目的 探讨1%聚维酮碘联合龈下刮治与根面平整术（subgingival scaling and root planing,SRP）对I期A级~II期B级牙周炎患者龈上菌斑、牙龈炎症的影响,及患者的接受度。方法 选取2021年12月到2024年12月于我院就诊的I期A级~II期B级牙周炎患者180例,采用信封法随机分为联合组（n=90,予以1%聚维酮碘联合SRP治疗）与SRP组（n=90,予以SRP治疗）。比较两组的菌斑控制效果[菌斑指数（plaque index,PLI）、菌斑占比]、牙龈炎症程度[牙龈指数（gingival index,GI）、牙龈血流量、探诊出血指数（bleeding on probing,BOP）]、牙周组织破坏指标[牙周袋深度（periodontal pocket depth,PD）、根面残留牙石位点总数、临床附着丧失（clinical attachment loss,CAL）]、中文版疾病接受度量表（Chinese Version of Acceptance of Illness Scale,AIS-CHI）评分及安全性。结果 治疗后3个月,两组的PLI、菌斑占比降低,且联合组低于SRP组;两组的GI、BOP、牙龈血流量降低,且联合组低于SRP组;两组的PD、CAL、根面残留牙石位点总数降低,且联合组低于SRP组;两组的AIS-CHI评分升高,且联合组高于SRP组。两组总不良反应发生率比较,差异无统计学意义。结论 1%聚维酮碘联合SRP治疗I期A级~II期B级牙周炎可控制菌斑、减轻牙龈炎症、改善牙周组织破坏程度,且能提高患者接受度,安全性可控,值得临床推广应用。
Abstract
Objective To investigate the influence of 1% povidone iodine combined with subgingival scaling and root planing (SRP) on supragingival plaque, gingival inflammation and patient acceptance in patients with stage I-II, grade A-B periodontitis. Methods 180 patients with stage I-II, grade A-B periodontitis who were treated in the hospital from December 2021 to December 2024 were selected and randomly divided into combined group (n=90, 1% povidone iodine combined with SRP) and SRP group (n=90, SRP) by envelope method. Plaque control effect[plaque index (PLI), plaque proportion], gingival inflammation degree [gingival index (GI), gingival blood flow, bleeding on probing (BOP)], periodontal tissue damage indexes [periodontal pocket depth (PD), total number of residual dental stone sites on root surface, clinical attachment loss (CAL)], Chinese version of acceptance of illness scale (AIS-CHI) score and safety were compared between the two groups. Results At 3 months after treatment, the PLI and proportion of plaque in the two groups were decreased, and the indexes in combined group were lower than those in SRP group. The GI, BOP and gingival blood flow were reduced in the two groups, and the indexes in combined group were lower. The PD, CAL and total number of residual dental stone sites on root surface in both groups were declined, and the indexes were lower in combined group than those in SRP group (P<0.05). The AIS-CHI score in the two groups was increased, and the score in combined group was higher compared to SRP group. There was no statistical difference in the total incidence rate of adverse reactions between the two groups. Conclusion 1% povidone iodine combined with SRP in the treatment of stage I-II, grade A-B periodontitis can control plaque, relieve gingival inflammation, improve the degree of periodontal tissue destruction, and enhance the acceptance of patients, with controllable safety.
关键词
牙周炎 /
聚维酮碘 /
龈下刮治根面平整术 /
牙斑菌 /
炎症
Key words
periodontitis /
povidone iodine /
subgingival scaling and root planing /
dental plaque /
inflammation
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参考文献
[1] 李芳菲, 刘佳, 梁晓龙, 等. 肿痛安胶囊联合盐酸米诺环素软膏治疗2型糖尿病伴牙周炎的疗效及对血清炎症因子水平的影响[J]. 西北药学杂志, 2025, 40(4): 196-201.
[2] 曹慧, 吴芳芳, 杜文芳, 等. TLR4、TLR9及IL-35在慢性牙周炎患者牙龈组织中的表达及其临床意义[J]. 分子诊断与治疗杂志, 2025, 17(4): 733-737.
[3] LUAN J, LI R, XU W, et al.Functional biomaterials for comprehensive periodontitis therapy[J]. Acta Pharm Sin B, 2023, 13(6): 2310-2333.
[4] AMATO M, SANTONOCITO S, POLIZZIA, et al. Local delivery and controlled release drugs systems: A new approach for the clinical treatment of periodontitis therapy[J]. Pharmaceutics, 2023, 15(4): 1312.
[5] KARDARAS G, CHRISTODORESCUR, OARIU M, et al.A low-cost protocol using the adjunctive action of povidone-iodine irrigations and sodium hypochlorite rinsing solution in step 2 of periodontal therapy for patients with stage III-IV periodontitis: a single-blind, randomized controlled trial[J]. Dent J, 2024, 12(5): 144.
[6] 付裕文, 曹文静, 岳鹏, 等. 牙龈卟啉单胞菌口腔感染增加心血管疾病风险的研究进展[J]. 感染、炎症、修复, 2021, 22(1): 54-57.
[7] 李宇, 葛振鸣.7种不同成分消毒剂对MS2噬菌体杀灭效果的比较[J]. 华东师范大学学报 (自然科学版), 2023, (02): 161-167.
[8] 孟焕新. 2018年牙周病和植体周病国际新分类简介[J]. 中华口腔医学杂志, 2019, 54(2): 73-78.
[9] 龚昕, 陈蔚, 宫耀, 等. 固定矫治患者菌斑指数、牙龈指数、龈沟出血指数的临床分析[J]. 上海口腔医学, 2006, 15(4): 367-369.
[10] 喻爱霞. 牙周炎患者应用牙周组织再生术联合正畸治疗的临床效果评价[J]. 河北医科大学学报, 2017, 38(3): 306-310.
[11] 赵雯雯. 中文版疾病接受度量表的信效度评价[J]. 中华现代护理杂志, 2018, 24(22): 2652-2655.
[12] 邱林, 舒成军, 吴晓东, 等. 慢性牙周炎与肺通气功能的相关性研究[J]. 中国基层医药, 2022, 29(7): 961-966.
[13] 黄道庆, 黄海花, 曾长余, 等. 铒激光和钕激光联合治疗慢性牙周炎的临床效果评价[J]. 湖南师范大学学报 (医学版), 2022, 19(3): 44-47.
[14] 刘恩言, 丁一, 刘程程, 等. 聚维酮碘辅助治疗牙周炎研究进展[J]. 中国实用口腔科杂志, 2024, 17(01): 118-123.
[15] 杨煦, 徐文靖, 李洪发. 聚维酮碘含漱液结合盐酸米诺环素软膏在慢性牙周炎治疗中的疗效及安全性评价[J]. 中国药物应用与监测, 2024, 21(2): 176-179.
[16] 刘书钗, 王美, 张楠. 慢性牙周炎患者血清Th17/Treg细胞因子表达水平及临床意义[J]. 湖南师范大学学报 (医学版), 2023, 20(4): 47-50, 64.
[17] HASSANG L, KAPOOR R, TYAGI P, et al.To compare and evaluate the efficacy of 1% alendronate gel and 10% doxycycline gel as an adjunct to SRP in patients with chronic periodontitis: a randomized controlled clinical Trial[J]. J Pharm Bioallied Sci, 2024, 16(Suppl 4): S3153-S3155.
[18] LIU E, DUAN D, XIE X, et al.Efficacy of 1% povidone-iodine mouthwash combined with scaling and root planing in the treatment of periodontitis: a randomized, controlled trial[J]. West China J Stomatol, 2025, 43(3): 362-369.
[19] LEE YY, LI MJ, YU ZY, et al.Modulation of proinflammatory mediators by viruses-bacteria synergism in human osteoblasts-an in vitro study[J]. J Formos Med Assoc, 2022, 121(4): 841-847.
[20] 李晶, 孟楠, 计春波, 等. 盐酸米诺环素软膏联合聚维酮碘含漱液治疗正畸者重度牙周炎的疗效分析[J]. 临床药物治疗杂志, 2022, 20(11): 31-35.
[21] 赵莹, 刘冀, 周林. 聚维酮碘含漱液和氯己定含漱液分别联合牙周基础治疗对慢性牙周炎治疗效果的比较[J]. 实用口腔医学杂志, 2021, 37(4): 505-508.
[22] UMITREL SI, MATICHESCU A, DINU S, et al.New insights regarding the use of relevant synthetic compounds in dentistry[J]. Molecules, 2024, 29(16): 3802.
[23] El MOBADDER M, NAMMOUR S, GRZECH-LEŚNIAK Z, et al. Efficacy of the adjunct use of povidone-iodine or sodium hypochlorite with non-surgical management of periodontitis: a systematic review and meta-analysis[J]. J Clin Med, 2022, 11(21): 6593.
基金
山西省卫健委项目 “后牙区微螺钉在拔牙病例内收上颌牙列时三维有限元模型建立与应力分析”（2023041）
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