光动力疗法（PDT）治疗种植体周围炎的短期临床疗效观察

发布时间：2018-06-14 16:27

本文选题：种植体周围炎 + 光动力疗法　；参考：《郑州大学》2017年硕士论文

【摘要】：背景:种植体周围炎(peri-implantitis)是最常见的种植修复后并发症,也是导致种植失败的主要原因之一。它是一种由菌斑生物膜所引起的,导致种植体周围软组织发生炎症及深层支持骨丧失的感染性疾病。目前临床上治疗种植体周围炎主要是通过机械方法进行种植体表面清创,但单纯的机械方法很难彻底清除感染,多数情况下需要配合全身或局部用药来减少致病菌及毒素,以提高治疗效果。然而,近些年来细菌耐药性的出现限制了抗生素的应用。因此,寻找一种更为安全有效的辅助抗菌疗法是非常必要的。光动力疗法(photodynamic therapy,PDT)是医学与多个学科交叉形成的一种新技术、新方法。它能够结合光敏剂和可见光产生活性氧(reactive oxygen species,ROS)来杀灭病原微生物。体内外研究结果显示PDT具有良好的抗牙周致病菌的特性,用于治疗慢性牙周炎可以提高治疗效果。然而,目前关于PDT辅助治疗种植体周围炎的临床随机对照研究相对较少。目的:评价光动力疗法(PDT)辅助治疗种植体周围炎的临床效果。方法:在河南省口腔医院收集40例种植体周围炎患者,随机分为两组:实验组(MD+PDT组)和对照组(MD组)。实验组进行机械清创(mechanical debridement,MD)辅助PDT治疗,对照组给予MD治疗。检查和记录两组患者治疗前、治疗后1个月和3个月的改良菌斑指数(mPLI)、种植体周袋深度(PPD)、改良龈沟出血指数(mSBI)和探诊出血(BOP),对比两组患者治疗前后临床指标的变化。结果:在光动力治疗整个过程中及治疗后,所有患者均未出现任何不适。两组患者的各项临床指标在治疗前均无明显差异(P0.05),具有可对比性。治疗后各时间点组内mPLI、PPD、mSBI和BOP均较治疗前降低(P0.05)。两组间对比,治疗后1个月PPD及治疗后1、3个月mSBI、BOP,实验组优于对照组(P0.05);而治疗后1、3个月mPLI,两组间无统计学差异(P0.05)。结论:PDT辅助机械清创治疗种植体周围炎在短期内可以更好的改善种植体周围组织的炎症,减轻探诊出血,降低种植体周袋深度,较单独进行MD获得的临床疗效更好。说明PDT在辅助治疗种植体周围炎方面有很好的应用前景。
[Abstract]:Background: peri-implant peri-implantitis is the most common post-implant complication and one of the main causes of implant failure. It is an infectious disease caused by plaque biofilm, causing inflammation of surrounding soft tissue and loss of deep supporting bone. At present, the clinical treatment of peri-implant inflammation is mainly done by mechanical method, but it is very difficult to remove the infection completely by mechanical method. In most cases, it is necessary to cooperate with systemic or local medication to reduce the pathogenic bacteria and toxins. To improve the therapeutic effect. However, the emergence of bacterial resistance in recent years has limited the use of antibiotics. Therefore, it is necessary to find a safer and more effective antimicrobial therapy. Photodynamic therapeutics (PDT) is a new technique and method for the cross formation of medicine and many disciplines. It can combine Guang Min and visible light to produce reactive oxygen species (oxygen) to kill pathogenic microorganisms. The results of in vivo and in vitro studies showed that PDT had good anti-periodontal pathogenic properties and could be used in the treatment of chronic periodontitis. However, there are relatively few clinical randomized controlled studies on PDT adjuvant treatment of periimplant inflammation. Objective: to evaluate the clinical effect of photodynamic therapy (PDT) in the treatment of periimplant inflammation. Methods: forty patients with peri-implant inflammation were randomly divided into two groups: experimental group (MD PDT group) and control group (MD group). The experimental group was treated with mechanical debridement MDT and the control group was treated with MD. Before treatment, 1 month and 3 months after treatment, the modified plaque index (mPLI), the depth of periimplant pouch (PPDD), the modified gingival sulcus bleeding index (MSBI) and the diagnostic bleeding (BOP) were examined and recorded. The changes of clinical indexes before and after treatment were compared between the two groups. Results: no discomfort was found in all patients during and after photodynamic therapy. There was no significant difference between the two groups before treatment. After treatment, the levels of mPLII PPDMSBI and BOP in each time point group were lower than those before treatment. The comparison between the two groups showed that one month after treatment and one and three months after treatment, the experimental group was superior to the control group (P 0.05), but there was no significant difference between the two groups at 1 and 3 months after treatment (P 0.05). Conclusion in a short period of time, the treatment of periimplant peri-implant inflammation with mechanical debridement with the help of 1% PDT can improve the inflammation of periimplant tissue, reduce the bleeding from probing and decrease the depth of peri-implant bag, and the clinical effect is better than that of MD alone in the treatment of peri-implant inflammation. It shows that PDT has a good application prospect in adjuvant treatment of periimplant inflammation.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.6

【相似文献】