辅助性亚抗菌剂量强力霉素用于机构养老慢性牙周炎老年患者的治疗

Adjunctive subantimicrobial dose doxycycline in the management of institutionalised geriatric patients with chronic periodontitis.

作者信息

Mohammad Abdel R, Preshaw Philip M, Bradshaw Mark H, Hefti Arthur F, Powala Christopher V, Romanowicz Michael

机构信息

College of Dentistry, Ohio State University, Columbus, OH 43210, USA.

出版信息

Gerodontology. 2005 Mar;22(1):37-43. doi: 10.1111/j.1741-2358.2004.00044.x.

DOI:10.1111/j.1741-2358.2004.00044.x

PMID:15747897

Abstract

OBJECTIVE

To assess the efficacy of subantimicrobial dose doxycycline (SDD; 20 mg doxycycline twice daily) as an adjunct to scaling and root planing (SRP) in the treatment of moderate-severe chronic periodontitis (CP) in institutionalised elderly patients aged 65 years or older.

BACKGROUND

Previous studies have shown that SDD is of clinical benefit in the treatment of CP. However, the benefits of SDD in geriatric populations (65+ years) have not been determined.

MATERIAL AND METHODS

A 9-month, double-blind, randomised, placebo-controlled pilot study was conducted. 24 institutionalised geriatric patients (65 years or older) with evidence of CP manifested by baseline clinical attachment levels (CAL) 5-9 mm, probing depths (PD) 4-9 mm and bleeding on probing (BOP) were recruited. At baseline, patients were treated by a standardised episode of SRP, and randomised to receive either adjunctive SDD or placebo. Full mouth PD and CAL were measured using the manual UNC-15 periodontal probe at 3, 6, and 9 months post-baseline to assess the response to treatment. Periodontal sites were stratified by baseline PD value: sites with PD 4-5 mm were considered moderately diseased and sites with PD > or = 6 mm severely diseased.

RESULTS

The SRP + placebo resulted in PD reductions similar to those reported previously in the literature. At all time-points and in both moderate and deep sites, SRP + SDD resulted in significantly greater PD reductions relative to baseline than SRP + placebo. At month 9, in moderate sites, mean PD reductions of 1.57 +/- 0.11 mm were reported in the adjunctive SDD group, compared with 0.63 +/- 0.11 mm in the adjunctive placebo group (p < 0.001). In deep sites at month 9, mean PD reductions of 3.22 +/- 0.29 mm were reported in the adjunctive SDD group, compared with 0.98 +/- 0.31 mm in the adjunctive placebo group (p < 0.05). Similar improvements were observed for CAL in the SDD group compared with the placebo group. Significantly lower BOP scores were also recorded at month 9 in the SDD group (7.5%) compared with the placebo group (71.2%) (p < 0.01).

CONCLUSION

SDD used as an adjunct to SRP provides significant benefit for elderly patients with CP compared with SRP alone.

摘要

目的

评估亚抗菌剂量强力霉素（SDD，每日两次，每次20mg强力霉素）作为洁治和根面平整术（SRP）辅助治疗手段，对65岁及以上机构养老老年患者中重度慢性牙周炎（CP）的疗效。

背景

既往研究表明，SDD对CP治疗具有临床益处。然而，SDD在老年人群（65岁及以上）中的益处尚未确定。

材料与方法

开展了一项为期9个月的双盲、随机、安慰剂对照试验性研究。招募了24名机构养老的老年患者（65岁及以上），其基线临床附着水平（CAL）为5 - 9mm、探诊深度（PD）为4 - 9mm且探诊出血（BOP），有CP证据。基线时，患者接受标准化的SRP治疗，然后随机分为接受辅助SDD或安慰剂治疗。在基线后3、6和9个月，使用手动UNC - 15牙周探针测量全口PD和CAL，以评估治疗反应。牙周部位按基线PD值分层：PD为4 - 5mm的部位视为中度病变，PD≥6mm的部位视为重度病变。

结果

SRP + 安慰剂组的PD降低情况与先前文献报道相似。在所有时间点以及中度和深度部位，与SRP + 安慰剂相比，SRP + SDD导致的PD相对于基线的降低幅度显著更大。在第9个月时，在中度部位，辅助SDD组的平均PD降低了1.57±0.11mm，而辅助安慰剂组为0.63±0.11mm（p < 0.001）。在第9个月时，在深度部位，辅助SDD组的平均PD降低了3.22±0.29mm，而辅助安慰剂组为0.98±0.31mm（p < 0.05）。与安慰剂组相比，SDD组的CAL也有类似改善。在第9个月时，SDD组的BOP评分（7.5%）也显著低于安慰剂组（71.2%）（p < 0.01）。