Griffiths G S, Smart G J, Bulman J S, Weiss G, Shrowder J, Newman H N
Department of Periodontology, Eastman Dental Institute and Hospital for Oral Health Care Sciences, University College London, UK.
J Clin Periodontol. 2000 Dec;27(12):910-7. doi: 10.1034/j.1600-051x.2000.027012910.x.
BACKGROUND, AIMS: Conventional treatment of chronic periodontitis involves mechanical debridement of periodontal pockets. Recently, subgingival antimicrobials have been used adjunctively following such debridement. This 2-centre study compared the clinical effects of subgingival scaling (SRP) with SRP plus subgingival application of 25% metronidazole gel, Elyzol (SRP+gel), in patients with chronic adult periodontitis.
Voluntary informed written consent was obtained from 45 subjects at the Eastman (mean age 46, range 34-63) and 43 subjects at RAF Halton (mean age 47, range 34-71) who participated in this blind, randomised split-mouth design study. All had at least 2 sites in each quadrant with probing pocket depth (PPD) > or = 5 mm. PPD, bleeding on probing (BOP), and clinical probing attachment levels (CAL) measured using a stent, were recorded at baseline and at 1, 3, 6 and 9 months post-therapy. After subgingival scaling of all quadrants, 2 quadrants were randomly selected to be treated with metronidazole gel.
A paired t-test on baseline values showed no bias between groups. Both treatments effectively reduced the signs of periodontitis. At each follow-up visit, reduction in PPD, CAL and BOP after the combined treatment was greater than for SRP alone. Paired t-tests showed that the improvement in the SRP+gel group was statistically significantly better (p<0.001) than for SRP alone (mean 0.5 +/- 0.6 mm. 95% CI 0.4-0.6 mm.) Similarly, the % of sites which improved to a final pocket depth of < or = 3 mm and the % of sites which improved over the 9 months of the study by as much as > or = 2 mm were greater for SRP+gel than for SRP alone.
At the end of the study, the mean reductions for PPD were 1.0 mm (SRP) compared to 1.5 mm (SRP+gel), and for CAL they were 0.4 mm (SRP) compared to 0.8 mm (SRP+gel), with mean difference for CAL between treatments of 0.4 +/- 0.6 mm (95% confidence intervals of 0.3-0.6 mm). The combination therapy of SRP+gel was superior to the conventional treatment of SRP alone, and these differences were maintained for 9 months.
慢性牙周炎的传统治疗包括对牙周袋进行机械清创。近来，在这种清创术后已辅助使用龈下抗菌药物。这项双中心研究比较了龈下刮治术（SRP）与SRP联合龈下应用25%甲硝唑凝胶（商品名：Elyzol，即SRP+凝胶）对慢性成人牙周炎患者的临床效果。
从伊斯特曼牙科医院的45名受试者（平均年龄46岁，范围34 - 63岁）和皇家空军哈顿医院的43名受试者（平均年龄47岁，范围34 - 71岁）处获得自愿签署的知情书面同意书，这些受试者参与了这项双盲、随机分组的口内对照设计研究。所有受试者每个象限至少有2个位点，探诊袋深度（PPD）≥5 mm。在基线时以及治疗后1、3、6和9个月记录PPD、探诊出血（BOP）以及使用定位器测量的临床探诊附着水平（CAL）。在对所有象限进行龈下刮治后，随机选择2个象限用甲硝唑凝胶治疗。
对基线值进行配对t检验显示两组之间无偏差。两种治疗均有效减轻了牙周炎症状。在每次随访时，联合治疗后PPD、CAL和BOP的降低幅度均大于单纯SRP治疗。配对t检验显示，SRP+凝胶组的改善在统计学上显著优于单纯SRP治疗（p<0.001）（平均0.
