| Objective: Periodontal-endodontic combined lesions is a disease simultaneous in periodontal diseases and dental pulp tissue,and contanct with each other.As the disease involved periodontal and dental pulp tissue at the same time,clinical symptoms usually very severe and infections bacteria’s species is relatively complex,which is an important cause of the tooth missing.This experiment application the photo-activated disinfection technology in root canal therapy and periodontal therapy play a role of high efficient sterilization,observing the clinical curative effect index and the relative percentage changes of periodontal pathogens in subgingival plaque,evaluate the clinical curative effect of PAD in periodontal-endodontic combined lesions,improve the cure rate of periodontal-endodontic combined lesions.Methods:1 Experimental subjects: according to the international classification of periodontal disease in 1999 seminar on periodontal-endodontic combined lesions defined exist for the same periodontal disease and dental pulp disease,and connected with each other.30 patients who have periodontal-endodontic combined lesions were selected randomly from hebei province stomatological hospital,as the experimental object,the patients aged from 25 to 70 years,with women 14,men 16.2 Grouping: 30 cases of periodontal-endodontic combined lesions patients randomly divided into three groups,each group of 10 cases,namely group A: conventional root canal treatment and periodontal basic treatment;Group B: PAD auxiliary conventional root canal treatment and conventional periodontal basic treatment;Group C: PAD auxiliary root canal treatment and periodontal basic treatment.3 Experimental methods: first,know the main cause of the patient andbasic situation,diagnosed the teeth through specific dental pulp vitality electric test,periodontal examination,root X-ray examination,percussion reaction,loose degree examination.According to actual condition and experimental arrangements,illustrate the specific condition and therapeutic schedule,get the patient’s informed consent,instructed the necessity of patients return and appointment on time,guiding the patients oral hygiene.All patients need perfect root canal therapy and periodontal basic treatment,the basis periodontal treatment including supragingival scaling,subgingival scaling,root planning,occlusal adjustment,generally referred to as the comprehensive treatment.Observe and record the change of patients before and after treatment for 6 weeks,12 weeks as following clinical indicators: periodontal probing depth,clinical attachment level,bleed on probing.Randomly select two loci(PD≥5mm)from each patient periodontal,Using real-time PCR technology to detect the relative content changes of Porphyromonas gingivalis in subgingival plaque,before the treatment and after treatment for 6 weeks,12 weeks.Random select a root from more root canal,application of Real-time PCR technology to measurement the change of the total bacteria in root canal before and after root canal therapy,compared the changes of total bacteria in each group.Analyze these data with repeated measures、one-way analysis of variance and rank sum test by using SPSS 21.0 software.Results:1 Clinical indicators: After comprehensive treatment the three groups of patients self-consciously symptoms disappeared or improved,gingival swelling almost disappeared,texture changed from soft tenacity,bleed on probing decreased,loose degree have different degrees of recovery.Repeated measures analysis of variance showed that there are interaction at different group and time points(P<0.05).Before comprehensive treatment,there was no statistically significant difference in PD,CAL,BOP among three groups(P>0.05).6 and 12 weeks after treatment,PD,CAL,BOP value within the groups are lower than before treatment,Within three group PD,CAL,BOP indicators at different time points difference has statistical significance(P<0.05).6 and 12 weeks after comprehensive treatment,PD,CAL,BOP value in different groups has statistical significance(P<0.05),group C PD,CAL,BOP indicators in 6 and 12 weeks after treatment are lower than the same period in group A and group B,the different has statistically significant(P<0.05).2 Root canal sterilization effect: single factor analysis of variance,three groups of bacterial quantity before the root canal treatment there was no statistically significant(P<0.05).After root canal treatment,bacterial quantity of group B and group less than group A,bacteria relative content in group A different from group B and group C had statistical significance(P<0.05),the different in group B and group C bacteria relative content has no statistical significance(P>0.05).3 Pg content relative to total bacteria: Repeated measures analysis of variance showed that there were interaction at different group and time points(P<0.05).Baseline,A,B,C three groups of Pg content relative to the total bacteria there was no statistically significant difference(P>0.05),Pg within each group content relative to the total bacteria at different time points difference was statistically significant(P<0.05),each group Pg content relative to the total bacteria in 6 and 12 weeks after treatment were lower than the baseline levels,shows that conventional mechanical periodontal therapy and PAD auxiliary treatment of periodontal therapy can effectively kill bacteria.In the treatment of 6 and 12 weeks,group C Pg content relative to the total bacteria is lower than that in group A and group B,the different between groups Pg content relative to the total bacteria have statistically significant(P<0.05).4 The curative effect of periodontal-endodontic combined lesions: after comprehensive treatment,rank sum test analysis,the different between three groups has statistically significant P<0.05.group A compared with group B,P>0.05 there was no statistically significant;group A compare with group C,P<0.05 the different has statistically significant;group B compared with Group C,P>0.05 there was no statistically significant.Conclusions:1 Conventional treatment and PAD auxiliary periodontal-endodontic lesions treatment both can improve control of self-conscious symptom,clinical symptoms and periodontal inflammation,but PAD adjuvant therapy effect is better.2 PAD auxiliary conventional root canal preparation is better than conventional root canal preparation,clinical curative effect is more significant.3 PAD technology with high efficient sterilization,which sterilization effect for periodontal pathogens Pg is better than that of the conventional treatment,and better periodontal inflammation control.4 PAD has small volume,simple and convenient operation,high efficient sterilization ability,safe and effective,and won’t produce side effects,which make PAD available to assist the treatment of periodontal-endodontic lesions. |
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