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目的比较牙周翻瓣术与二次龈下刮治和根面平整术(scaling and root planing,SRP)治疗慢性牙周炎的临床疗效。方法选取牙周基础治疗6w后牙周探诊深度为5～7mm的单根牙117颗作为研究对象,同一患者的左右两侧牙随机分为二次SRP组和改良Widman翻瓣组。二次SRP组患者在局麻下对纳入的患牙用赛特力超声治疗机和Gracey刮治器进行龈下刮治和根面平整术,翻瓣组患者在局麻下行改良Widman翻瓣术。治疗后3、6个月对两组患者进行复诊,并对患者的受试牙进行牙周专业检查,记录探诊出血(BOP)、探诊深度(PD)、临床附着水平(CAL)及牙龈退缩(GR)。结果二次SRP组和改良Widman翻瓣组治疗后6个月患牙的BOP阳性率、PD、CAL、GR分别为16.92%、(2.82±0.74)mm、(5.05±1.02)mm、(2.02±0.60)mm和11.60%、(2.54±0.49)mm、(4.90±0.83)mm、(2.35±0.67)mm,两组治疗后6个月各项指标与治疗前比较差异均有统计学意义(P<0.05)。治疗后6个月两组间BOP阳性率、PD及CAL比较差异无统计学意义(P>0.05),但改良Widman翻瓣组GR明显高于二次SRP组(P<0.05)。结论对于单根牙,二次SRP和改良Widman翻瓣术可达到相同的治疗效果,但翻瓣术后的牙龈退缩较二次SRP明显。
Objective To compare the clinical effects of periodontal flap surgery with secondary subgingival scaling and scaling and root planing (SRP) in the treatment of chronic periodontitis. Methods One hundred and seven teeth of periodontal probing depth of 5 ~ 7mm were selected as experimental subjects after 6 weeks of periodontal treatment. The left and right teeth of the same patient were randomly divided into secondary SRP group and modified Widman flap group. Patients in the secondary SRP group underwent local subgingival scaling and root planing with the Systex ultrasound machine and Gracey scraping device under local anesthesia. Patients in the flap group underwent modified Widman flap surgery under local anesthesia. At 3 and 6 months after treatment, two groups of patients were referred to the hospital and the periodontal examination was performed on the test teeth of the patients. BOP, PD, CAL and gingiva Retreat (GR). Results The BOP positive rate, PD, CAL and GR of teeth in secondary SRP group and modified Widman flap group were 16.92%, (2.82 ± 0.74) mm, (5.05 ± 1.02) mm and (2.02 ± 0.60) mm and 11.60%, (2.54 ± 0.49) mm, (4.90 ± 0.83) mm and (2.35 ± 0.67) mm, respectively. There was significant difference between the two groups at 6 months after treatment <0.05). There was no significant difference in BOP positive rate, PD and CAL between the two groups at 6 months after treatment (P> 0.05). However, GR in the modified Widman flap group was significantly higher than that in the secondary SRP group (P <0.05). Conclusions The same treatment effect can be achieved for single tooth, secondary SRP and modified Widman flap, but the gingival recession after flap flap is more obvious than secondary SRP.