Mârţu S, Mocanu C, Popovici C G
Facultatea de Medicină Stomatologică, Disciplina de Parodontologie, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2000 Apr-Jun;104(2):125-30.
Control of subgingival plaque is the key of the treatment of periodontal diseases. The use of subgingival sustained-release antibiotic therapy is advocated for the beneficial effect on anaerobic flora. A single-blind clinical trial was carried out in 13 patients with adult periodontitis to compare the effects of subgingival application of metronidazole dental gel with those of subgingival scaling.
A split mouth design was used so that each patient received all treatments simultaneously. Randomly selected quadrants were treated with applications of 25% metronidazole gel, subgingival scaling, or a combination of scaling and gel application. The remaining quadrant in each patient was left untreated as a control.
All three treatments were effective in significantly reducing bleeding on probing over the 14 weeks observation period. No statistically significant differences were found between scaling alone and combined treatment. Scaling and combined treatment were better than metronidazole. Metronidazole produced transient effects, best noted during the first 4 weeks after treatment. No additive effect of metronidazole was noted in the combined treatment. At week 14, only combined treatment sites and scaled showed statistically greater probing depths reduction than control sites.
For the treatment of mild to moderate adult periodontitis, subgingival scaling alone is as effective as the combination of scaling and antibiotic therapy.
控制龈下菌斑是牙周疾病治疗的关键。由于对厌氧菌具有有益作用，因此提倡使用龈下缓释抗生素疗法。对13例成人牙周炎患者进行了一项单盲临床试验，以比较龈下应用甲硝唑牙凝胶与龈下刮治的效果。
采用双侧设计，使每位患者同时接受所有治疗。随机选择象限分别进行25%甲硝唑凝胶应用、龈下刮治或刮治与凝胶应用联合治疗。每位患者其余象限不进行治疗作为对照。
在14周的观察期内，所有三种治疗方法均能有效显著减少探诊出血。单独刮治与联合治疗之间未发现统计学上的显著差异。刮治及联合治疗优于甲硝唑治疗。甲硝唑产生短暂效果，在治疗后的前4周最为明显。联合治疗中未观察到甲硝唑的叠加效应。在第14周时，仅联合治疗部位和刮治部位的探诊深度减少在统计学上显著大于对照部位。
对于轻至中度成人牙周炎的治疗，单独龈下刮治与刮治和抗生素联合治疗同样有效。
