Reynolds M A, Lavigne C K, Minah G E, Suzuki J B
Department of Periodontics and Microbiology, University of Maryland, Dental School, Baltimore 21201.
J Clin Periodontol. 1992 Sep;19(8):595-600. doi: 10.1111/j.1600-051x.1992.tb00689.x.
The clinical and microbial effects of a single episode of simultaneous ultrasonic scaling and subgingival irrigation with chlorhexidine (CHX) were studied as a function of clinical probing depth in patients with adult periodontitis. 60 patients were randomly assigned to receive subgingival irrigation under cavitation with either sterile water or 0.12% CHX delivered through the tip of an ultrasonically activated scaler as part of initial periodontal therapy in a double-blind study design. 3 periodontal sites were randomly selected for examination from each patient on the basis of clinical probing depth, with 1 site being selected within each of the following ranges: 1-3 mm, 4-6 mm, and 7-9 mm. Pretreatment and post-treatment (days 14 and 28) clinical assessments included a plaque index (PI), gingival index (GI), and clinical probing depth (CPD). Subgingival specimens also were collected from 1-3 mm and 4-6 mm sites on a random subset of patients (15 per group). Plaque counts of spirochetes and motile organisms were made by darkfield microscopy. Significant reductions in PI, GI, and CPD were observed among all sites within both treatment groups at 14 and 28 days post-treatment. CHX irrigation resulted in a significantly greater reduction in CPD than did water among sites initially probing 4-6 mm at both 14 and 28 days post-treatment (25% versus 13% and 31% versus 18%, respectively). Spirochete counts were modestly but nonsignificantly reduced at 14 days post-treatment among sites 4-6 mm within both treatment groups. These results suggest that subgingival irrigation with CHX during ultrasonic scaling provides differential clinical benefits that are site-dependent.
在患有成人牙周炎的患者中，研究了单次同时进行超声洁治和用洗必泰（CHX）进行龈下冲洗的临床和微生物学效果，并将其作为临床探诊深度的函数。在一项双盲研究设计中，60名患者被随机分配接受通过超声激活洁治器尖端输送的无菌水或0.12% CHX在空化作用下进行龈下冲洗，作为初始牙周治疗的一部分。根据临床探诊深度，从每位患者中随机选择3个牙周部位进行检查，在以下每个范围内各选1个部位：1 - 3毫米、4 - 6毫米和7 - 9毫米。治疗前和治疗后（第14天和第28天）的临床评估包括菌斑指数（PI）、牙龈指数（GI）和临床探诊深度（CPD）。还从随机抽取的患者亚组（每组15人）的1 - 3毫米和4 - 6毫米部位采集龈下标本。通过暗视野显微镜对螺旋体和活动菌进行菌斑计数。在治疗后第14天和第28天，两个治疗组的所有部位的PI、GI和CPD均显著降低。在治疗后第14天和第28天，对于初始探诊深度为4 - 6毫米的部位，CHX冲洗导致的CPD降低幅度明显大于用水冲洗（分别为25%对13%和31%对18%）。在治疗后第14天，两个治疗组中4 - 6毫米部位的螺旋体计数均有适度但不显著的降低。这些结果表明，在超声洁治期间用CHX进行龈下冲洗可提供与部位相关的不同临床益处。
