目的:研究半导体激光联合去釉突治疗在伴有釉突的Ⅱ度根分叉病变治疗中的临床效果及其影响因素.方法:纳入存在Ⅱ型釉突的Ⅱ度根分叉病变患者24例,共48颗患牙,随机分为根面平整组(SRP组)、去釉突+SRP组(D+SRP组)、去釉突+SRP+半导体激光组(D+SRP+L组).SRP组不去釉突直接行SRP;D+SRP组去除釉突后行SRP;D+SRP+L组去釉突后,联合使用半导体激光辅助SRP.分别于治疗前及治疗后4周、3个月比较3组患者的探诊深度(PD)、牙龈出血指数(BI)、牙龈退缩(GR)和附着丧失(CAL).收集36颗存在Ⅱ型釉突的离体牙,随机分为以上3组,制备根片,原子力显微镜下观察3组的表面形态,测定表面粗糙度(Ra值);免疫荧光细胞迁移实验观察牙周膜成纤维细胞(hPDLFs)迁移能力;牙龈卟啉单胞菌培养观察菌落形态.结果:治疗后4周及3个月,牙周各指标改善情况,D+SRP+L组最显著,D+SRP组次之,SRP组最差(P＜0.01).原子力显微镜下测定各组表面粗糙度:D+SRP+L组最大,D+SRP组次之,SRP组最小.荧光显微镜下观察hPDLFs迁移细胞数目,D+SRP+L组迁移能力最高,组间差异具有统计学意义(P＜0.01).原子力显微镜下VPM(peak material volume)值,D+SRP组与SRP组相比无明显差异;而D+SRP+L组最低,与SRP组相比差异有统计学意义.3组菌层厚度无明显差异(P＞0.05).结论:半导体激光联合去釉突可以提高有釉突的Ⅱ度根分叉病变患牙的基础治疗效果.
Effects of Diode Laser on Periodontal Initial Treatment of Class Ⅱ Furcation Involvement with Enamel Projection
Objective:To study the clinical effect of deglazing combined with diode laser on the treatment of classⅡ root furcation involvement.Methods:Forty-eight teeth with grade Ⅱ enamel projections which had root furcation involvement were randomly divided into SRP group,deglazing combined SRP group(D+SRP group),and deglaz-ing combined SRP and diode laser group(D+SRP+L group).The periodontal probing depth(PD),gingival bleeding index(BI),gingival recession(GR),and clinical attachment loss(CAL)in three groups at baseline and four weeks and three months after treatment were compared.At the same time,thirty-six isolated teeth with grade Ⅱ cervi-cal enamel projections were collected and randomly divided into three groups,which were given the same treatment mentioned above.Root slices were prepared.The surface morphology and surface roughness(Ra)were observed un-der atomic force microscope.Immunofluorescent cells scratch was used to observe the migration of periodontal membrane fibroblasts(hPDLFs).Dental colony morphology was observed by porphyromonas gingivalis culture.Results:Four weeks and three months after treatment,the most significant improvement was found in the D+SRP+L group,followed by D+SRP group and the worst was in the SRP group(P＜0.01).Atomic force microscope showed that the largest Ra value was found in D+SRP+L group,followed by the D+SRP group,and the smallest in SRP group(P＜0.01).Cell migration ratio of hPDLFs showed the highest migration ability was in the D+SRP+L group,followed by D+SRP group,and the lowest was in the SRP group.The difference between groups was sta-tistically significant(P＜0.01).For VPM(peak material volume)value under AFM,there was significant differ-ence between D+SRP+L group and SRP group.But there was no significant difference between D+SRP group and SRP group.There was no significant difference in the germ layer thickness among three groups(P＞0.05).Con-clusion:Deglazing combined with diode laser can improve the effect of initial treatment of root furcation involve-ment.
万方数据
维普
