龈下菌斑对慢性牙周炎患者种植体周骨吸收的影响

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　　 【摘要】 目的：研究齦下菌斑对慢性牙周炎患者种植体周骨吸收的影响。方法：选取2015年8月-2018年8月来本院接受种植体修复的48例慢性牙周炎牙列缺失患者（研究组）及48例牙周健康牙列缺损者（参照组）作为研究对象。两组均经过常规种植体修复治疗，研究组术前接受牙周基础治疗。观察记录两组种植前及种植后3个月龈下菌斑、种植体周骨吸收、龈沟出血及不良反应发生情况，采用疼痛评分、舒适感评分、咀嚼效率对治疗效果进行评定。结果：治疗前，研究组龈下菌斑指数高于参照组，差异有统计学意义（P<0.05）;两组治疗后龈下菌斑指数均低于治疗前，差异均有统计学意义（P<0.05），但两组治疗后比较，差异无统计学意义（P>0.05）。治疗后，两组近中及远中边缘骨吸收量均低于治疗前，差异均有统计学意义（P<0.05），且研究组治疗后的近中边缘吸收量低于参照组，远中边缘吸收量则高于参照组，差异均有统计学意义（P<0.05）。治疗后，两组牙龈出血指数均低于治疗前，且参照组明显低于研究组，差异均有统计学意义（P<0.05）。研究组不良反应发生率为12.00%（6/50），高于参照组的0，差异有统计学意义（字2=4.536，P=0.033）。研究组疼痛评分明显高于参照组，舒适感评分及咀嚼效率均低于参照组，差异均有统计学意义（P<0.05）。结论：龈下菌斑可对慢性牙周炎患者种植体周骨吸收造成影响，术前给予牙周基础治疗能够减少影响，值得临床采纳。
　　 【关键词】 龈下菌斑; 慢性牙周炎; 种植体; 骨吸收; 龈沟出血
　　 【Abstract】 Objective：To study the effect of subgingival plaque on peri-implant bone resorption in patients with chronic periodontitis.Method：From August 2015 to August 2018，48 patients with chronic periodontitis（study group）and 48 cases with healthy periodontal defects（reference group）who received implant repair in our hospital were selected as research objects.Both groups were treated with conventional implant prosthesis，and the study group received periodontal basic treatment before surgery.The incidence of subgingival plaque，peri-implant bone resorption，gingival sulcus bleeding and adverse reactions were observed and recorded in the two groups before and 3 months after implantation，pain score，comfort score and mastication efficiency were used to evaluate the therapeutic effect.Result：Before treatment，the subgingival plaque index of the study group was higher than that of the reference group，the difference was statistically significant（P<0.05）;after treatment，the subgingival plaque index of both groups were lower than that before treatment，the differences were statistically significant（P<0.05），but there was no statistically significant difference after treatment between the two groups（P>0.05）.After treatment，the amount of bone absorption at the mesial and distal marginal of both groups were lower than those before treatment，the differences were statistically significant（P<0.05）;in addition，the amount of bone absorption at the mesial and distal marginal of the study group was lower than that of the reference group，and the amount of bone absorption at the mesial and distal marginal of the study group was higher than that of the control group，the differences were statistically significant（P<0.05）.After treatment，the gingival bleeding index of both groups were lower than those before treatment，and that of the reference group was significantly lower than that of the study group，with statistically significant differences（P<0.05）.The incidence of adverse reactions in the study group was 12.00%（6/50），higher than 0 in the control group，the difference was statistically significant（字2=4.536，P=0.033）.Pain score in the study group was significantly higher than that in the control group，while comfort scores and chewing efficiency were lower than those in the control group，with statistically significant differences（P<0.05）.Conclusion：Subgingival plaque can affect peri-implant bone resorption in patients with chronic periodontitis，preoperative periodontal basic treatment can reduce the impact and is worthy of clinical adoption. 　　[7]万英明，王景云，毕铭，等.清胃散联合头孢拉定治疗牙周病患者效果观察及对菌斑指数、牙周袋探针深度、龈沟出血指数的影响[J].中国现代医学杂志，2016，26（10）：71-74.
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　　（收稿日期：2019-01-15） （本文编辑：张爽）
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