中国实用口腔科杂志

中国实用口腔科杂志 ›› 2025, Vol. 18 ›› Issue (5): 557-563.DOI: 10.19538/j.kq.2025.05.009

• 论著 • 上一篇    下一篇

机械清创联合Nd∶YAG激光治疗种植体周炎的临床效果评价

施怡嘉，张浩筠，胡文杰，危伊萍，王    翠，刘    建   

  1. 北京大学口腔医学院·口腔医院牙周科，国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，口腔数字医学北京市重点实验室，北京 100081
  • 出版日期:2025-09-30 发布日期:2025-09-30
  • 通讯作者: 胡文杰
  • 基金资助:
    国家自然科学基金（82173647）

  • Online:2025-09-30 Published:2025-09-30

摘要： 目的    评价机械清创联合Nd∶YAG激光治疗种植体周炎的临床指标变化。方法    研究采用随机对照临床试验，选取2024年7月至2025年1月于北京大学口腔医院牙周科就诊的种植体周炎患者22例（22颗种植体）。将所有患者随机分为试验组和对照组，每组11例（11颗种植体）；试验组采用钛刮治器刮治联合Nd∶YAG激光治疗，对照组仅采用钛刮治器刮治治疗。分别在基线（治疗前）和治疗后3个月对患者进行种植体周临床检查，并记录唇（颊）、腭（舌）侧近中、中央、远中6个位点的种植体周探诊深度（peri-implant probing depth，PPD）、改良龈沟出血指数（modified sulcus bleeding index，mSBI）和改良菌斑指数（modified plaque index，mPLI），比较2组患者之间种植体的平均PPD和最深种植体周探诊深度（deepest peri-implant probing depth，dPPD）、mSBI最大值、mPLI最大值，以及PPD ≥ 5 mm和≥ 7 mm位点百分比差异。结果    2组患者基线时平均PPD、dPPD、mSBI、mPLI，以及PPD ≥ 5 mm和≥ 7 mm位点百分比比较，差异均无统计学意义（均P > 0.05）。治疗后3个月，2组患者的平均PPD、dPPD、mSBI均较基线明显改善，差异均有统计学意义（均P < 0.05），但2组间比较差异均无统计学意义（均P > 0.05）；对照组患者PPD ≥ 5 mm位点百分比较基线明显下降，试验组患者PPD ≥ 7 mm位点百分比较基线明显下降，差异均有统计学意义（均P < 0.05），但2组间比较差异均无统计学意义（均P > 0.05）。结论    机械清创联合或不联合Nd∶YAG激光治疗均可有效改善PPD、dPPD和mSBI，机械清创联合Nd∶YAG激光治疗可能降低种植体周深袋（PPD ≥ 7 mm）位点百分比。

关键词: 种植体周炎, 非手术治疗, 激光治疗, 机械清创

Abstract: Objective    To evaluate changes in clinical parameters of mechanical debridement with Nd∶YAG laser therapy for peri-implantitis. Methods    A randomized controlled clinical trial was conducted，enrolling 22 patients（22 implants）with peri-implantitis who visited the Department of Periodontology at Peking University Hospital of Stomatology between July 2024 and January 2025. The patients were randomly allocated into two groups：the test group（n = 11，11 implants），treated with titanium curette debridement combined with Nd∶YAG laser，and the control group（n = 11，11 implants），treated with titanium curette debridement alone. Clinical examinations were performed at baseline（pre-treatment）and 3 months after treatment，recording peri-implant probing depth（PPD），modified sulcus bleeding index（mSBI），and modified plaque index（mPLI）at six sites of each implant（buccal/facial and palatal/lingual sides，including mesial，middle，and distal sites）. The mean PPD，deepest PPD（dPPD），maximum mSBI，and maximum mPLI，as well as the percentages of sites with PPD ≥ 5 mm and ≥ 7 mm were compared between the two groups. Results    At baseline，no statistically significant differences were observed between the two groups in mean PPD，dPPD，mSBI，mPLI，or the percentages of sites with PPD ≥ 5 mm and ≥ 7 mm（all P > 0.05）. At 3 months after treatment，both groups showed significant improvements in mean PPD，dPPD，and mSBI compared to baseline（all P < 0.05），with no significant intergroup differences（all P > 0.05）. The control group exhibited a significant reduction in the percentage of sites with PPD ≥ 5 mm（P < 0.05），while the test group demonstrated a significant decrease in the percentage of sites with PPD ≥ 7 mm（P < 0.05）. However，no significant intergroup differences were observed（all P > 0.05）. Conclusion    Both mechanical debridement alone and its combination with Nd∶YAG laser therapy can effectively improve PPD，dPPD，and mSBI. The combined approach may reduce the percentage of deep peri-implant pockets（PPD ≥ 7 mm）.

Key words: peri-implantitis, non-surgical treatment, laser therapy, mechanical debridement