Nd∶YAP激光与三联抗生素糊剂在年轻恒牙牙髓血运重建术中消毒效果的对比分析OACSTPCD
Effect of Nd∶YAP Laser on the Levels of VEGF,bFGF and MMP-2 in Gingival Crevicular Fluid During Pulp Blood Reconstruction of Young Permanent Teeth
目的:分析比较Nd∶YAP激光与三联抗生素糊剂在年轻恒牙牙髓血运重建术中的消毒效果.方法:选取2018年2月-2020年2月收治的112例年轻恒牙牙髓坏死或根尖周炎患者,随机分成对照组和观察组各56例,对照组采用三联抗生素糊剂方式封药消毒,观察组采用Nd∶YAP激光照射消毒,消毒完毕后均行牙髓血运重建术,随访2年.比较两组患者治疗后2年临床疗效、不良反应发生率、牙骨质样组织沉积率,分析两组患者治疗前及治疗后2年牙根长度、牙冠根比和牙根管壁厚度,并对比两组患者治疗前和治疗后6个月龈沟液中血管内皮生长因子(Vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(Basic fibroblast growth factor,bFGF)和基质金属蛋白酶-2(Matrix metalloproteinase-2,MMP-2)水平.结果:治疗后2年,两组治疗总有效率比较差异无统计学意义(P＞0.05).治疗后2年,两组不良反应发生率差异无统计学意义(P＞0.05).治疗后2年,两组上述指标较治疗前均有上升(P＜0.05),但组间差异无统计学意义(P＞0.05).治疗后2年,对照组患者牙骨质样组织沉积率为(64.80±8.11)%,观察组患者牙骨质样组织沉积率为(65.64±7.42)%,组间比较差异无统计学意义(t=0.572,P=0.569).治疗后6个月,两组龈沟液中VEGF、bFGF、MMP-2水平较治疗前均有上升(P＜0.05),但组间差异无统计学意义(P＞0.05).结论:相较于三联抗生素糊剂封药消毒,年轻恒牙标准牙髓血运重建术中采用Nd∶YAP激光照射消毒可达到同样的临床疗效,可能通过影响牙组织中VEGF、bFGF和MMP-2表达,诱导牙根继续发育,值得临床验证.
Objective Analysis and Comparison of the Disinfection Effect of Nd:YAP Laser and Triple Antibiotic Paste in Young Permanent Teeth Pulp Revascularization Surgery.Methods 112 young permanent teeth with pulp necrosis or periapical periodontitis admitted from February 2018 to February 2020 were randomly divided into a control group and an observation group,with 56 cases in each group,patients in the control group were treated with triple antibiotic paste for drug sealing disinfection,and patients in the observation group were treated with Nd∶YAP laser irradiation for disinfection.After disinfection,all patients were treated with pulp blood reconstruction,and followed up for 2 years.The clinical efficacy,incidence of adverse reactions,and cementoid tissue deposition rate of 2 years after treatment were compared between two groups,the root length,The levels of Vascular endothelial growth factor(VEGF),basic Fibroblast growth factor(bFGF)and Matrix metalloproteinase 2(matrix MMP-2)in gingival crevicular fluid of the two groups were compared before treatment and 6 months after treatment.Results After 2 years of treatment,there was no statistically significant difference in the total effective rate between the two groups(P＞0.05).After 2 years of treatment,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).After 2 years of treatment,both groups showed an increase in the above indicators compared to before treatment(P＜0.05),but there was no statistically significant difference between the groups(P＞0.05).Two years after treatment,the deposition rate of dental bone like tissue in the control group was (64.80±8.11)％,while the deposition rate of dental bone like tissue in the observation group was (65.64±7.42)％.There was no statistically significant difference between the two groups (t=0.572,P=0.569).Six months after treatment,the levels of VEGF,bFGF,and MMP-2 in gingival crevicular fluid in both groups increased compared to before treatment (P＜0.05),but there was no statistically significant difference between the groups (P＞0.05).Conclusion Compared with triple antibiotic paste sealing disinfection,Nd∶YAP laser irradiation disinfection can achieve the same clinical efficacy in standard pulp blood reconstruction of young permanent teeth.It may induce the continuous development of tooth roots by affecting the expressions of VEGF,bFGF and MMP-2 in tooth tissue,which is worthy of clinical verification.
刘虹秀;单轶;包春艳;刘海波
秦皇岛市妇幼保健院口腔科 河北 秦皇岛 066000
口腔医学
Nd∶YAP激光三联抗生素糊剂年轻恒牙牙髓血运重建术
Nd∶YAP lasertriple antibiotic pasteyoung permanent teethpulp blood reconstruction
《中国美容医学》 2024 (009)
130-134 / 5
秦皇岛市科学技术研究与发展计划任务书(编号:202101A065)
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