Roldán Silvia, Herrera David, O'Connor Ana, González Itziar, Sanz Mariano
Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.
J Periodontol. 2005 Jun;76(6):1025-33. doi: 10.1902/jop.2005.76.6.1025.
Clinical research assessing different therapeutic protocols aimed at treating oral halitosis is scarce. The aim of this study was to evaluate the effects of a combined mechanical and pharmacological approach to treat oral halitosis on clinical and microbiological outcomes on patients followed for 3 months.
Nineteen subjects with oral malodor participated. At baseline, all subjects completed a questionnaire and carried out an examination including full-mouth organoleptic and volatile sulfur compound (VSC) levels and the Winkel tongue coating index. Standard periodontal outcome variables were assessed at six teeth. Standardized microbiological samples of subgingival plaque, unstimulated saliva, and tongue coating were obtained for culture analysis. The treatment protocol included supragingival prophylaxis; instructions in oral hygiene (toothbrushing, interproximal cleaning, and tongue scraping); and gargling with a mouthrinse containing chlorhexidine, cetylpiridinium chloride, and zinc lactate. The same outcome variables were registered 1 and 3 months after baseline.
Statistically significant reductions in organoleptic scores (P <0.001), VSC levels (P <0.05), and tongue coating index (P <0.05) were observed after 1 and 3 months. Mean probing depth and plaque levels also demonstrated significant reductions after 3 months (P <0.05). Total anaerobic counts were significantly reduced at all three locations after 1 month (P <0.05), and in samples from tongue coating and subgingival plaque at 3 months (P <0.05). Aerobic counts were significantly reduced in saliva at 1 month (P <0.05), and the anaerobic/aerobic ratio significantly increased in the tongue samples. Among the selected pathogens evaluated, Porphyromonas gingivalis was the most affected of the three microflora evaluated.
The evaluated therapeutic approach demonstrated its efficacy in the management of oral halitosis, demonstrating statistically significant improvements in both organoleptic and VSC values at 1 and 3 months. The proposed clinical protocol significantly affected the microbial composition in tongue coating, saliva, and subgingival microflora.
评估不同治疗方案治疗口腔异味的临床研究较少。本研究的目的是评估机械和药物联合治疗方法对口腔异味患者进行3个月随访的临床和微生物学结局的影响。
19名有口腔异味的受试者参与研究。在基线时，所有受试者完成一份问卷并进行检查，包括全口感官评估、挥发性硫化物（VSC）水平和温克尔舌苔指数。在六颗牙齿上评估标准牙周结局变量。获取龈下菌斑、非刺激性唾液和舌苔的标准化微生物样本进行培养分析。治疗方案包括龈上洁治；口腔卫生指导（刷牙、牙间隙清洁和舌面清洁）；以及用含氯己定、西吡氯铵和乳酸锌的漱口水漱口。在基线后1个月和3个月记录相同的结局变量。
在1个月和3个月后，感官评分（P<0.001）、VSC水平（P<0.05）和舌苔指数（P<0.05）有统计学意义的降低。3个月后，平均探诊深度和菌斑水平也有显著降低（P<0.05）。1个月后，所有三个部位的总厌氧菌计数均显著降低（P<0.05），3个月时舌苔和龈下菌斑样本中的总厌氧菌计数也显著降低（P<0.05）。1个月时唾液中的需氧菌计数显著降低（P<0.05），舌样本中的厌氧/需氧比显著增加。在所评估的选定病原体中，牙龈卟啉单胞菌是所评估的三种微生物群落中受影响最大的。
所评估的治疗方法在口腔异味管理中显示出疗效，在1个月和3个月时感官和VSC值有统计学意义的显著改善。所提出的临床方案显著影响了舌苔、唾液和龈下微生物群落的微生物组成。
