| Objective: Periodontitis is a devastatingly infectious disease whichinvolved with the periodontal soft and hard tissue and is initially caused byperiodontal pathogens. Periodontitis can occur to all ethnic groups andpeople from all ages and stages. It usually involves with multiple teeth in themouth and can lead to tooth loss when the condition is severe thus decreasethe life quality of patients. The development of periodontitis is influenced bythe results of the interaction of periodontal pathogens and the immuneresponse of the host; which makes the treatment become complex. But the keytreatment lies in removing and controlling of dental plaque, thus thefoundational treatment is of vital importance. Generally, the foundationaltreatments include: plaque control, supragingival scaling and subgingivalscaling. The clinician tends to apply the auxiliary drugs in local treatment infoundational treatment to achieve better therapeutic effect since there arelimitations in the pure mechanical treatment. XiPaYi Mouthrinse had certaineffect which had been proved by clinical applications for more than ten years.While KangFuXin solution proved to have extensive pharmacological effectsand thus was used in many clinical treatments, despite the fact that it wasrarely used in the treatment of periodontitis before. Compared with thetraditional methods, ultrasonic scaling combining with simultanous irrigationhad the advantage such as timesaving, effort saving and better drug effect.Based on the foundational treatment of the Periodontitis of the patients, thisstudy chose XiPaYi Mouthrinse and KangFuXin solution for patients’ garglingor ultrasonic scaling combined with the simultanous irrigation. The curativeeffect of two drugs and two methods for the treatment of patients ofperiodontitis were recorded and compared on the periodontal clinical indices(PD, AL, BI, PLI) and the level of TNF-α, HGF (detected by ELISA) of gingival crevicular fluid of the observed teeth before and after the treatment.Methods:45patients of chronic periodontitis were chosen for this study.They were patients selected from the Department of stomatological of theDepartment of Oral Medicine of Hebei Medical University form May2012toJanuary2013; including24males,21females; they were aged form25to56with an average age of39. The standards of patients’ selection were: hadgeneral conditions; had no history of drug allergy and smoking; had notreceived any periodontal treatment systematically within6months and had nottaken any antibiotics and hormone drugs within3months. The female patientsshould not have pregnancy as well as breastfeeding. All the patients shouldhave at least20teeth in the mouth. The tooth had probing depth≥4mm;attachment loss≥2mm; absorption of alveolar bone in X-ray less than2/3ofthe root length; loose of teeth should no more than Ⅱ degrees and withoutcavity and filling on the cervix was selected as the observed tooth.Patients were randomly divided into5groups with9patients in each group:Group A: Gargled XiPaYi Mouthrinse applied after ultrasonic scalingcombined with simultaneous distilled water irrigation;10ml per time for3minutes at a time; three times a day;Group B: Gargled KangFuXin solution applied after ultrasonic scalingcombined with simultaneous distilled water irrigation;10ml per time for3minutes; three times a day;Group C: Ultrasonic scaling combined with simultaneous XiPaYi Mouth-rinse irrigation (Diluted with equal amount of distilled water);Group D: Ultrasonic scaling combined with simultaneous KangFuXinsolution irrigation (Diluted with equal amount of distilled water);Group E (The control group): Ultrasonic scaling combined with simul-taneous distilled water irrigation.Oral health education was performed to all patients before the treatment:BASS brushing methods should be applied: they should brush their teeth atleast one time in the morning and one time in the night, each brush should last3minutes or more. After treatment for a week, gingival crevicular fluid would be collected and periodontal clinical indices (PD, AL, BI, PLI) would berecorded of the observed teeth at baseline. Inspection operations wereperformed by the same Dentist. All observed teeth of one patient were treatedat the same time. Patients of group A and B began gargled mouthwash aftertheir treatment,10ml of fluid for3minutes at a time, three times a day anddrum washing was used as the standard method.After all patients follow-up visited were completely, the level of TNF-α andHGF in gingival crevicular fluid would be detected by using enzyme-linkedimmunosorbent assay (ELISA). At last, the data of periodontal clinical indicesand the level of TNF-α and HGF before and after treatment were analyzed.Results:1Sex ratio and age differences had no statistically significant difference ineach group (P＞0.05).2Periodontal clinical indices and the level of TNF-α and HGF at baselinehad no statistically significant difference in each group (P＞0.05).3All the indicators were matched test within each group before and afterthe treatments, all of them had statistically significant difference in each groupexcept AL (P＜0.05).4The D-value (value before the treatment－value after the treatment) of allthe indicators before and after the treatments was compared between thecontrol group(E) and the experimental groups(ABCD), PD, BI, PLI, HGF hadstatistically significant difference between group E and group A, B (P＜0.05).PD, BI, TNF-α, HGF had statistically difference between group E and group C,D (P＜0.05).5The D-value of all the indicators before and after the treatments had nostatistically significant difference between group A and group B(P＞0.05).The D-value of all the indicators before and after the treatments had nostatistically significant difference between group C and group D (P＞0.05).6The D-value of PLI, TNF-α, HGF before and after the treatments hadstatistically significant difference between group A and group C (P＜0.05).The D-value of TNF-α, HGF before and after the treatments had statistically significant difference between group B and group D (P＜0.05).Conclusions:1Mechanical treatment’s curative effect in patients with periodontitis wasconfirmed, but with the local application of auxiliary drug could improve theeffect of foundational treatment.2KangFuXin Solution had similar curative effect to XiPaYi Mouthrinse inboth Gargled and ultrasonic scaling combined with simultaneous irrigation, itis suggested that KangFuXin Solution to be used as a drug for the treatmentsof periodontitis.3The level of TNF-α and HGF of ultrasonic scaling combined withsimultaneous irrigation had signifycantly reductoin compared to gargled withKangFuXin Solution or XiPaYi Mouthrinse, thus it is suggested that ultrasonicscaling combined with simultaneous irrigation had better effect and Simplerprocedures thus were economic compared to gargled. |
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