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甲硝唑联合阿莫西林作为唯一治疗方法对未经治疗的慢性牙周炎微生物学和临床参数的影响

Effects of metronidazole plus amoxicillin as the only therapy on the microbiological and clinical parameters of untreated chronic periodontitis.

作者信息

López Néstor J, Socransky Sigmund S, Da Silva Isabel, Japlit Michele R, Haffajee Anne D

机构信息

Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.

出版信息

J Clin Periodontol. 2006 Sep;33(9):648-60. doi: 10.1111/j.1600-051X.2006.00957.x.

Abstract

AIM

To determine the effect of metronidazole plus amoxicillin (M+A) as the sole therapy, on the subgingival microbiota of chronic periodontitis.

MATERIAL AND METHODS

Twenty-two patients with untreated chronic periodontitis were randomly assigned to a group that received M+A for 7 days, or to a group receiving scaling and root planing (SRP) and two placebos. Clinical measurements including sites with plaque, bleeding on probing (BOP), probing depth (PD) and attachment level (AL) were made at baseline, 3, 6, 9 and 12 months. Subgingival plaque samples were taken from all teeth at baseline 3, 6, 9 and 12 months for the counts of 40 subgingival species using checkerboard DNA-DNA hybridization.

RESULTS

Mean PD was reduced from 2.80+/-0.45 at baseline to 1.95+/-0.05 at 12 months (P<0.001) and from 2.39+/-0.41 to 1.95+/-0.10 (P<0.001) in the M+A- and SRP-treated patients, respectively. Corresponding values for relative mean AL were 10.07+/-1.30-9.77+/-0.34 (P<0.001) and 9.94+/-0.28-9.77+/-0.26 (P<0.001). Percentage of sites exhibiting BOP were 40.6+/-18.3-14.0+/-1.4 (P<0.001), and 38.5+/-5.1-19.0+/-2.8 (P<0.001) in the M+A and SRP groups, respectively. Mean total DNA probe counts and counts of the majority of the 40 test species were significantly reduced over time in both groups, with no significant differences detected at any time point between groups. At 12 months many of the species were still present at significantly lowered levels compared with their baseline counts in both groups.

CONCLUSIONS

Changes in clinical and microbiological parameters were similar after receiving systemically administered M+A as the sole therapy or after receiving SRP only.

摘要

目的

确定甲硝唑联合阿莫西林(M+A)作为单一疗法对慢性牙周炎龈下微生物群的影响。

材料与方法

将22例未经治疗的慢性牙周炎患者随机分为两组,一组接受M+A治疗7天,另一组接受龈上洁治和根面平整(SRP)及两种安慰剂治疗。在基线、3个月、6个月、9个月和12个月时进行临床测量,包括有菌斑的部位、探诊出血(BOP)、探诊深度(PD)和附着水平(AL)。在基线、3个月、6个月、9个月和12个月时从所有牙齿采集龈下菌斑样本,使用棋盘式DNA-DNA杂交技术对40种龈下菌种进行计数。

结果

在接受M+A治疗和SRP治疗的患者中,平均PD分别从基线时的2.80±0.45降至12个月时的1.95±0.05(P<0.001)和从2.39±0.41降至1.95±0.10(P<0.001)。相对平均AL的相应值分别为10.07±1.30至9.77±0.34(P<0.001)和9.94±0.28至9.77±0.26(P<0.001)。M+A组和SRP组中出现BOP的部位百分比分别为40.6±18.3至14.0±1.4(P<0.001)和38.5±5.1至19.0±2.8(P<0.001)。两组中平均总DNA探针计数和40种测试菌种中的大多数菌种计数随时间均显著降低,两组在任何时间点均未检测到显著差异。在12个月时,与两组的基线计数相比,许多菌种的水平仍显著降低。

结论

接受全身应用M+A作为单一疗法或仅接受SRP治疗后,临床和微生物学参数的变化相似。

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