Jorgensen M G, Slots J
Department of Periodontology, University of Southern California School of Dentistry, USA.
J Calif Dent Assoc. 2000 Mar;28(3):185-93.
New products and treatment modalities for the management of periodontal disease continue to offer the clinician a large number of choices, many of which involve antimicrobials. 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 upon effective control of the periodontopathic bacteria. This is accomplished by professional treatment of diseased periodontal sites and patient-performed plaque control. Attention to community factors, such as water contamination and bacterial transmission among family members, facilitates preventive measures and early treatment for the entire family. 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 (antibiotics) or via local delivery (povidone-iodine) may enhance eradication or marked 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.
用于牙周疾病治疗的新产品和治疗方式持续为临床医生提供了大量选择，其中许多都涉及抗菌药物。特定的致病细菌在破坏性牙周疾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融入坚韧的生物膜中。成功预防和治疗牙周炎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控制牙菌斑来实现。关注社区因素，如水污染和家庭成员间的细菌传播，有助于采取预防措施并对整个家庭进行早期治疗。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菌的基本手段。可全身给药（抗生素）或通过局部给药（聚维酮碘）的合适抗菌剂，可能会增强对龈下病原菌的根除或显著抑制。微生物检测可帮助临床医生选择最有效的抗菌剂或抗菌剂组合。了解抗生素和防腐剂的益处及局限性将优化它们在对抗牙周感染中的效用。
