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[光动力疗法在慢性广泛性中度牙周炎综合治疗中的应用]

[The use of photodynamic therapy in the complex treatment of chronic generalized moderate periodontitis].

作者信息

Losev F F, Krechina E K, Ivanova E V, Kuksa E Yu, Guseva I E

机构信息

Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.

Russian Medical Academy for Continuous Professional Education, Moscow, Russia.

出版信息

Stomatologiia (Mosk). 2023;102(2):11-15. doi: 10.17116/stomat202310202111.

Abstract

OBJECTIVE

Improving the effectiveness of the treatment of chronic generalized periodontitis by photodynamic therapy (PDT) due to clinical and functional validation of the effects of a photosensitizer.

MATERIAL AND METHODS

A clinical and functional study and treatment of moderate chronic generalized periodontitis was carried out in 60 people (24 males and 36 females) aged 35 to 50 years without somatic pathology with orthognathic bite. The patients were divided into 2 groups depending on the type of treatment: group 1 (main) included 30 patients (17 males and 13 females, mean age of patients was 42.5±3.3 years) who received comprehensive treatment consisting of oral sanitation, removal of dental plaque and curettage of periodontal pockets followed by PDT with 1% Geleophor gel using an AFS Spektr LED emitter with a wavelength of 660 nm and a power of 2.5 W, the course consisted of 4 procedures with exposure time of 7 minutes each; group 2 (control) included 30 patients (11 males and 19 females, mean age of patients was 43.0±2.1 years) undergoing standard treatment followed by protective capping with no active therapeutic agent. The state of microcirculation in tissues was studied by the laser Doppler flowmetry (LDF) using the LAKK-M device (Lazma, Russia).

RESULTS

According to LDF data in both groups, it was found that the improvement of microcirculation in periodontal tissues after complex treatment is accompanied by an increase in blood flow and its activity, at that the level of oxygenation and specific oxygen consumption increased more pronounced after PDT, the effect persisted after 6 and 12 months.

CONCLUSION

The use of PDT with LED emitter has a normalizing effect on the state of microcirculation and oxygenation in periodontal tissues.

摘要

目的

通过对光敏剂效果的临床和功能验证,提高光动力疗法(PDT)治疗慢性广泛性牙周炎的有效性。

材料与方法

对60名年龄在35至50岁、无躯体疾病且咬合正常的患者(24名男性和36名女性)进行中度慢性广泛性牙周炎的临床和功能研究及治疗。根据治疗类型将患者分为2组:第1组(主要组)包括30名患者(17名男性和13名女性,患者平均年龄为42.5±3.3岁),接受包括口腔清洁、去除牙菌斑和刮治牙周袋在内的综合治疗,随后使用波长为660 nm、功率为2.5 W的AFS Spektr LED发射器,用1%的Geleophor凝胶进行光动力疗法,疗程包括4次治疗,每次照射时间为7分钟;第2组(对照组)包括30名患者(11名男性和19名女性,患者平均年龄为43.0±2.1岁),接受标准治疗,随后进行保护性封盖,不使用活性治疗剂。使用LAKK-M设备(俄罗斯Lazma公司)通过激光多普勒血流仪(LDF)研究组织中的微循环状态。

结果

根据两组的LDF数据发现,综合治疗后牙周组织微循环的改善伴随着血流量及其活性的增加,光动力疗法后氧合水平和特定氧消耗量增加更为明显,该效果在6个月和12个月后持续存在。

结论

使用LED发射器的光动力疗法对牙周组织的微循环和氧合状态具有归一化作用。

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