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可吸收膜引导组织再生中抗生素治疗的临床意义

Clinical significance of antibiotic therapy in guided tissue regeneration with a resorbable membrane.

作者信息

Minabe M, Kodama T, Kogou T, Fushimi H, Sugiyama T, Takeuchi K, Miterai E, Nishikubo S

机构信息

Oral Reconstruction Therapy Institute, Kagoshima, Japan.

出版信息

Periodontal Clin Investig. 2001;23(1):20-30.

Abstract

This study was designed to evaluate the clinical significance of antibiotic therapy combined with guided tissue regeneration (GTR) therapy with a collagen membrane. The subjects were 20 adults diagnosed with periodontitis (20 intrabony periodontal defects). Ten patients were treated with GTR alone (control group) and the other 10 patients were treated with a combination of GTR and antibiotics (antibiotic group). In the antibiotic group, minocycline ointment was applied locally before GTR therapy, and doxycycline and amoxyline were systemically administered after GTR therapy. Clinical manifestations, the presence or absence of exposed membrane, and microbiological findings were assessed 1 month before, immediately after, and 2 weeks, 6 weeks, and 3 months after GTR therapy. The results showed no significant differences in reduction of probing depth, probing attachment gain (PAG), or the ratio of PAG to intraoperative depth of the intrabony defect (vertical relative attachment gain) between the antibiotic group and the control group before and 3 months after GTR therapy. A DNA probe test and specific enzymatic activity test revealed no significant differences in the improvement and the rate of bacterial negativity before, and 6 weeks and 3 months after, GTR therapy. These findings indicate that antibiotic therapy is not clinically beneficial when combined with GTR therapy with a collagen membrane.

摘要

本研究旨在评估抗生素治疗联合胶原膜引导组织再生(GTR)治疗的临床意义。研究对象为20名被诊断为牙周炎的成年人(20个骨内牙周缺损)。10名患者仅接受GTR治疗(对照组),另外10名患者接受GTR与抗生素联合治疗(抗生素组)。在抗生素组中,在GTR治疗前局部应用米诺环素软膏,在GTR治疗后全身给予强力霉素和阿莫西林。在GTR治疗前1个月、治疗后即刻、治疗后2周、6周和3个月评估临床表现、是否存在膜暴露以及微生物学检查结果。结果显示,在GTR治疗前及治疗后3个月,抗生素组与对照组在探诊深度减少、探诊附着获得(PAG)或PAG与骨内缺损术中深度的比值(垂直相对附着获得)方面无显著差异。DNA探针检测和特异性酶活性检测显示,在GTR治疗前、治疗后6周和3个月,改善情况和细菌转阴率无显著差异。这些结果表明,抗生素治疗与胶原膜GTR治疗联合应用在临床上并无益处。

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