21):3455-3457.
[12]张秀,潘亚萍.慢性牙周炎患者牙周支持治疗对临床疗效指标的影响[J].中国实用口腔科杂志,2016,9(10):635-638.
[13]Khorsand A,Bayani M,Yaghobee S,et al.Evaluation of salivary leptin levels in healthy subjects and patients with advanced periodontitis[J].J Dent,2016,13(1):1-9.
[14]杨栋,李红梅,刘林花,等.Th17及其相关因子在不同牙周炎症状态龈沟液中的检测[J].口腔医学研究,2017,33(11):1161-1164.
[15]谭葆春,钟泉,闫福华.重度牙周炎的牙髓治疗研究进展[J].中国实用口腔科杂志,2016,9(4):205-208.
[16]赵红,王新林,吕治,等.基于高通量测序技术研究慢性牙周炎患者龈下刮治和根面平整术治疗前后龈下菌群的变化[J].国际口腔医学杂志,2017,44(3):294-300.
[17]张菊梅.牙周炎牙根根面微生物群落结构比较[J].四川大学学报:医学版,2016,47(6):848-851.
[18]徐云龙,于金华.益生菌含片对慢性牙周炎治疗的临床效果及微生物学的影响:一份一年的随访调查报道[J].口腔生物医学,2016,13(2):109.
[19]张光宇,林莉.牙龈卟啉单胞菌诱导的牙周微环境失调引发牙周炎的作用机制研究进展[J].中国实用口腔科杂志,2016,9(9):561-565.
[20]王慧敏,彭舒婷,李连伟,等.牙周炎患者口腔微生物菌群的空间异质性探讨[J].河南科学,2017,35(12):1935-1939.