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局部用米诺环素微球与局部用氯己定凝胶作为早期种植体周围感染机械清创辅助治疗的随机临床试验。

Topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement of incipient peri-implant infections: a randomized clinical trial.

作者信息

Renvert Stefan, Lessem Jan, Dahlén Gunnar, Lindahl Christel, Svensson Marie

机构信息

Department of Health Sciences, Kristianstad University, Kristianstad, Sweden.

出版信息

J Clin Periodontol. 2006 May;33(5):362-9. doi: 10.1111/j.1600-051X.2006.00919.x.

Abstract

AIM

This randomized clinical trial presents a 12-month follow-up of the clinical and microbiological results after application of minocycline microspheres as an adjunct to mechanical treatment of incipient peri-implant infections compared with an adjunctive treatment using 1% chlorhexidine gel application.

MATERIAL AND METHODS

Thirty-two subjects with probing depth > or =4 mm, combined with bleeding and/or exudate on probing and presence of putative pathogenic bacteria were given oral hygiene instructions and mechanical treatment of infected areas adjacent to implants. The subjects were then randomly assigned adjunctive subgingival antimicrobial treatment using either chlorhexidine gel or minocycline microspheres. Sixteen patients in the minocycline group and 14 in the chlorhexidine group completed the study. Follow-up examinations were carried out after 10 days, 1, 2, 3, 6, 9 and 12 months.

RESULTS

The adjunctive use of minocycline microspheres resulted in improvements of probing depths and bleeding scores, whereas the adjunctive use of chlorhexidine only resulted in limited reduction of bleeding scores. For the deepest sites of the treated implants in the minocycline group, the mean probing depth was reduced from 5.0 to 4.4 mm at 12 months. This study could not show any significant difference in the levels of bacterial species or groups at any time point between the two antimicrobial agents tested. The present findings encourage further studies on adjunctive use of minocycline microspheres in the treatment of peri-implant lesions.

CONCLUSIONS

The use of a local antibiotic as an adjunct to mechanical treatment of incipient peri-implantitis lesions demonstrated improvements in probing depths that were sustained over 12 months.

摘要

目的

本随机临床试验对米诺环素微球作为早期种植体周围感染机械治疗辅助手段与使用1%氯己定凝胶辅助治疗相比的临床和微生物学结果进行了为期12个月的随访。

材料与方法

32名探诊深度≥4mm、探诊时伴有出血和/或渗出物且存在可疑病原菌的受试者接受了口腔卫生指导以及对种植体周围感染区域的机械治疗。然后,受试者被随机分配接受使用氯己定凝胶或米诺环素微球的龈下抗菌辅助治疗。米诺环素组16例患者和氯己定组14例患者完成了研究。在10天、1、2、3、6、9和12个月后进行了随访检查。

结果

米诺环素微球的辅助使用使探诊深度和出血评分得到改善,而氯己定的辅助使用仅使出血评分有有限程度的降低。在米诺环素组治疗的种植体最深部位,12个月时平均探诊深度从5.0mm降至4.4mm。本研究未显示在任何时间点两种测试抗菌剂之间的细菌种类或菌群水平有任何显著差异。目前的研究结果鼓励进一步研究米诺环素微球在种植体周围病变治疗中的辅助使用。

结论

使用局部抗生素作为早期种植体周围炎病变机械治疗的辅助手段,显示探诊深度在12个月内持续改善。

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