象限根面平整术与同日全口根面平整术。I. 临床发现。

Quadrant root planing versus same-day full-mouth root planing. I. Clinical findings.

作者信息

Apatzidou D A, Kinane D F

机构信息

Periodontal and Oral Immunology Research Group, Glasgow Dental School, Glasgow, UK.

出版信息

J Clin Periodontol. 2004 Feb;31(2):132-40. doi: 10.1111/j.0303-6979.2004.00461.x.

Abstract

OBJECTIVES

The aim of this study was to test the hypothesis that same-day full-mouth scaling and root planing (FM-SRP) resulted in greater clinical improvement compared to quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients over a period of 6 months.

MATERIAL AND METHODS

Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Whole-mouth clinical measurements were recorded with a manual periodontal probe at baseline (BAS) and at reassessment 1 (R1) (approximately 6 weeks after the completion of therapy), and at reassessment 2 (R2) (6 months after the initiation of therapy). Selected site analyses were performed on the deepest site in each quadrant before and after therapy (R1 and R2) and clinical indices were recorded with an electronic pressure sensitive probe. In addition, during the active phase of treatment clinical data were collected at 2-weekly intervals from the remaining untreated quadrants in the Q-SRP group only.

RESULTS

Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A continuous clinical improvement was seen for both treatment groups during the experimental period, which reached peak levels at 6 months (DeltaPD=1.8 mm, DeltaCAL=1.1 mm, p<0.001; PD: pocket depth; CAL: clinical attachment level). The selected-site analysis revealed no significant differences in any clinical index between the two treatment groups at R2 (DeltaPD=2.8 mm, DeltaRAL=1.1 mm; RAL: relative attachment level). At the selected sites, the analysis of the deep pockets (>7 mm) showed a significantly greater gain in RAL for the FM-SRP group compared to the Q-SRP group at R2 (p<0.05). The results of this analysis however, should be interpreted with care due to the small number of deep pockets. Data from the Q-SRP group provided an insight into how treated and untreated quadrants responded during the initiation of plaque control measures. There were significant reductions in PD, suppuration (SUP), modified gingival index (MGI) and plaque index (PI) in the remaining untreated quadrants in the Q-SRP group during the initial phase of treatment (p<0.05), while minimum changes in RALs and bleeding on probing (BOP) occurred. Nevertheless, the improvement in PD was clearly inferior to that seen after scaling and root planing.

CONCLUSION

Following both therapeutic modalities, there were marked clinical improvements at both R1 and R2 (6 months) from baseline. The current study, in contrast to previous findings, failed to show that FM-SRP is a more efficacious periodontal treatment modality compared to Q-SRP. However, both modalities are efficacious and the clinician should select the treatment modality based on practical considerations related to patient preference and clinical workload.

摘要

目的

本研究的目的是检验以下假设:在6个月的时间里,与象限刮治和根面平整术(Q-SRP)相比,同日全口刮治和根面平整术(FM-SRP)能使慢性牙周炎患者获得更大的临床改善。

材料与方法

40名患者被纳入本研究。受试者被随机分为两组。FM-SRP组在同一天完成全口刮治和根面平整,而Q-SRP组在连续四个疗程中每隔两周接受一次象限根面平整。在基线(BAS)、重新评估1(R1)(治疗完成后约6周)和重新评估2(R2)(治疗开始后6个月)时,用手动牙周探针记录全口临床测量数据。在治疗前后(R1和R2)对每个象限最深的部位进行选定部位分析,并用电子压敏探针记录临床指标。此外,在治疗的活跃期,仅从Q-SRP组中未治疗的其余象限每隔两周收集一次临床数据。

结果

两种治疗方法在R1和R2时所有临床指标均有显著改善。在实验期间,两个治疗组的临床均持续改善,在6个月时达到峰值水平(探诊深度变化量[DeltaPD]=1.8mm,临床附着水平变化量[DeltaCAL]=1.1mm,p<0.001;PD:牙周袋深度;CAL:临床附着水平)。选定部位分析显示,在R2时,两个治疗组之间的任何临床指标均无显著差异(DeltaPD=2.8mm,相对附着水平变化量[DeltaRAL]=1.1mm;RAL:相对附着水平)。在选定部位,对深度牙周袋(>7mm)的分析显示,与Q-SRP组相比,FM-SRP组在R2时RAL的增加显著更大(p<0.05)。然而,由于深度牙周袋数量较少,该分析结果应谨慎解读。Q-SRP组的数据提供了关于在开始菌斑控制措施期间已治疗和未治疗象限反应的见解。在治疗初始阶段,Q-SRP组中未治疗的其余象限的PD、化脓(SUP)、改良牙龈指数(MGI)和菌斑指数(PI)有显著降低(p<0.05),而RAL和探诊出血(BOP)的变化最小。尽管如此,PD的改善明显低于刮治和根面平整术后的情况。

结论

采用两种治疗方式后,从基线到R1和R2(6个月)时临床均有显著改善。与之前的研究结果相反,本研究未能表明FM-SRP比Q-SRP是一种更有效的牙周治疗方式。然而,两种方式均有效,临床医生应根据与患者偏好和临床工作量相关的实际考虑因素选择治疗方式。

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