Machion Luciana, Andia Denise Carleto, Benatti Bruno Braga, Carvalho Marcelo Diniz, Nogueira-Filho Getúlio R, Casati Márcio Zafallon, Nociti Francisco H, Sallum Enilson Antonio
Department of Periodontics and Prosthodontics, Division of Periodontics, School of Dentistry at Piracicaba, University of Campinas, Piracicaba, São Paulo, Brazil.
J Periodontol. 2004 Mar;75(3):464-9. doi: 10.1902/jop.2004.75.3.464.
The aim of this clinical study was to evaluate the association of locally delivered doxycycline (10%) with scaling and root planing in the periodontal treatment of smokers.
Forty-three patients with chronic periodontitis and a minimum of four pockets (> or = 5 mm) on anterior teeth that bled on probing were selected. Patients were randomly assigned to scaling and root planing (SRP) or scaling and root planing followed by local application of doxycycline (SRP-D). Plaque, bleeding on probing, gingival recession, relative attachment level (RAL), and probing depth (PD) were recorded at baseline, 45 days, and 3 and 6 months. Differences between baseline and each period were considered for analysis.
At 6 months, no difference was found between groups regarding plaque, bleeding reduction, gingival recession or PD (P > 0.05). However, RAL gain was greater for SRP-D (1.63 +/- 0.93 mm) than for SRP (1.04 +/- 0.71 mm) (P = 0.025). In addition, deep pockets (> or = 7 mm) showed a significant reduction (3.78 +/- 1.41 versus 2.60 +/- 1.28 mm, P = 0.039) and RAL gain (2.54 +/- 1.27 mm versus 1.29 +/- 0.95 mm, P = 0.01) when doxycycline was applied. The proportion of sites showing RAL gain of 1 to 2 mm was 36.8% versus 21.7% for SRP-D and SRP, respectively (P = 0.01).
The use of locally delivered doxycycline may constitute an important adjunct for the treatment of severe periodontal disease in smokers.
本临床研究的目的是评估局部应用强力霉素（10%）与龈下刮治及根面平整术联合用于吸烟者牙周治疗的相关性。
选取43例患有慢性牙周炎且前牙至少有4个探诊出血的牙周袋（≥5mm）的患者。患者被随机分为龈下刮治及根面平整术组（SRP）或龈下刮治及根面平整术联合局部应用强力霉素组（SRP-D）。在基线、45天、3个月和6个月时记录菌斑、探诊出血、牙龈退缩、相对附着水平（RAL）和探诊深度（PD）。分析基线与各时间段之间的差异。
在6个月时，两组在菌斑、出血减少、牙龈退缩或PD方面未发现差异（P>0.05）。然而，SRP-D组的RAL增加量（1.63±0.93mm）大于SRP组（1.04±0.71mm）（P=0.025）。此外，应用强力霉素时，深牙周袋（≥7mm）的PD有显著降低（3.78±1.41对2.60±1.28mm，P=0.039），RAL增加量也更大（2.54±1.27mm对1.29±0.95mm，P=0.01）。显示RAL增加1至2mm的部位比例，SRP-D组为36.8%，SRP组为21.7%（P=0.01）。
局部应用强力霉素可能是治疗吸烟者重度牙周疾病的重要辅助手段。
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