Quirynen Marc, De Soete Marc, Boschmans Geert, Pauwels Martine, Coucke Wim, Teughels Wim, van Steenberghe Daniel
Department of Periodontology, Faculty of Medicine, Catholic University of leuven, Leuven, Belgium.
J Clin Periodontol. 2006 Sep;33(9):639-47. doi: 10.1111/j.1600-051X.2006.00959.x. Epub 2006 Jul 20.
The beneficial effects of the one-stage, full-mouth disinfection remain controversial in the scientific literature. This might be due to the fact that an entire mouth disinfection with the use of antiseptics has been confused with a full-mouth scaling and root planing. This parallel, single blind RCT study aimed to compare several full-mouth treatment strategies with each other.
Seventy-one patients with moderate periodontitis were randomly allocated to one of the following treatment strategies: scaling and root planing, quadrant by quadrant, at two-week intervals (negative control, NC), full-mouth scaling and root planing within 2 consecutive days (FRP), or three one-stage, full-mouth disinfection (FM) protocols within 2 consecutive days applying antiseptics to all intra-oral niches for periopathogens using as antiseptics: chlorhexidine (FMCHX) for 2 months, amine fluoride/stannous fluoride for 2 months (FMF), or chlorhexidine for 2 months followed by amine fluoride/stannous fluoride for another 6 months (FMCHX+F). At baseline and after 2, 4, and 8 a series of periodontal parameters were recorded.
All treatment strategies resulted in significant (p<0.05) improvements of all clinical parameters over the entire duration of the study. Inter-treatment differences were often encountered. The NC group nearly always showed significant smaller improvements than the two CHX groups. The differences between the FRP or FM groups, and the two CHX groups only sporadically reached a statistical significance.
These observations indicate that the benefits of the "OSFMD" protocol are partially due to the use of the antiseptics and partially to the completion of the therapy in a short time.
一期全口消毒的有益效果在科学文献中仍存在争议。这可能是因为使用防腐剂进行的全口消毒与全口龈下刮治和根面平整相混淆。这项平行、单盲随机对照试验旨在比较几种全口治疗策略。
71例中度牙周炎患者被随机分配至以下治疗策略之一：龈下刮治和根面平整，逐象限进行，间隔两周（阴性对照，NC）；连续两天内完成全口龈下刮治和根面平整（FRP）；或连续两天内进行三种一期全口消毒（FM）方案，使用防腐剂对所有口腔内牙周病原菌滋生部位进行处理，使用的防腐剂分别为：洗必泰（FMCHX），为期2个月；胺氟/氟化亚锡，为期2个月（FMF）；或洗必泰2个月，随后胺氟/氟化亚锡再使用6个月（FMCHX+F）。在基线以及2、4和8周后记录一系列牙周参数。
在整个研究期间，所有治疗策略均使所有临床参数有显著（p<0.05）改善。治疗组间差异经常出现。NC组几乎总是显示出比两个洗必泰组显著更小的改善。FRP组或FM组与两个洗必泰组之间的差异仅偶尔达到统计学显著性。
这些观察结果表明，“一期全口消毒”方案的益处部分归因于防腐剂的使用，部分归因于在短时间内完成治疗。
