摘要
目的初步探讨甘氨酸颗粒喷砂抛光对维护期牙周炎患者龈下微生物的影响。方法从北京大学口腔医学院·口腔医院牙周科2011年12月至2012年11月复诊病例中纳人无系统性疾病、进入维护期的慢性牙周炎患者21例，采用自身左右侧分口对照设计，试验侧使用65μm甘氨酸颗粒喷砂抛光（试验组，共248颗牙，1488个位点），对照侧采用超声洁治＋抛光膏抛光进行维护治疗（对照组，共249颗牙，1494个位点），分别记录治疗前和治疗后12周两组各项牙周指标，于治疗前及治疗后2、4、8、12周在每位患者的第一或第二磨牙近中颊侧位点取龈下菌斑，进行刚果红染色，分类计数球菌、杆菌和螺旋体，并比较各时间点两组各项临床牙周指标（探诊深度、出血指数、探诊出血阳性位点百分比、菌斑指数）及微生物百分含量。结果治疗前及治疗后各时间点两组间的各项临床牙周指标差异均无统计学意义（P〉0．05）；治疗后12周试验组及对照组探诊深度[分别为（2．33±0．90）和（2．37±1．18）mm]、出血指数（分别为0．96±0．70和0．98±0．78）和菌斑指数[分别为0．00（1．00）和0．00（1．00）】均较治疗前[探诊深度分别为（2．48±1．17）和（2．46±0．99）mm、出血指数分别为（1．07±0．72）和（1．08±0．75）、菌斑指数分别为0．00（1．00）和0．00（1．00）1显著改善（P〈O．05）；探诊出血阳性位点百分比仅对照组治疗后12周[（17．25±2．21）％]较治疗前[（25．23±2．83）％]显著降低（P〈0．05）。各时间点两组间及两组内不同时间点的球菌、杆菌和螺旋体的百分含量差异均无统计学意义（P〉0．05）。结论应用甘氨酸颗粒喷砂抛光进行牙周维护治疗与超声维护治疗效果类似，其龈下微生物构成比例无明显变化，螺旋体均维持在低水平。对维护期的牙周炎患者，使用65μm甘氨酸颗粒喷砂抛光与传统方法治疗效果相近，但其临床适应证应有选择。
Objective To research the variation of subgingival microorganisms after 65 μm glycine powder air-polishing （GPAP） in patients with periodontitis during periodontal maintenance phase and make comparison with conventional method. Methods From Department of Periodontology, Peking University School and Hospital of Stomatology, twenty-one patients at the age of 35-72 （8 males and 13 females） who were systematically healthy were recruited in this study. According to splitting-mouth design, one side of a mouth was randomly assigned to the experiment group （21 patients, 248 teeth, 1 488 sites） with 65 p,m GPAP therapy while the opposite side served as the control group （21 patients, 249 teeth, 1 494 sites） with ultrasonic scaling plus polishing paste therapy. The clinical periodontal parameters including probing depth （PD）, bleeding index （BI）, bleeding on probing （BOP） and plaque index （PLI） were recorded. Using sterile currette, the subgingival plaque samples were collected at the mesio-buccal site of the first or second molars at baseline, 2, 4, 8 and 12 weeks after therapy, respectively. After Congo red staining, the microorganisms were classified into cocci, bacilli and spirochetes and counted respectively. Results All clinical periodontal parameters have no difference between two groups at baseline and after treatment 12 weeks. In the experiment group and the control group, PD （[2.33±0.90] and [2.37±1.18] mm）, BI （0.96±0.70 and 0.98±0.78） and PLI （0.00[1.00] and 0.00[1.00]） of two groups after treatment 12 weeks were better than those at baseline （PD： [2.48~1.17] and [2.46±0.99] mm; BI： 1.07±0.72 and 1.08±0.75; PLI： 0.00 [1.00] and 0.00 [1.00]） （P〈0.05）. But BOP（＋）% was observably reduced only in the control group after treatment 12 weeks （[17.25±2.211% vs [25.23±2.83]%） （P〈0.05）. The percentages of cocci, bacilli and spirochetes were stable and there were not significant differences between the two groups （P 〉 0.05）. Conclusions After 65 μm GPAP therapy, the differences of proportion of subgingival microorganisms are not significant, while the control group has the same trend. The spirochetes remained at a low level, but they rebounded fasterly in the test group than that in the control group. The results indicate that 65 μm glycine powder air-polishing has the similar clinical effects compared with ultrasonic scaling plus polishing paste. However, the clinical indications should be limited to the patients with shallow pockets and without obvious dental calculus.
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2017年第7期410-414,共5页
Chinese Journal of Stomatology
基金
“十一五”国家科技支撑计划（2007BAI18B02）
国家临床重点专科建设项目（2010）
关键词
甘氨酸
牙抛光
牙菌斑
牙周维护期
Glycine
Dental polishing
Dental plaque
Periodontal maintenance phase
