摘要
目的探讨牙周内窥镜(periodontal endoscope,PE)辅助龈下刮治和根面平整术(scaling and root plan⁃ning,SRP)的临床疗效及对牙周炎患者心理和生活质量的影响,为临床应用牙周内窥镜提供参考。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。收集2018年4月—2022年12月于南京大学医学院附属口腔医院牙周病科就诊的,传统SRP治疗6周后复查仍有残留牙周袋探诊深度(probing depth,PD)≥5 mm的牙周炎患者,进一步行PE辅助SRP(PE+SRP)。在传统SRP治疗后6周,PE+SRP治疗3个月后分别测量牙周临床指标包括菌斑指数(plaque index,PLI)、PD、临床附着丧失(clinical attachment loss,CAL)及探诊出血(bleeding on probing,BOP);同时分别收集传统SRP和PE辅助SRP治疗即刻视觉模拟评分量表(visual analogue scale,VAS);在传统SRP治疗和PE辅助SRP治疗3个月后分别收集牙周组织自我认知表、口腔健康影响程度量表⁃14(oral health impact profile⁃14,OHIP⁃14)以及牙科畏惧调查量表(dental fear scale,DFS)。结果共纳入牙周炎患者23例,患牙486颗,832个位点纳入临床研究。PE+SRP治疗后3个月,各项牙周临床指标:PLI(t=9.254,P<0.001)、PD(t=50.724,P<0.001)、CAL(t=22.407,P<0.001)以及BOP(t=9.217,P<0.001)均显著改善;与传统SRP(VAS:2.48±1.70)相比,PE+SRP(VAS:2.57±1.80)给患者带来的疼痛感无显著差异(t=0.192,P=0.850);两组牙周组织自我认知表得分无显著性差异(t=1.485,P=0.152);同时传统SRP完成后OHIP⁃14的得分为(12.13±7.63)分,PE+SRP完成后OHIP⁃14得分为(10.26±5.25)分,两者无显著差异(t=-1.589,P=0.126);传统SRP完成后DFS量表得分为(40.70±12.63)分,PE+SRP完成后DFS量表得分为(41.57±12.61)分,两者无显著差异(t=0.404,P=0.690)。结论PE辅助SRP治疗牙周炎患者残留牙周袋后各项牙周临床指标均显著改善,且与传统SRP相比,PE辅助SRP对牙周炎患者的生活质量和心理状况没有负面影响,可以临床广泛推广。
Objective To investigate the clinical efficacy and effects of periodontal endoscope(PE)⁃assisted subgin⁃gival scaling and root planning(SRP)and traditional SRP on the psychological and quality of life of patients with peri⁃odontitis.Methods This study was reviewed and approved by the Ethics Committee,and informed consent was ob⁃tained from the patients.Patients with periodontitis who were treated in the Department of Periodontology,Nanjing Sto⁃matological Hospital,Medical School of Nanjing University from April 2018 to December 2022 with residual periodontal pockets(PD≥5 mm)6 weeks after traditional SRP treatment were enrolled,and the residual periodontal pockets were further treated with PE⁃assisted SRP(PE+SRP).After 6 weeks of traditional SRP treatment and 3 months of PE+SRP treatment,clinical indicators,including plaque index(PLI),probing depth(PD),clinical attachment loss(CAL)and bleeding on probing(BOP),were measured,and periodontal tissue self⁃awareness scale scores,oral health impact profile⁃14(OHIP⁃14)score and dental fear scale(DFS)score were collected.Moreover,visual analog scale(VAS)scores were col⁃lected after traditional SRP and PE⁃assisted SRP treatments.Results Twenty⁃three patients with periodontitis,includ⁃ing 832 sites of 486 affected teeth,were included in the clinical study.Three months after PE+SRP treatment,all clini⁃cal periodontal indicators,PLI(t=9.254,P<0.001),PD(t=50.724,P<0.001),CAL(t=22.407,P<0.001)and BOP(t=9.217,P<0.001),were significantly improved.Compared with traditional SRP(VAS:2.48±1.70),the pain caused by PE+SRP(VAS:2.57±1.80)was not significantly different(t=0,192,P=0.850).There was no significant dif⁃ference in the scores of the periodontal tissue self⁃awareness scale between the two groups(t=1.485,P=0.152).The OHIP⁃14(SRP:12.13±7.63;PE+SRP:10.26±5.25,t=-1.589,P=0.126)and DFS(SRP:40.70±12.63;SRP+PE:41.57±12.61,t=0.404,P=0.690)scores were not significantly different.Conclusion All clinical periodontal indi⁃cators were significantly improved after PE⁃assisted SRP treatment of residual periodontal pockets,and compared with traditional SRP,PE⁃assisted SRP had no negative impact on the quality of life or psychological status of patients with periodontitis.Therefore,PE+SRP can be promoted in clinical practice.
作者
苏秋葆
王宁祥
张梅
吴娟
SU Qiubao;WANG Ningxiang;Zhang Mei;WU Juan(Department of Periodontology,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Nan-jing University,Nanjing 210008,China;Department of Stomatology,Nanjing Hospital of Chinese Medicine,Nan-jing University of Traditional Chinese Medicine,Nanjing 210006,China;Department of Endodontics,Affiliated Nantong Stomatological Hospital of Nantong University,Nantong 226006,China)
出处
《口腔疾病防治》
2024年第1期50-56,共7页
Journal of Prevention and Treatment for Stomatological Diseases
基金
江苏省自然科学基金青年项目(BK20200149)
南京大学医学院附属口腔医院3456骨干人才资助项目(0222C104)。
关键词
牙周炎
牙周袋
牙周内窥镜
龈下刮治
口腔健康相关生活质量
牙科畏惧
口腔健康影响程度量表
问卷调查
periodontitis
periodontal pockets
periodontal endoscopy
subgingival scaling
oral health⁃relat⁃ed quality of life
dental fear
oral health impact profile
questionnaire survey
