Knöfler Gerhild, Purschwitz Regina, Jentsch Holger, Birkenmeier Gerd, Schmidt Hannelore
Department of Conservative Dentistry and Periodontology, University of Leipzig, Leipzig, Germany.
Quintessence Int. 2008 May;39(5):381-9.
The aim of this study was to compare the influence of topical metronidazole gel application and scaling and root planing on gingival crevicular fluid variables.
In a split-mouth study, 39 volunteers with chronic periodontitis were treated by metronidazole gel or scaling and root planing. Clinical attachment level and probing depth were recorded, and aspartate aminotransferase (AST) and total/transformed Alpha2-macroglobulin were determined in the gingival crevicular fluid at baseline, as well as after 3 and 6 months.
Both treatment procedures resulted in a gain of clinical attachment-0.67 mm for metronidazole and 0.50 mm for scaling and root planing (P< .001)-at the end of the study. The median probing depth was significantly reduced by 0.66 mm for metronidazole and 1.00 mm for scaling and root planing (P< .001) after 6 months. No change of AST was found. Alpha2-macroglobulin was significantly reduced for scaling and root planing and metronidazole after 3 and 6 months (P< .001). No significant difference was found between the 2 procedures at any variable.
These data suggest that Alpha2-macroglobulin reflects clinical changes better than AST and that metronidazole and scaling and root planing have the same influence on clinical outcome and biochemical variables in the gingival crevicular fluid.
本研究旨在比较局部应用甲硝唑凝胶与龈下刮治及根面平整术对龈沟液变量的影响。
在一项双侧对照研究中，39名患有慢性牙周炎的志愿者接受了甲硝唑凝胶治疗或龈下刮治及根面平整术。记录临床附着水平和探诊深度，并在基线时以及3个月和6个月后测定龈沟液中的天冬氨酸转氨酶（AST）和总/转化α2-巨球蛋白。
在研究结束时，两种治疗方法均使临床附着水平有所增加——甲硝唑治疗组增加了0.67mm，龈下刮治及根面平整术治疗组增加了0.50mm（P<0.001）。6个月后，甲硝唑治疗组的探诊深度中位数显著降低了0.66mm，龈下刮治及根面平整术治疗组降低了1.00mm（P<0.001）。未发现AST有变化。3个月和6个月后，龈下刮治及根面平整术组以及甲硝唑治疗组的α2-巨球蛋白均显著降低（P<0.001）。在任何变量上，两种治疗方法之间均未发现显著差异。
这些数据表明，α2-巨球蛋白比AST能更好地反映临床变化，并且甲硝唑与龈下刮治及根面平整术对龈沟液的临床结果和生化变量具有相同的影响。
