Novak M John, Dawson Dolphus R, Magnusson Ingvar, Karpinia Katherine, Polson Alan, Polson Anne, Ryan Maria E, Ciancio Sebastian, Drisko Connie H, Kinane Denis, Powala Christopher, Bradshaw Mark
Center for Oral Health Research, University of Kentucky, Lexington, KY 40536-0305, USA.
J Periodontol. 2008 Jan;79(1):33-41. doi: 10.1902/jop.2008.070237.
Previous studies showed that host modulation therapy (HMT) or topical antimicrobial therapy (TAT) provided significant adjunctive benefits to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). The purpose of this study was to evaluate a combination therapy involving SRP, HMT, and TAT in the treatment of moderate to severe CP.
A 6-month, randomized, multicenter, placebo-controlled, examiner-masked study was undertaken to evaluate the clinical usefulness of a combination treatment of systemically delivered doxycycline hyclate (HMT; 20 mg, twice a day) plus locally delivered doxycycline hyclate gel (TAT; 10%, in pockets > or =5 mm) in combination with SRP versus SRP plus placebo. Clinical outcomes included mean changes in probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and gingival index (GI) at baseline and at 3 and 6 months.
In 171 subjects, combination therapy provided significantly greater clinical benefits than control therapy for all clinical measures at 3 and 6 months. In moderate CP (PD of 4 to 6 mm), combination therapy provided significant benefits over control for PD (3 and 6 months: P <0.01), CAL (3 months: P <0.01; 6 months: P <0.03), BOP (3 months: P <0.02; 6 months: P <0.05), and GI (3 months: P <0.01; 6 months: P <0.03). In severe CP (PD > or =7 mm), combination therapy provided significant benefits over control for PD (3 and 6 months: P <0.01), CAL (3 months: P <0.01; 6 months: P <0.02), BOP (3 months: P <0.01; 6 months: P >0.05), and GI (3 months: P <0.01; 6 months: P <0.01).
Combination therapy, including SRP, HMT, and TAT, provided significantly greater clinical benefits than SRP alone in the treatment of moderate to severe CP.
既往研究表明，宿主调控疗法（HMT）或局部抗菌疗法（TAT）在慢性牙周炎（CP）治疗中，对龈下刮治及根面平整术（SRP）具有显著的辅助益处。本研究旨在评估一种联合疗法，即SRP联合HMT及TAT治疗中度至重度CP的效果。
开展一项为期6个月的随机、多中心、安慰剂对照、检查者盲法研究，以评估全身应用盐酸多西环素（HMT；20mg，每日两次）联合局部应用盐酸多西环素凝胶（TAT；10%，用于牙周袋≥5mm）并结合SRP的联合治疗方案相较于SRP联合安慰剂的临床有效性。临床结局包括基线、3个月及6个月时探诊深度（PD）、临床附着水平（CAL）、探诊出血（BOP）及牙龈指数（GI）的平均变化。
在171名受试者中，联合治疗在3个月及6个月时，对于所有临床指标，均比对照治疗带来显著更大的临床益处。在中度CP（PD为4至6mm）中，联合治疗在PD（3个月和6个月：P<0.01）、CAL（3个月：P<0.01；6个月：P<0.03）、BOP（3个月：P<0.02；6个月：P<0.05）及GI（3个月：P<0.01；6个月：P<0.03）方面比对照治疗有显著益处。在重度CP（PD≥7mm）中，联合治疗在PD（3个月和6个月：P<0.01）、CAL（3个月：P<0.01；6个月：P<0.02）、BOP（3个月：P<0.01；6个月：P>0.05）及GI（3个月：P<0.01；6个月：P<0.01）方面比对照治疗有显著益处。
在中度至重度CP的治疗中，包括SRP、HMT及TAT的联合治疗比单独使用SRP带来显著更大的临床益处。
