歯列欠損者に対する口腔インプラント修復の効果と歯肉クレヴィキュラー液中のTNF-αおよびIL-6レベルへの影響

[Effect of oral implant restoration on dentition defect patients and its impact on TNF-α and IL-6 levels in gingival crevicular fluid].

• Zhong-Fu Chang
• Dan-Dan Jiang
• Zhi-Rong Zhang
• Jian-Ying Cai

抄録

目的:

歯列欠損を有する患者における口腔インプラント修復の臨床効果と、歯肉溝液中の腫瘍壊死因子-α(TNF-α)およびインターロイキン-6(IL-6)レベルへの影響を検討する。

PURPOSE: To investigate the clinical effects of oral implant restoration in patients with dentition defects and the its impact on tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) levels in gingival crevicular fluid.

方法:

2017年5月から19年8月までに上海浦東区人民病院に入院した歯列欠損患者84名を登録し、対照群（n=42）と実験群（n=42）に無作為に分けた。対照群の患者は日常的な方法で修復を行い、実験群の患者は口腔内インプラント修復を行った。治療後6ヶ月後に修復の効果を評価した。歯肉溝液中のTNF-α、IL-6のレベルと歯機能を2群間で比較した。データはSPSS 18.0ソフトウェアパッケージを使用して分析しました。

METHODS: Eighty-four patients with dentition defects from May 2017 to August 1919 in People's Hospital of Shanghai Pudong District were enrolled and randomly divided into control group (n=42) and experimental group (n=42). Patients in the control group were repaired by routine methods,while those in the experimental group were treated with oral implant restoration. The effect of restoration was evaluated 6 months after treatment. The levels of TNF-α, IL-6 in the gingival crevicular fluid and dental function were compared between the 2 groups. The data were analyzed using SPSS 18.0 software package.

結果:

治療後の実験群および対照群のTNF-αおよびIL-6のレベルは、治療前と比較して有意に高かった（P＜0.05）。実験群のTNF-αおよびIL-6のレベルは、治療6ヵ月後に対照群と比較して有意に低かった(P<0.05)。歯の機能のスコアは、実験群と対照群で治療前と比較して有意に高かった(P<0.05)。治療後6ヶ月後の保持力、発話力、咀嚼力、審美性のスコアは、実験群が対照群に比べて有意に高かった(P<0.05)。実験群では、感染症、むし歯、歯ぎしり、後歯とコアの脱落、歯抜けの発生率が対照群に比べて有意に低かった(P<0.05)。

RESULTS: The levels of TNF-α and IL-6 in the experimental group and the control group after treatment were significantly higher than those before treatment (P<0.05). The levels of TNF-α and IL-6 in the experimental group were significantly lower than those in the control group 6 months after treatment (P<0.05). The scores of dental function in the experimental group and the control group were significantly higher than those before treatment (P<0.05). The scores of retention, speech, chewing and aesthetics of the experimental group 6 months after treatment were significantly higher than the control group (P<0.05). The incidence of infection, pricking, post and core loosing and teeth missing in the experimental group was significantly lower than that of the control group (P<0.05).

結論:

歯列欠損を有する患者の治療において、インプラント修復は、歯肉溝液中のＴＮＦ-αおよびＩＬ-６のレベルにほとんど影響を及ぼさず、歯科機能の改善および術後合併症の発生率の低減に有用である。したがって、臨床応用として普及させる価値がある。

CONCLUSIONS: In the treatment of patients with dentition defects, implant restoration has little effect on the levels of TNF-α and IL-6 in gingival crevicular fluid, which is helpful to improve dental function and reduce the incidence of postoperative complications. Therefore, it is worthwhile to be popularized in clinical application.