Kurtiş Bülent, Tüter Gülay, Serdar Muhittin, Pinar Selin, Demirel Ilkim, Toyman Utku
Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
J Periodontol. 2007 Jan;78(1):104-11. doi: 10.1902/jop.2007.060217.
It has been established that smoking is an important risk factor for the initiation and progression of chronic periodontitis (CP). This study investigates the effects of phase I periodontal therapy and adjunctive flurbiprofen administration on prostaglandin E(2) (PGE(2)) and thiobarbituric acid reactive substance (TBARS) levels in gingival crevicular fluid (GCF) samples from smoker and non-smoker patients with CP.
Twenty-one non-smoker and 21 smoker patients with CP were divided into four groups according to treatment modalities. Group 1 (non-smokers with CP) and group 3 (smokers with CP) patients received daily 100-mg flurbiprofen tablets in a 2 x 1 regimen for 10 days together with scaling and root planing (SRP). Patients in group 2 (non-smokers with CP) and group 4 (smokers with CP) received placebo tablets in a 2 x 1 regimen for 10 days together with SRP. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) measurements were recorded and GCF samples were collected at baseline and on day 10 of drug intake from each sampling area by a single examiner who was unaware of the treatment modality. Assays for GCF PGE(2) and TBARS were carried out by an enzyme-linked immunosorbent assay and fluorometric method, respectively.
All groups showed statistically significant reductions in PI and GI scores following the phase I periodontal treatment on day 10 (P <0.05), but no statistical differences were observed in PD and CAL scores after the therapy. In groups 1 and 2, the reduction of GCF PGE(2) and TBARS levels were not significant after the therapy compared to baseline levels. In group 3, GCF PGE(2) and TBARS levels exhibited a statistically significant decrease (P <0.05) after the therapy. Group 4 showed significant reductions (P <0.05) in GCF PGE(2) levels after the therapy. No statistically significant reductions were observed in group 4 with regard to GCF TBARS levels. When groups 1 and 3 were compared according to GCF TBARS levels after the therapy, a more statistically significant reduction was observed in group 3 (P = 0.001).
These results suggest that additional flurbiprofen administration may have more inhibitory effects on GCF levels of PGE(2) and TBARS in the groups of smokers compared to non-smokers with CP.
吸烟已被确认为慢性牙周炎（CP）发生和发展的重要危险因素。本研究调查了I期牙周治疗及辅助使用氟比洛芬对CP吸烟者和非吸烟者龈沟液（GCF）样本中前列腺素E2（PGE2）和硫代巴比妥酸反应性物质（TBARS）水平的影响。
21例非吸烟CP患者和21例吸烟CP患者根据治疗方式分为四组。第1组（非吸烟CP患者）和第3组（吸烟CP患者）在进行龈上洁治和根面平整（SRP）的同时，按2×1方案每日服用100mg氟比洛芬片，共10天。第2组（非吸烟CP患者）和第4组（吸烟CP患者）在进行SRP的同时，按2×1方案每日服用安慰剂片，共10天。记录菌斑指数（PI）、牙龈指数（GI）、探诊深度（PD）和临床附着水平（CAL），并由一名不了解治疗方式的检查者在基线时以及服药第10天从每个采样区域收集GCF样本。分别采用酶联免疫吸附测定法和荧光法检测GCF中PGE2和TBARS。
在第10天进行I期牙周治疗后，所有组的PI和GI评分均有统计学显著降低（P<0.05），但治疗后PD和CAL评分无统计学差异。在第1组和第2组中，治疗后GCF中PGE2和TBARS水平与基线水平相比无显著降低。在第3组中，治疗后GCF中PGE2和TBARS水平有统计学显著降低（P<0.05）。第4组治疗后GCF中PGE2水平显著降低（P<0.05）。第4组GCF中TBARS水平无统计学显著降低。治疗后根据GCF中TBARS水平比较第1组和第3组时，第3组降低更具统计学显著性（P=0.001）。
这些结果表明，与非吸烟CP患者相比，额外使用氟比洛芬对吸烟CP患者组GCF中PGE2和TBARS水平可能具有更强的抑制作用。
