早期牙周炎患者中,全身应用奥硝唑在进行和未进行龈下刮治部位的临床及微生物学效果。
The clinical and microbiological effects of systemic ornidazole in sites with and without subgingival debridement in early-onset periodontitis patients.
作者信息
Kamma J J, Nakou M, Mitsis F J
机构信息
Department of Periodontology, School of Dental Medicine, University of Athens, Greece.
出版信息
J Periodontol. 2000 Dec;71(12):1862-73. doi: 10.1902/jop.2000.71.12.1862.
BACKGROUND
The purpose of this study was to evaluate the clinical and microbiological effects of systemic ornidazole (ORN) in sites with or without subgingival debridement in early-onset periodontitis (EOP) patients.
METHODS
Two pooled bacterial samples consisting of 4 sites each (scaled and non-scaled sites) were obtained from 30 individuals exhibiting EOP. All patients received oral hygiene instruction (OHI), supragingival scaling and ORN. Subgingival scaling and root planing (SRP) was carried out only in scaled sites. Bacterial samples were taken at baseline (BL) and 1 week and 2, 6, and 12 months after systemic ornidazole administration (500 mg/bid for 7 days). One more sample was taken at scaled sites, one week after SRP.
RESULTS
One week following SRP (scaled sites) Gram-negative facultative and anaerobic rods were significantly reduced while Gram-positive facultative cocci were significantly increased. After ORN administration, P. gingivalis, P. denticola, P. intermedia, B. forsythus, C. rectus, and S. sputigena were no longer detectable in either scaled or non-scaled sites. A statistically significant long-term (2, 6, and 12 months) reduction of P. gingivalis, P. intermedia, P. loescheii, B. forsythus, and C. rectus and a pronounced increase of S. milleri, S. oralis, and S. sanguis counts in both scaled and non-scaled sites were detected in comparison to baseline. A sustained reduction of bleeding tendency and of probing depth was also observed in both scaled and non-scaled sites.
CONCLUSIONS
ORN combined with SRP effects beneficial shifts in the bacterial population associated with substantial clinical improvement, thereby indicating that ORN is effective adjunct in the treatment of EOP deep periodontal pockets where anaerobic bacteria are predominant.
背景
本研究的目的是评估全身应用奥硝唑(ORN)对早发性牙周炎(EOP)患者龈下刮治部位和未刮治部位的临床及微生物学影响。
方法
从30例早发性牙周炎患者中获取两组细菌样本,每组各包含4个部位(刮治部位和未刮治部位)。所有患者均接受口腔卫生指导(OHI)、龈上洁治和ORN治疗。仅在刮治部位进行龈下刮治和根面平整(SRP)。在基线(BL)、全身应用奥硝唑(500mg,每日两次,共7天)后1周、2个月、6个月和12个月采集细菌样本。在SRP后1周,在刮治部位再采集一份样本。
结果
SRP后1周(刮治部位),革兰氏阴性兼性菌和厌氧菌显著减少,而革兰氏阳性兼性球菌显著增加。应用ORN后,在刮治部位和未刮治部位均未检测到牙龈卟啉单胞菌、齿垢密螺旋体、中间普氏菌、福赛坦氏菌、直肠弯曲菌和具核梭杆菌。与基线相比,在刮治部位和未刮治部位均检测到牙龈卟啉单胞菌、中间普氏菌、洛氏普氏菌、福赛坦氏菌和直肠弯曲菌数量在长期(2个月、6个月和12个月)内有统计学意义的减少,米勒链球菌、口腔链球菌和血链球菌数量显著增加。在刮治部位和未刮治部位还观察到出血倾向和探诊深度持续降低。
结论
ORN联合SRP可使与临床显著改善相关的细菌群落发生有益变化,从而表明ORN是治疗以厌氧菌为主的EOP深牙周袋的有效辅助药物。