Gupta Rajan, Pandit Nymphea, Aggarwal Shweta, Verma Ashish
Department of Periodontics, D.A.V. (C) Dental College in Yamunanagar, Haryana, India.
J Contemp Dent Pract. 2008 Nov 1;9(7):25-32.
The aim of this study was to evaluate and compare the efficacy of subgingivally delivered 10% doxycycline hyclate and xanthan based chlorhexidine gels when used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.
A randomized, controlled, single center study was conducted involving 90 sites in 30 patients suffering from moderate to advanced chronic periodontitis. Each patient contributed three sites which were randomized to three treatment groups: SRP + insertion of doxycycline gel [SRP+DH], SRP + insertion of chlorhexidine gel [SRP+CHX]), and SRP alone [SRP]. Gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline, 1 month, and 3 months post therapy.
All treatments showed significant reductions in PPD and CAL at 1 and 3 months when compared to baseline values (p<0.001). At 3 months, sites treated with SRP+DH and SRP+CHX showed an additional reduction in PPD of 0.86 +/- 1.0 mm and 0.66 +/- 1.58 mm, respectively, significantly greater than SRP alone (p<0.02). Differences in mean PPD reduction between SRP+DH and SRP+CHX were not significant (p=0.46). At 3 months, differences in relative CAL between both SRP+DH (0.80 +/- 0.92) and SRP+CHX (0.63 +/- 1.47) and SRP alone were statistically significant (p<0.02). Differences in relative CAL between SRP+DH and SRP+CHX were not significant (p=0.54).
The results suggest treatment with 10% doxycycline hyclate and xanthan based chlorhexidine gels as an adjunct to SRP improves PPD and CAL patients with periodontitis compared to SRP alone.
The use of local drug therapy may refocus the need for surgical periodontal therapy toward deeper pockets.
本研究旨在评估和比较龈下应用10%盐酸多西环素和基于黄原胶的洗必泰凝胶作为龈上洁治和根面平整（SRP）辅助治疗慢性牙周炎的疗效。
进行了一项随机、对照、单中心研究，纳入30例中重度慢性牙周炎患者的90个位点。每位患者提供三个位点，随机分为三个治疗组：SRP+多西环素凝胶置入组[SRP+DH]、SRP+洗必泰凝胶置入组[SRP+CHX]和单纯SRP组[SRP]。在基线、治疗后1个月和3个月记录牙龈指数（GI）、菌斑指数（PI）、探诊深度（PPD）和临床附着水平（CAL）。
与基线值相比，所有治疗在1个月和3个月时PPD和CAL均显著降低（p<0.001）。在3个月时，SRP+DH组和SRP+CHX组治疗的位点PPD分别额外降低0.86±1.0mm和0.66±1.58mm，显著大于单纯SRP组（p<0.02）。SRP+DH组和SRP+CHX组平均PPD降低差异不显著（p=0.46）。在3个月时，SRP+DH组（0.80±0.92）和SRP+CHX组（0.63±1.47）与单纯SRP组相比，相对CAL差异有统计学意义（p<0.02）。SRP+DH组和SRP+CHX组相对CAL差异不显著（p=0.54）。
结果表明，与单纯SRP相比，10%盐酸多西环素和基于黄原胶的洗必泰凝胶作为SRP的辅助治疗可改善牙周炎患者的PPD和CAL。
局部药物治疗的应用可能会将牙周手术治疗的需求重新聚焦于更深的牙周袋。
