Clinical effects of non-surgical treatment on severe generalized aggressive periodontitis

目的 观察重度广泛型侵袭性牙周炎(generalized aggressive periodontitis,GAgP)患者牙周非手术治疗后临床指标的变化,并评价其治疗效果.方法 19例GAgP患者在洁治后1个月内完成刮治和根面平整,每2个月进行1次牙周维护,纵向观察6个月.在基线和维护期各时间点记录全口探诊深度(probing depth,PD)、探诊出血(bleeding on probing,BOP)、附着丧失(attachment loss,AL)和牙齿松动度,磨牙记录根分叉病变的程度,其中7例患者在基线和治疗后6个月进行白细胞计数、中性粒细胞百分比和甘油三酯的检测.结果 在基线时患者的平均PD为(5.1±2.1)mm,BOP阳性位点占98.0%,AL(3.9±1.9)mm.治疗后6个月平均PD为(3.0±1.1)mm,BOP阳性位点减少至11.9%,AL(3.2±1.2)mm,其中重度位点治疗后PD减少[(4.0±1.6)mm]大于中度位点[(2.2±0.9)mm,P<0.001],切牙治疗后PD减少大于磨牙,中性粒细胞百分比治疗后6个月[(55.4±9.3)%]较治疗前[(65.7±9.9)%]明显减少(P<0.05).结论 GAgP患者经牙周非手术治疗和定期牙周维护能取得良好的治疗效果,磨牙可能需要进一步的刮治和根面平整或手术治疗.Objective To investigate the clinical results of non-surgical periodontal treatment of generalized aggressive periodontitis in a Chinese population.Methods Nineteen patients aged(24.5±4.1)years with generalized aggressive periodontitis were included in this prospective study.All subjects received scaling and root planing and were clinically monitored every 2 months for 6 months.The clinical parameters,including probing depth(PD),bleeding on probing(BOP),attachment loss(AL)and mobility,furcation involvement of molars were recorded at baseline,2,4 and 6 months after treatment.White blood cells,neutrophil percentage,triglyceride of 7 patients were detected at baseline and 6 months after treatment.Results At baseline,the mean PD of patients was(5.1±2.1)mm,the percentage of BOP positive sites was 98.0% and mean AL was(3.9±1.9)mm.At 6 months after treatment,the mean pocket depth reduction was 2.0 mm,the percentage of BOP positive sites reduced to 11.9% and 0.6 mm attachment level was gained.Incisors showed greater PD reduction than molars,the baseline PD had predictive effect on PD reduction,deep sites showed greater PD reduction than shallow sites.There was a statistically significant decrease of neutrophil percentage at 6 months after treatment[(65.7±9.9)% vs.(55.4±9.3)%,P<0.05].Conclusions Non-surgical treatment is effective for the generalized aggressive pefiodontitis and every 2 months SPT is necessary for maintenance.Further surgical treatment or repeated SRP is recommended for molars.国家自然科学基金; 国家科技支撑计划; 卫生部部属(管)医疗机构临床学科重点项目; 教育部教育振兴行动计划特殊专项(九工程)PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)05264-2684