Rupf Stefan, Brader Iris, Vonderlind Doris, Kannengiesser Sabine, Eschrich Klaus, Roeder Ingo, Merte Knut
Department of Conservative Dentistry and Periodontology, University of Leipzig, Leipzig, Germany.
J Periodontol. 2005 Nov;76(11):1942-9. doi: 10.1902/jop.2005.76.11.1942.
The purpose of this study was to conduct an in vitro and short-term clinical and microbiological evaluation of a linear oscillating device for scaling and root planing (SRP). A comparison was made between conventional ultrasonic scaling (US) and hand scaling (HS) with and without chlorhexidine.
In vitro, SRP was carried out on human teeth with calculus. Roots and cross-sections thereof were microscopically examined for the efficacy of calculus removal, hard tissue loss, and surface smoothness. In vivo, 11 patients with chronic periodontitis and single-rooted teeth in all quadrants with probing depths of > or =5 mm were selected. One quadrant was treated with linear oscillation and compared to US with chlorhexidine irrigation in the contralateral site. The other arch was treated with HS and compared to HS followed by laser disinfection. One hundred twenty teeth were assessed for clinical attachment level, probing depth, bleeding on probing, and suppuration at baseline and 7, 28, 90, and 180 days. Microbiologically, total numbers of bacteria and six specific periodontal pathogens were determined by quantitative polymerase chain reaction prior to and 1 and 28 days after SRP. Clinical and microbiological data were analyzed statistically with respect to the SRP method, patient specificity, and time effect.
In vitro, linear oscillation preserved more root tissues but left more calculus (P <0.05). Significant improvements of all clinical and microbiological parameters were observed for all groups. However, 21 out of 24 tests demonstrated that the clinical microbiological correlations between linear oscillation and control groups did not differ (P <0.05).
Linear oscillation scaling was clinically acceptable and microbiologically comparable to the control groups despite microscopic remnants of calculus observed in vitro.
本研究旨在对一种用于龈下刮治和根面平整(SRP)的线性振荡装置进行体外、短期临床和微生物学评估。对常规超声龈下刮治(US)和手工龈下刮治(HS)在使用和不使用洗必泰的情况下进行了比较。
在体外,对有牙结石的人牙进行SRP。对牙根及其横截面进行显微镜检查,以评估牙结石清除效果、硬组织损失和表面光滑度。在体内,选择11例全象限患有慢性牙周炎且单根牙探诊深度≥5 mm的患者。一个象限采用线性振荡治疗,并与对侧使用洗必泰冲洗的超声龈下刮治进行比较。另一牙弓采用手工龈下刮治,并与手工龈下刮治后进行激光消毒的情况进行比较。在基线以及第7、28、90和180天,对120颗牙齿的临床附着水平、探诊深度、探诊出血和化脓情况进行评估。在微生物学方面,在SRP前以及SRP后1天和28天,通过定量聚合酶链反应测定细菌总数和六种特定牙周病原体。对临床和微生物学数据就SRP方法、患者特异性和时间效应进行统计学分析。
在体外,线性振荡保留了更多的牙根组织,但残留的牙结石更多(P<0.05)。所有组的所有临床和微生物学参数均有显著改善。然而,24项测试中有21项表明,线性振荡组与对照组之间的临床微生物学相关性无差异(P<0.05)。
尽管在体外观察到牙结石的微观残留,但线性振荡龈下刮治在临床上是可接受的,并且在微生物学上与对照组相当。