Jorgensen M G, Slots J
Department of Periodontology, University of Southern California School of Dentistry, Los Angeles, California, USA.
Compend Contin Educ Dent. 2000 Feb;21(2):111-4, 116, 118-20 passim; quiz 124.
Specific pathogenic bacteria play a central role in the etiology and pathogenesis of destructive periodontal disease. Under suitable conditions, periodontal pathogens colonize the subgingival environment and are incorporated into a tenacious biofilm. Successful prevention and treatment of periodontitis is contingent on effective control of the periodontopathic bacteria, which is accomplished with professional treatment of diseased periodontal sites and patient performed plaque control. Subgingival mechanical debridement, with or without surgery, constitutes the basic means of disrupting the subgingival biofilm and controlling pathogens. Appropriate antimicrobial agents that can be administered systemically or via local delivery may enhance eradication or suppression of subgingival pathogens. Microbiological testing may aid the clinician in the selection of the most effective antimicrobial agent or combination of agents. Understanding the benefits and limitations of antibiotics and antiseptics will optimize their usefulness in combating periodontal infections.
特定的致病细菌在破坏性牙周病的病因和发病机制中起着核心作用。在适宜条件下，牙周病原体定植于龈下环境并形成坚韧的生物膜。牙周炎的成功防治取决于对牙周病原菌的有效控制，这可通过对患病牙周部位进行专业治疗以及患者自身进行菌斑控制来实现。龈下机械清创术，无论是否联合手术，都是破坏龈下生物膜和控制病原体的基本手段。可全身给药或局部应用的合适抗菌剂，可能会增强对龈下病原体的根除或抑制效果。微生物检测有助于临床医生选择最有效的抗菌剂或联合用药方案。了解抗生素和防腐剂的益处与局限性，将使其在对抗牙周感染中发挥最大效用。
