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目的 :探讨袋深3~6 mm的龈下环境中,龈下喷砂技术的治疗效果及维持时间,比较龈下喷砂技术与传统手器刮治的效果。方法:对处于牙周维护治疗阶段的慢性牙周炎患者依据split-mouth及随机数表建立实验组与对照组,对其口内袋深3~6 mm的4个牙位分组行喷砂及手器刮治,清除龈下菌斑。在术前、术后第7天及术后第30天分别记录菌斑指数(PI)、探诊深度(PD)、探诊出血(BOP)及牙龈退缩(GR),同时计算治疗前、后“牙周袋闭合”(PD≤4 mm且BOP阴性)的位点百分比,作为辅助观测指标。采用SAS8.2软件包对实验数据进行配对t检验。结果:研究纳入31例患者,治疗过程中PI均值为0.8。喷砂组与手器刮治组术后第7天PD均显著下降(P<0.01)。喷砂组术后第7天BOP百分比(BOP%)与术前相比显著减少(P=0.0390),术后第30天则与术前无显著差异;手器刮治组在术后30天观察期内BOP%呈下降趋势,并于术后第30天较术前出现显著改善;但喷砂、手器刮治2组间比较,其BOP%无显著差异。喷砂组与手器刮治组“牙周袋闭合”位点百分比在术后第30天均显著提高(分别为P=0.0329及P=0.0035)。结论:针对袋深3~6 mm的龈下环境,甘氨酸龈下喷砂技术与传统手器刮治同样对改善维护期牙周临床指标有一定效果,但2种治疗方法间无显著差异。
OBJECTIVE: To investigate the therapeutic effect and duration of subgingival blasting technique in subgingival environment of 3 ~ 6 mm in pocket depth and to compare the effect of subgingival sand blasting and conventional hand scraping. Methods: The chronic periodontitis patients who underwent periodontal maintenance treatment were divided into experimental group and control group according to split-mouth and random number table. Four teeth whose pocket depth was 3 ~ 6 mm were treated with sand blasting and hand Scraping, subgingival plaque removal. The plaque index (PI), probing depth (PD), bleeding on probing (BOP) and gingival recession (GR) were recorded before operation, 7 days after operation and 30 days after operation respectively. “Periodontal pocket closure ” (PD≤4 mm and BOP negative) as a secondary observational index. SAS8.2 package was used to paired t-test data. Results: The study enrolled 31 patients with a PI mean of 0.8 during the course of treatment. The PD in the sandblasting and hand scraping groups decreased significantly on the 7th day after operation (P <0.01). The BOP percentage (BOP%) of blast-treated group on day 7 was significantly lower than that of preoperative (P = 0.0390) and no significant difference on the 30th day after operation During the observation period, the BOP% showed a downward trend, and significantly improved on the 30th day after surgery. However, there was no significant difference in BOP% between the two groups after sandblasting and hand scraping. The percentage of sites of “periodontal pouch closure” in blast-treated group and hand-shaved group was significantly increased on the 30th day after operation (P = 0.0329 and P = 0.0035, respectively). CONCLUSIONS: For the subgingival environment of 3 to 6 mm in pocket depth, glycine subgingival blasting has the same effect on improving periodontal clinical indexes as traditional handpiece scraping treatment, but there is no significant difference between the two treatment methods.