Pietruska M, Bernaczyk A, Knaś M, Pietruski J, Zwierz K
Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, Poland.
Adv Med Sci. 2006;51 Suppl 1:158-61.
The aim of the study was the clinical assessment of the periodontium in patients with aggressive periodontitis (AP) after treatment with doxycycline hyclate. Moreover, an attempt was made to evaluate the effect of the treatment on the salivary concentrations of beta-glucuronidase, HEX, HEX A and HEX B in AP patients.
Sixteen patients with aggressive periodontitis, aged 28-45 years, were enrolled in the study. The patients were treated with a doxycycline hyclate preparation (Periostat) for 2 months at a dose of 20 mg twice a day. The clinical examination was performed twice, directly prior to pharmacological treatment and after its termination. The following clinical parameters were evaluated: the plaque index (PI), the sulcus bleeding index (SBI), the pocket probing depth (PPD) and the clinical attachment level (CAL). Biochemical determination of beta-glucuronidase, HEX, HEX A and HEX B concentrations in non-stimulated saliva was performed before and after treatment.
In AP patients, the values of PI, SBI and CAL before and after treatment were comparable. The mean pocket probing depth before treatment was 3.5 mm, which decreased significantly after treatment (3.2 mm). The values expressed as pKat/kg protein for specific enzymatic activities of HEX, HEX A, HEX B and beta-glucuronidase in the saliva of AP patients before and after doxycycline treatment were similar.
A 2-month treatment with doxycycline is too short to obtain clinical changes. Although the assessment of the activity of such enzymes as beta-glucuronidase, HEX, HEX A and HEX B in the saliva of AP patients allows detection of periodontal inflammation, it cannot be used to determine the risk of its development and therefore has no practical significance.
本研究旨在对接受盐酸多西环素治疗后的侵袭性牙周炎（AP）患者的牙周组织进行临床评估。此外，还试图评估该治疗对AP患者唾液中β-葡萄糖醛酸酶、己糖胺酶（HEX）、己糖胺酶A（HEX A）和己糖胺酶B（HEX B）浓度的影响。
16例年龄在28 - 45岁之间的侵袭性牙周炎患者纳入本研究。患者接受盐酸多西环素制剂（派丽奥）治疗，剂量为每日2次，每次20 mg，持续2个月。在药物治疗前及治疗结束后直接进行两次临床检查。评估以下临床参数：菌斑指数（PI）、龈沟出血指数（SBI）、牙周袋探诊深度（PPD）和临床附着水平（CAL）。在治疗前后对非刺激性唾液中的β-葡萄糖醛酸酶、HEX、HEX A和HEX B浓度进行生化测定。
在AP患者中，治疗前后PI、SBI和CAL的值具有可比性。治疗前平均牙周袋探诊深度为3.5 mm,治疗后显著降低（3.2 mm）。盐酸多西环素治疗前后AP患者唾液中HEX、HEX A、HEX B和β-葡萄糖醛酸酶的比活性以pKat/kg蛋白表示的值相似。
为期2个月的盐酸多西环素治疗时间过短，无法获得临床变化。虽然评估AP患者唾液中β-葡萄糖醛酸酶、HEX、HEX A和HEX B等酶的活性可检测牙周炎症，但它不能用于确定其发展风险，因此没有实际意义。
