Clinical efficacy evaluation of minimally invasive periodontal therapy assisted by endoscopy

doi:10.12016/j.issn.2096-1456.2021.03.005

Abstract

Abstract:

Objective To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis. Methods Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe. Results For sites of 4P < 0.05). There was no significant difference between the two groups at 6 months (P >0.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (P > 0.05). For sites with PD > 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (P < 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (P>0.05). Conclusion When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.

Key words: periodontitis, subgingival scaling, root planning, periodontal endoscope, initial periodontal therapy, probing depth, bleeding on probing, attachment loss

摘要：

目的探讨牙周内窥镜辅助下超声龈下刮治及根面平整（subgingival scaling and root planning,SRP）对重度牙周炎治疗的临床疗效。方法选取2017年6月至2019年1月于南京大学医学院附属口腔医院就诊的Ⅲ-Ⅳ期牙周炎患者19例,随机分为内窥镜组及对照组。内窥镜组在龈上洁治术1周后,牙周内窥镜下行一次SRP;对照组在龈上洁治术1周后,行常规微创下SRP,隔周复查,对探诊出血位点行再次SRP,每个位点SRP最多3次。SRP前、治疗后3个月和6个月,采用Florida探针检查记录牙周状况：探诊深度（probing depth,PD）、探诊出血（bleeding on probing,BOP）阳性率及附着丧失（attachment loss,AL）。结果 4 < PD ≤ 6 mm位点：两组在基线时,PD、BOP阳性率、AL差异均无统计学意义。内窥镜组和对照组PD、BOP阳性率、AL在治疗后3个月和6个月时较基线均显著下降。PD在治疗后3个月时内窥镜组小于对照组（P < 0.05）,6个月时两组间未见明显差别（P > 0.05）。BOP阳性率、AL两组在3个月和6个月时均未见明显差别（P > 0.05）。PD>6 mm位点：在基线时,内窥镜组的PD、BOP阳性率及AL均比对照组更严重,差异有统计学意义。两组PD、BOP阳性率、AL在治疗后3个月和6个月时较基线均显著下降。但治疗后3个月和6个月后,内窥镜组PD较对照组变的更浅（P<0.05）,BOP阳性率、AL在治疗后3个月和6个月时两组间没有明显统计学差异（P > 0.05）。结论与常规微创下SRP相比,内窥镜下SRP有利于改善PD水平和减少更深位点的BOP及AL。

关键词: 牙周炎, 龈下刮治, 根面平整, 牙周内窥镜, 牙周基础治疗, 探诊深度, 探诊出血, 附着丧失

CLC Number:

XIA Jiaojiao,LI Houxuan. Clinical efficacy evaluation of minimally invasive periodontal therapy assisted by endoscopy[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(3): 171-177.

夏娇娇,李厚轩. 内窥镜辅助下微创牙周基础治疗的临床疗效评价[J]. 口腔疾病防治, 2021, 29(3): 171-177.

Figures/Tables 7

References 16

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Group	Age（x ± s,years）	Gender		Teeth	Research sites
Group	Age（x ± s,years）	Male	Female	Teeth	4 mm≤PD<6 mm	PD≥6 mm
Endoscopic	33.22 ± 4.09	5	4	112	248	208
Control	29.00 ± 4.90	5	5	123	292	188
t/χ²	t = 2.027	χ² = 0.229			χ² = 3.72
P	0.059	0.821			0.053

Group	Age（x ± s,years）	Gender		Teeth	Research sites
Group	Age（x ± s,years）	Male	Female	Teeth	4 mm≤PD<6 mm	PD≥6 mm
Endoscopic	33.22 ± 4.09	5	4	112	248	208
Control	29.00 ± 4.90	5	5	123	292	188
t/χ²	t = 2.027	χ² = 0.229			χ² = 3.72
P	0.059	0.821			0.053

Group	Number of sites	4 < PD ≤6 mm							Number of sites	PD>6 mm
Group	Number of sites	Baseline	3 months		6 months	P_a	P_b	P_c	Number of sites	Baseline	3 months	6 months	P_a	P_b	P_c
Endoscopic	248	5.05 ± 0.60		3.11 ± 1.25	3.17 ± 1.19	< 0.001	<0.001	0.404	208	7.96 ± 1.40	3.79 ± 1.36	3.37 ± 1.30	< 0.001	< 0.001	< 0.001
Control	292	5.13 ± 0.59		3.34 ± 1.31	3.26 ± 1.31	< 0.001	<0.001	0.402	188	7.71 ± 1.55	4.44 ± 1.80	4.24 ± 1.65	< 0.001	< 0.001	0.092
t		1.833		4.633	0.707					6.14	11.741	31.492
P		0.175		0.031	0.4					0.013	<0.001	<0.001

Group	Number of sites	4 < PD ≤6 mm							Number of sites	PD>6 mm
Group	Number of sites	Baseline	3 months		6 months	P_a	P_b	P_c	Number of sites	Baseline	3 months	6 months	P_a	P_b	P_c
Endoscopic	248	5.05 ± 0.60		3.11 ± 1.25	3.17 ± 1.19	< 0.001	<0.001	0.404	208	7.96 ± 1.40	3.79 ± 1.36	3.37 ± 1.30	< 0.001	< 0.001	< 0.001
Control	292	5.13 ± 0.59		3.34 ± 1.31	3.26 ± 1.31	< 0.001	<0.001	0.402	188	7.71 ± 1.55	4.44 ± 1.80	4.24 ± 1.65	< 0.001	< 0.001	0.092
t		1.833		4.633	0.707					6.14	11.741	31.492
P		0.175		0.031	0.4					0.013	<0.001	<0.001

Group	Number of sites	4 < PD ≤ 6 mm							Number of sites	PD>6 mm
Group	Number of sites	Baseline	3 months		6 months	P_a	P_b	P_c	Number of sites	Baseline	3 months	6 months	P_a	P_b	P_c
Endoscopic	248	43.96%		20.97%	14.52%	< 0.001	<0.001	0.06	208	66.35%	15.87%	25%	<0.001	<0.001	0.021
Control	292	42.47%		23.29%	13.36%	< 0.001	<0.001	0.002	188	51.06%	11.70%	18.09%	<0.001	<0.001	0.082
χ²		0.121		0.418	0.151					9.54	1.431	2.777
P		0.728		0.518	0.698					0.002	0.232	0.096