等离子体射流联合刮治术治疗犬种植体周围炎的实验研究
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摘要
目的：评价低温等离子体射流联合刮治术治疗犬种植体周围炎的临床、微生物、放射学和组织学成果。
方法：拔除六只比格犬双侧下颌第一磨牙；三个月后种牙；三个月后埋线引导种植体周围炎形成,三个月后当种植体支持骨吸收40%时,除去引导线；采用树脂刮治器和0.2%氯己定葡萄糖酸盐治疗对照组,采用树脂刮治器、0.2%氯己定葡萄糖酸盐和等离子体喷流治疗实验组；在治疗前和治疗后三个月分别作龈沟出血指数、探诊深度、牙槽骨丧失深度和CT检查；在治疗后三个月作Micro CT和硬组织切磨片检查；在治疗前和治疗后1、2和3个月时,取微生物样本并作聚合酶链式反应(Polymerase chain reaction, PCR)分析。
结果：在治疗后牙龈卟啉单胞菌(Porphyromonas gingivalis, Pg)和福赛拟杆菌(Bacteroides forsythus, Bf)的检出率有显著性下降(P<0.05),实验组和对照组之间的差异有统计学意义(P<0.05)；实验组的龈沟出血指数(sulcus bleeding index, SBI)和探诊深度(probing depth, PD)有显著性下降(P<0.05),分别从4.42±0.58和4.77±1.45mm下降到1.21±0.58和2.52±0.7 mm,实验组和对照组之间的差异有统计学意义(P<0.05)；实验组骨丧失深度(The distance from the shoulder of the implant to the bottom of the bony defect, DSB)有显著性下降(P<0.05),从3.35±0.70mm下降到2.21±0.90 mm,实验组和对照组之间的差异有统计学意义(P<0.05)。实验组新生骨大量形成,并且与种植体发生骨整合,对照组新生骨形成较少。
结论：低温等离子体喷流联合刮治术治疗犬种植体周围炎取得了很好的治疗效果,改善了临床症状,减少了种植体周围的细菌,促进了种植体和牙槽骨的再结合。
Objective:To evaluate the clinical, microbiological radiological, and histological effects with low temperature atmospheric pressure plasma and scaling against the ligature-induced peri-implantitis in dogs.
Material and Methods:Ligature-induced peri-implantitis was performed for six beagle dogs at 3 months after dental implants. When approximately 40% of the supporting bone was lost, the ligatures were removed. Scaling and local antiseptic cleansing using 0.2% chlorhexidine digluconate were performed in control group. Scaling, local antiseptic cleansing using 0.2% chlorhexidine digluconate and low temperature atmospheric pressure plasma were performed in experimental group. Clinical and radiographic examinations were performed before and at 3 months after treatment respectively. Micro CT and histological examinations were performed at 3 months after treatment. Microbiological samples were obtained and analysed at basement and 1 month,2 moths, and 3 months after treatment respectively.
Results:The prevalence of Pg and Bf was significantly reduced after treatment. Sulcus Bleeding Index (SBI) and probing depth (PD) have significantly decreased (P< 0.05) from 4.42±0.58 and 4.77±1.45 mm to 1.21±0.58 and 2.52±0.7 mm respectively in low temperature atmospheric pressure plasma and scaling group. The differences between the experimental group and the control group were statistically significant (P< 0.05) after treatment in SBI and PD. The radiologically determined distance from the shoulder of the implant to the bottom of the bony defect (DSB) in experimental group significantly decreased from 3.35±0.70 mm to 2.21±0.90 mm (P < 0.05). The DSB in control group decreased from 3.27±0.90 mm to 2.88±0.90 mm and the decrease was not statistically significant. The differences of DSB between the experimental group and the control group after treatment were statistically significant (P< 0.05). The experimental group presented a higher bone height gain. Re-osseointegration occurred in the experimental group.
Conclusions:Therapy of peri-implantitis in dogs with low temperature atmospheric pressure plasma and scaling had positive effects on clinical, microbiological, radiologically and histological parameters.
方法：拔除六只比格犬双侧下颌第一磨牙；三个月后种牙；三个月后埋线引导种植体周围炎形成,三个月后当种植体支持骨吸收40%时,除去引导线；采用树脂刮治器和0.2%氯己定葡萄糖酸盐治疗对照组,采用树脂刮治器、0.2%氯己定葡萄糖酸盐和等离子体喷流治疗实验组；在治疗前和治疗后三个月分别作龈沟出血指数、探诊深度、牙槽骨丧失深度和CT检查；在治疗后三个月作Micro CT和硬组织切磨片检查；在治疗前和治疗后1、2和3个月时,取微生物样本并作聚合酶链式反应(Polymerase chain reaction, PCR)分析。
结果：在治疗后牙龈卟啉单胞菌(Porphyromonas gingivalis, Pg)和福赛拟杆菌(Bacteroides forsythus, Bf)的检出率有显著性下降(P<0.05),实验组和对照组之间的差异有统计学意义(P<0.05)；实验组的龈沟出血指数(sulcus bleeding index, SBI)和探诊深度(probing depth, PD)有显著性下降(P<0.05),分别从4.42±0.58和4.77±1.45mm下降到1.21±0.58和2.52±0.7 mm,实验组和对照组之间的差异有统计学意义(P<0.05)；实验组骨丧失深度(The distance from the shoulder of the implant to the bottom of the bony defect, DSB)有显著性下降(P<0.05),从3.35±0.70mm下降到2.21±0.90 mm,实验组和对照组之间的差异有统计学意义(P<0.05)。实验组新生骨大量形成,并且与种植体发生骨整合,对照组新生骨形成较少。
结论：低温等离子体喷流联合刮治术治疗犬种植体周围炎取得了很好的治疗效果,改善了临床症状,减少了种植体周围的细菌,促进了种植体和牙槽骨的再结合。
Objective:To evaluate the clinical, microbiological radiological, and histological effects with low temperature atmospheric pressure plasma and scaling against the ligature-induced peri-implantitis in dogs.
Material and Methods:Ligature-induced peri-implantitis was performed for six beagle dogs at 3 months after dental implants. When approximately 40% of the supporting bone was lost, the ligatures were removed. Scaling and local antiseptic cleansing using 0.2% chlorhexidine digluconate were performed in control group. Scaling, local antiseptic cleansing using 0.2% chlorhexidine digluconate and low temperature atmospheric pressure plasma were performed in experimental group. Clinical and radiographic examinations were performed before and at 3 months after treatment respectively. Micro CT and histological examinations were performed at 3 months after treatment. Microbiological samples were obtained and analysed at basement and 1 month,2 moths, and 3 months after treatment respectively.
Results:The prevalence of Pg and Bf was significantly reduced after treatment. Sulcus Bleeding Index (SBI) and probing depth (PD) have significantly decreased (P< 0.05) from 4.42±0.58 and 4.77±1.45 mm to 1.21±0.58 and 2.52±0.7 mm respectively in low temperature atmospheric pressure plasma and scaling group. The differences between the experimental group and the control group were statistically significant (P< 0.05) after treatment in SBI and PD. The radiologically determined distance from the shoulder of the implant to the bottom of the bony defect (DSB) in experimental group significantly decreased from 3.35±0.70 mm to 2.21±0.90 mm (P < 0.05). The DSB in control group decreased from 3.27±0.90 mm to 2.88±0.90 mm and the decrease was not statistically significant. The differences of DSB between the experimental group and the control group after treatment were statistically significant (P< 0.05). The experimental group presented a higher bone height gain. Re-osseointegration occurred in the experimental group.
Conclusions:Therapy of peri-implantitis in dogs with low temperature atmospheric pressure plasma and scaling had positive effects on clinical, microbiological, radiologically and histological parameters.
引文
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Fig.1. (a) The photograph of the plasma jet with working flowing through 5.25% sodium hypochlorite curving in a simulated root canal infected by Enterococcus faecalis. (b) The photograph of working gas flowing through 5.25% sodium hypochlorite by using a three-neck flask.
Fig.2 Plots of viability of Enterococcus faecalis:after the plasma jet with/without working gases flowing through 5.25% sodium hypochlorite sterilization.
Fig.3 Plots of Viability of the Enterococcus faecalis:after irrigating root canals with 1 ml sterile physiologic saline and plasma jet sterilization and the plasma jet with/without working gases flowing through 5.25% sodium hypochlorite sterilization.
Fig.4 Transmission electron microscopy of Enterococcus faecalis after plasma jet sterilization. (a) Control cell. (b) Nuclear chromatin condensation. (c) Cell division arrest. (d) Cell wall rupture.
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Fig.1. (a) The photograph of the plasma jet with working flowing through 5.25% sodium hypochlorite curving in a simulated root canal infected by Enterococcus faecalis. (b) The photograph of working gas flowing through 5.25% sodium hypochlorite by using a three-neck flask.
Fig.2 Plots of viability of Enterococcus faecalis:after the plasma jet with/without working gases flowing through 5.25% sodium hypochlorite sterilization.
Fig.3 Plots of Viability of the Enterococcus faecalis:after irrigating root canals with 1 ml sterile physiologic saline and plasma jet sterilization and the plasma jet with/without working gases flowing through 5.25% sodium hypochlorite sterilization.
Fig.4 Transmission electron microscopy of Enterococcus faecalis after plasma jet sterilization. (a) Control cell. (b) Nuclear chromatin condensation. (c) Cell division arrest. (d) Cell wall rupture.
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