Rooney J, Wade W G, Sprague S V, Newcombe R G, Addy M
Division of Restorative Dentistry, Dental School, Bristol, UK.
J Clin Periodontol. 2002 Apr;29(4):342-50. doi: 10.1034/j.1600-051x.2002.290410.x.
Several studies have reported adjunctive benefits to scaling and root planing (SRP) of systemic amoxycillin and metronidazole in the treatment of periodontal diseases. To date no comparisons have been made of these antimicrobials alone or in combination. The aim of this study was to compare the adjunctive benefits to SRP of amoxycillin and metronidazole alone and combined.
66 subjects <46 years of age with advanced chronic periodontal disease participated in this randomised, double blind, 4 parallel treatment group designed study. All subjects received quadrant SRP and then were prescribed amoxycillin capsules (250 mg) and metronidazole tablets (200 mg) (AM) or lactate capsules and metronidazole (PM) or amoxycillin and calcium lactate tablets (AP) or lactate and calcium lactate (PP). All medication was 3 of each per day for 7 days. Subgingival plaque samples were obtained and probing depth (PD), loss of attachment (LOA), bleeding on probing (BOP), suppuration (SUPP) and plaque (DEP) were recorded pre-treatment, 1, 3 and 6 months post-treatment.
Final group sizes were: AM=15, PM=16, AP=16 and PP=15. PD improved in all groups. Treatment effects were highly significantly different and always greatest in the AM and least in the PP groups. Benefits of PM and AP over PP were also noted. LOA improved in all groups and showed the same highly significant treatment differences, again favouring AM. BOP improved in all groups, particularly in AM compared to the other groups. SUPP improved in all groups and was virtually eradicated in AM with differences among treatments highly significant. DEP changed little in any group and there were no significant differences among groups. Microbiological data showed significant differences in favour of AM compared to PP and PM for total aerobes and anaerobes at 1 month. P. intermedia counts were always lower in active groups compared to PP and reached significance for AM and AP at 1 month and AM and PM at 3 months.
The significant differences among treatment groups and the overall trend in the data, in line with other studies, support the considerable adjunctive benefits to SRP of amoxycillin and metronidazole combined in the treatment of advanced chronic periodontal disease.
多项研究报道了全身性阿莫西林和甲硝唑辅助龈下刮治及根面平整（SRP）治疗牙周疾病的益处。迄今为止，尚未对这些抗菌药物单独使用或联合使用进行比较。本研究的目的是比较阿莫西林和甲硝唑单独及联合使用辅助SRP的益处。
66名年龄小于46岁的重度慢性牙周病患者参与了这项随机、双盲、4平行治疗组设计的研究。所有受试者均接受象限SRP治疗，然后分别给予阿莫西林胶囊（250毫克）和甲硝唑片（200毫克）（AM组）、乳酸钙胶囊和甲硝唑（PM组）、阿莫西林和乳酸钙片（AP组）或乳酸钙和乳酸钙片（PP组）。所有药物均为每日3次，共服用7天。在治疗前、治疗后1、3和6个月采集龈下菌斑样本，并记录探诊深度（PD）、附着丧失（LOA）、探诊出血（BOP）、化脓（SUPP）和菌斑（DEP）情况。
最终各组样本量为：AM组 = 15例，PM组 = 16例，AP组 = 16例，PP组 = 15例。所有组的PD均有所改善。治疗效果差异极显著，且始终以AM组最大，PP组最小。也注意到PM组和AP组相对于PP组的益处。所有组的LOA均有所改善，且显示出相同的极显著治疗差异，同样以AM组为优。所有组的BOP均有所改善，尤其是AM组与其他组相比。所有组的SUPP均有所改善，在AM组中几乎根除，治疗间差异极显著。任何组的DEP变化均很小，组间无显著差异。微生物学数据显示，在1个月时，AM组与PP组和PM组相比，需氧菌和厌氧菌总数存在显著差异，有利于AM组。与PP组相比，活动组的中间普氏菌计数始终较低，在1个月时AM组和AP组、3个月时AM组和PM组达到显著水平。
治疗组之间的显著差异以及数据的总体趋势，与其他研究一致，支持阿莫西林和甲硝唑联合辅助SRP治疗重度慢性牙周病具有显著益处。
