目的 探讨Er,Cr:YSGG激光联合浓缩生长因子(CGF)膜治疗种植体周围炎的临床疗效。方法 将2021-02至2024-01于潍坊医学院附属医院口腔科就诊的60例种植体周围炎患者纳入研究,随机分为对照组(n=30)和试验组(n=30)。对照组给予引导骨再生(GBR)手术+ Er,Cr:YSGG激光照射+胶原膜治疗;试验组给予GBR手术+Er,Cr:YSGG激光照射+CGF膜治疗。比较两组治疗后的总有效率、PLI、SBI、PD、CAL,龈沟液炎症因子IL-1β、IL-6和MMP-8水平;对比两组治疗前和治疗后3个月前牙区的美学指标、种植体稳定性、患者生活质量及疼痛情况。结果 治疗后3个月,试验组总有效率高于对照组(96.7% vs. 80.0%;P=0.04);相较于治疗前,试验组和对照组在治疗后的PLI、SBI、PD、CAL及龈沟液炎症因子水平均下降,且治疗后试验组较对照组PLI、SBI、PD、CAL及龈沟液炎症因子水平降低更明显(P<0.05);试验组和对照组的美学指标、种植体稳定性、生活质量和疼痛评分相较于治疗前均升高,且治疗后试验组较对照组更加明显(P<0.05)。结论 Er,Cr:YSGG激光联合浓缩生长因子膜治疗对种植体周围炎有更好的临床疗效,可降低炎症和疼痛程度,提高美学效果。
Abstract
Objective To explore the clinical efficacy of Er, Cr:YSGG laser combined with concentrated growth factor membrane in the treatment of peri-implantitis. Methods A total of 60 patients with peri-implantitis from the Department of Stomatology of Affiliated Hospital of Weifang Medical College between February 2021 and February 2024 were included in the study and randomly divided into an experimental group (n=30)and a control group (n=30). The control group received GBR surgery + Er,Cr:YSGG laser irradiation + collagen membrane, while the experimental group received GBR surgery+ Er,Cr:YSGG laser irradiation + CGF membrane. The total effective rate, PLI, SBI, PD, CAL, and changes in inflammatory factors IL-1β, IL-6, and MMP-8 in gingival crevicular fluid were compared between the two groups; the aesthetic indicators, implant stability, patient quality of life, and pain conditions of the dental area before and 3 months after treatment were compared between the two groups. Results After three months of treatment, the total effective rate of the experimental group (96.7%) was higher than that of the control group (80.0%) (P=0.04). Compared with baseline measurements, PLI, SBI, PD, CAL, and inflammatory factors in GCF decreased in both groups after treatment, with the experimental group showing a more pronounced reduction (P<0.05). Additionally, the aesthetic indicators, implant stability, quality of life, and pain scores improved in both groups compared to pre-treatment levels, with the experimental group demonstrating significantly greater improvements than the control group (P<0.05). Conclusions Er,Cr:YSGG laser combined with CGF membrane has better clinical efficacy for peri-implantitis, which can reduce inflammation and pain, and improve aesthetic effects.
关键词
Er,Cr:YSGG激光 /
浓缩生长因子膜 /
种植体周围炎 /
种植体稳定性 /
炎症因子
Key words
Er,Cr:YSGG laser /
concentrated growth factor membrane /
peri-implantitis /
implant stability /
inflammatory factors
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Liñares A, Sanz-Sánchez I, Dopico J, et al. Efficacy of adjunctive measures in the non-surgical treatment of peri-implantitis: a systematic review[J]. J Clin Periodontol, 2023, 50 (Suppl 26): 224-243.
[2] Lin C J, Tsai M H, Wu Y L, et al. The effect of an Er, Cr: YSGG laser combined with implantoplasty treatment on implant surface roughness and morphologic analysis: a pilot in vitro study[J]. J Funct Biomater, 2022, 13(3):133.
[3] Alpaslan N Z, Altindal D, Akbal D, et al. Evaluation of the effect of Er,Cr:YSGG laser application on peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand and osteoprotegerin levels in the non-surgical treatment of peri-implantitis: a randomized clinical trial[J]. J Periodontol, 2024, 95(10): 917-928.
[4] 王 姹. Er,Cr:YSGG激光辅助治疗中重度慢性牙周炎13例[J]. 安徽医药, 2020, 24(2): 349-352.
[5] Alqutub M N.Peri-implant parameters and cytokine profile among peri-implant disease patients treated with Er Cr YSGG laser and PDT[J]. Photodiagn Photodyn Ther, 2022, 37: 102641.
[6] 李腾艳, 聂敏海, 刘旭倩. 浓缩生长因子与表皮生长因子干预口腔黏膜等效细胞的增殖和衰老[J]. 中国组织工程研究, 2022, 26(20): 3164-3172.
[7] 肖 莉, 笪海芹, 郭凤芹. 意向性再植结合浓缩生长因子在重度牙周炎的临床疗效[J]. 安徽医学, 2024, 45(12): 1553-1557.
[8] Herrera D, Berglundh T, Schwarz F, et al. Prevention and treatment of peri-implant diseases-the EFP S3 level clinical practice guideline[J]. J Clin Periodontol, 2023, 50 (Suppl 26): 4-76.
[9] Donker V J J, Raghoebar G M, Slagter K W, et al. Immediate implant placement with immediate or delayed provisionalization in the maxillary aesthetic zone: a 10-year randomized trial[J]. J Clin Periodontol, 2024, 51(6): 722-732.
[10] Gehlot M, Sharma R, Tewari S, et al. Effect of orthodontic treatment on periodontal health of periodontally compromised patients[J]. Angle Orthod, 2022, 92(3): 324-332.
[11] 张银昌, 齐东杰, 嵇步云, 等. 二甲双胍缓释片对2型糖尿病患者种植体龈沟液炎症介质的变化[J]. 锦州医科大学学报, 2023, 44(1): 80-84.
[12] Camps-Font O, Pérez-Beltrán I, Fornés-Nieto V, et al. Patient-centered outcomes after surgical treatment of peri-implantitis: a prospective clinical study[J]. Med Oral Patol Oral Cir Bucal, 2023, 28(1): e72-e80.
[13] Zhao L L, Yuan Q, Shen B L, et al. Clinical efficacy and safety of tinidazole combined with minocycline in treating peri-implantitis[J]. Am J Transl Res, 2024, 16(12): 7405-7415.
[14] Ramanauskaite A, Cafferata E A, Begic A, et al. Surgical interventions for the treatment of peri-implantitis[J]. Clin Implant Dent Relat Res, 2023, 25(4): 682-695.
[15] Feres M, Martins R, Souza J G S, et al. Unraveling the effectiveness of antibiotics for peri-implantitis treatment: a scoping review[J]. Clin Implant Dent Relat Res, 2023, 25(4): 767-781.
[16] Birand C, Kurtulmus-Yilmaz S. Evaluation of Er,Cr:YSGG laser irradiation for debonding of zirconia hybrid abutment crowns from titanium bases[J]. Lasers Med Sci, 2022, 37(6): 2675-2685.
[17] Hashim A, Kheir El Din N H, El-Khazragy N, et al. Comparison of the efficacy of Er,Cr:YSGG laser on oral biofilm removal from implant surfaces with various application times for the treatment of peri-implantitis defects: ex vivo study[J]. BMC Oral Health, 2024, 24(1): 980.
[18] 夏婷婷, 汪 涌. 重度牙周炎后牙位点保存术中联合应用浓缩生长因子的疗效评价[J]. 上海口腔医学, 2023, 32(6): 650-655.
[19] Liu Q Q, Wu W W, Yang J, et al. A GP130-targeting small molecule, LMT-28, reduces LPS-induced bone resorption around implants in diabetic models by inhibiting IL-6/GP130/JAK2/STAT3 signaling[J]. Mediators Inflamm, 2023, 2023: 9330439.
[20] Zhang Q, Guo S, Li Y, et al. Analysis of risk indicators for implant failure in patients with chronic periodontitis[J]. BMC Oral Health, 2024, 24(1): 1051.
[21] Elsadek M F, Almoajel A. Assessment of clinical and radiographic peri-implant parameters in the obese and non-obese, along with destructive pro-inflammatory cytokines IL-1β-and IL-6 in patients treated with Photodynamic therapy[J]. Photodiagnosis Photodyn Ther, 2022, 39: 102844.
[22] Hentenaar D F M, De Waal Y C M, Vissink A, et al. Biomarker levels in peri-implant crevicular fluid of healthy implants, untreated and non-surgically treated implants with peri-implantitis[J]. J Clin Periodontol, 2021, 48(4): 590-601.
[23] Räisänen I T, Aji N, Sakellari D, et al. Active matrix metalloproteinase-8 (aMMP-8) versus total MMP-8 in periodontal and peri-implant disease point-of-care diagnostics[J]. Biomedicines, 2023, 11(11):10.
[24] Önder Y B, Alpaslan N Z. Peri-implant phenotype, calprotectin and MMP-8 levels in cases diagnosed with peri-implant disease[J]. Clin Oral Investig, 2024, 28(7): 404.
基金
山东省医药卫生科技项目(202308020556)
PDF(1264 KB)
