Williams R C, Paquette D W, Offenbacher S, Adams D F, Armitage G C, Bray K, Caton J, Cochran D L, Drisko C H, Fiorellini J P, Giannobile W V, Grossi S, Guerrero D M, Johnson G K, Lamster I B, Magnusson I, Oringer R J, Persson G R, Van Dyke T E, Wolff L F, Santucci E A, Rodda B E, Lessem J
Department of Periodontology, University of North Carolina, School of Dentistry, Chapel Hill 27599-7450, USA.
J Periodontol. 2001 Nov;72(11):1535-44. doi: 10.1902/jop.2001.72.11.1535.
Periodontitis is an inflammatory condition of tooth-supporting tissues that is usually treated by mechanical removal of plaque and microorganisms that adhere to teeth. This treatment, known as scaling and root planing, is not optimally effective. Adjunctive therapy with locally delivered antimicrobials has resulted in improved clinical outcomes such as probing depth reduction. This article reports on the efficacy and safety of locally administered microencapsulated minocycline.
Seven hundred forty-eight (748) patients with moderate to advanced periodontitis were enrolled in a multi-center trial and randomized to 1 of 3 treatment arms: 1) scaling and root planing (SRP) alone; 2) SRP plus vehicle; or 3) SRP plus minocycline microspheres. The primary outcome measure was probing depth reduction at 9 months. Clinical assessments were performed at baseline and 1, 3, 6, and 9 months.
Minocycline microspheres plus scaling and root planing provided substantially more probing depth reduction than either SRP alone or SRP plus vehicle. The difference reached statistical significance after the first month and was maintained throughout the trial. The improved outcome was observed to be independent of patients' smoking status, age, gender, or baseline disease level. There was no difference in the incidence of adverse effects among treatment groups.
Scaling and root planing plus minocycline microspheres is more effective than scaling and root planing alone in reducing probing depths in periodontitis patients.
牙周炎是一种牙齿支持组织的炎症性疾病,通常通过机械清除附着在牙齿上的牙菌斑和微生物来治疗。这种治疗方法,即龈下刮治术和根面平整术,效果并不理想。局部应用抗菌药物的辅助治疗已改善了临床疗效,如探诊深度降低。本文报告局部应用微囊化米诺环素的疗效和安全性。
748例中重度牙周炎患者参加了一项多中心试验,并随机分为3个治疗组之一:1)单纯龈下刮治术和根面平整术(SRP);2)SRP加赋形剂;或3)SRP加米诺环素微球。主要观察指标是9个月时探诊深度的降低。在基线、1、3、6和9个月时进行临床评估。
米诺环素微球联合龈下刮治术和根面平整术比单纯SRP或SRP加赋形剂能更显著地降低探诊深度。差异在第一个月后达到统计学意义,并在整个试验中保持。观察到改善的结果与患者的吸烟状况、年龄、性别或基线疾病水平无关。各治疗组不良反应发生率无差异。
在降低牙周炎患者的探诊深度方面,龈下刮治术和根面平整术加米诺环素微球比单纯龈下刮治术和根面平整术更有效。