摘要
目的分析拔牙后保留炎性肉芽组织对拔牙窝愈合效果的影响。方法回顾性选取2020年1月至2021年6月邯郸市第一医院收治因慢性牙周炎或根尖周炎进行拔牙的120例患者作为研究对象。按随机数字表法分为两组,各60例。观察组拔牙后保留炎性肉芽组织,对照组拔牙后以刮匙清除炎性肉芽组织。使用锥形束CT(CBCT)测量术后即刻和术后3个月拔牙窝牙槽骨高度及宽度,统计拔牙窝早期创口愈合指数(EHI)分级、牙龈指数(GI)、龈沟出血指数(SBI)、牙菌斑指数(PLI)、牙周探诊深度(PPD)、血清前列素E2(PGE2)、可溶性细胞间黏附分子-1(sICAM-1)、碱性磷酸酶(ALP)、p-21激活激酶5(PAK5)水平及术后并发症发生情况。结果两组术后拔牙窝牙槽骨高度及宽度比较,差异无统计学意义(P>0.05);观察组拔牙窝愈合时间为(6.06±1.11)d,显著少于对照组[(7.14±1.31)d],差异有统计学意义(P<0.05)。观察组早期创口愈合指数(EHI)Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级和Ⅴ级比例分别为25.00%、38.33%、30.00%、5.00%和1.67%,对照组EHIⅠ级、Ⅱ级、Ⅲ级、Ⅳ级和Ⅴ级比例为20.00%、33.33%、35.00%、8.33%和3.33%,相比差异无统计学意义(P>0.05)。治疗后,观察组GI、SBI、PLI、PPD、PGE2、sICAM-1、ALP、PAK5为(0.31±0.03)分、(1.35±0.24)分、(0.69±0.03)%、(2.54±0.22)mm、(360.65±42.34)ng/L、(171.62±17.48)ng/L、(421.45±46.73)U/L、(28.45±6.74)μg/L,均低于对照组[(0.67±0.06)分、(2.53±0.35)分、(1.53±0.08)%、(3.75±0.36)mm、(452.62±57.57)ng/L、(201.48±26.65)ng/L、(473.56±42.66)U/L、(33.63±5.45)μg/L],差异均有统计学意义(P<0.05)。观察组与对照组术后并发症总发生率比较(61.67%vs.60.00%),差异无统计学意义(P>0.05)。结论拔牙后保留炎性肉芽组织可明显缩短拔牙窝愈合时间,并没有明显增加牙槽骨吸收及术后并发症发生率,对拔牙窝愈合有利,可兹临床参考。
Objective To analyze the effect of retaining inflammatory granulation tissue after tooth extraction on the healing effect of tooth extraction socket.Methods A total of 120 patients who were admitted to Handan First Hospital for tooth extraction due to chronic periodontitis or apical periodontitis from January 2020 to June 2021 were retrospectively select as the research object.According to the random number table method,they were divided into two groups.The observation group had 60 cases,and the inflammatory granulation tissue was preserved after tooth extraction,and the control group had 60 cases.After the tooth extraction,the inflammatory granulation tissue was removed with a curette.Use cone beam CT(CBCT)to measure the height and width of the alveolar bone of the extraction socket immediately after the operation and 3 months after the operation,The early wound healing index(EHI)grade of extraction socket,gingival index(GI),sulcus bleeding index(SBI),plaque index(PLI),periodontal probing depth(PPD),PGE2,sICAM-1,ALP,PAK5 level were analyzed.Results There was no statistically significant difference in the height and width of the alveolar bone between the two groups after the extraction socket(P>0.05).The healing time of the extraction socket in the observation group was(6.06±1.11)d,which was significantly shorter than that of the control group[(7.14±1.31)d],and the difference was statistically significant(P<0.05).The the proportions of early wound healing index(EHI)of the observation group was 25.00%,38.33%,30.00%,5.00%,and 1.67%of grade I,grade II,grade III,grade IV and grade V,the proportions of EHI grade I,grade II,grade III,grade IV and grade V of the control group was 20.00%,33.33%,35.00%,8.33%and 3.33%,and the differences were not statistically significant(P>0.05).After treatment,the GI,SBI,PLI,PPD,PGE2,sICAM-1,ALP,and PAK5 of the observation group were(0.31±0.03)points,(1.35±0.24)points,(0.69±0.03)%,(2.54±0.22)mm,(360.65±42.34)ng/L,(171.62±17.48)ng/L,(421.45±46.73)U/L,(28.45±6.74)μg/L,which were lower than those of the control group[(0.67±0.06)points,(2.53±0.35)points,(1.53±0.08)%,(3.75±0.36)mm,(452.62±57.57)ng/L,(201.48±26.65)ng/L,(473.56±42.66)U/L,(33.63±5.45)μg/L],the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of postoperative complications between the observation group and the control group(61.67%vs.60.00%)(P>0.05).Conclusion Preserving inflammatory granulation tissue after tooth extraction can significantly shorten the extraction socket healing time,and does not significantly increase the alveolar bone resorption and the incidence of postoperative complications.It is beneficial to the extraction socket healing.Clinical reference can be made as appropriate.
作者
郑冬冬
付欣
魏娜
王亚红
郑再欣
ZHENG Dong-dong;FU Xin;WEI Na(Department of Stomatology,Handan First Hospital,Handan Hebei 056002,China;Department of Oral Implantology,Handan Stomatological Hospital,Handan Hebei 056001,China)
出处
《临床和实验医学杂志》
2022年第14期1562-1566,共5页
Journal of Clinical and Experimental Medicine
基金
河北省卫生健康委员会科研基金项目(编号:20200431)。
关键词
慢性牙周炎
慢性根尖周炎
炎性肉芽组织
拔牙窝
愈合效果
Inflammatory granulation tissue
Chronic periodontitis
Chronic apical periodontitis
Extraction socket
Healing effect
