Cionca Norbert, Giannopoulou Catherine, Ugolotti Giovanni, Mombelli Andrea
Department of Periodontology, University of Geneva, Geneva, Switzerland.
J Periodontol. 2009 Mar;80(3):364-71. doi: 10.1902/jop.2009.080540.
It has been suggested that scaling and root planing of all pockets within a few hours and chlorhexidine treatments (full-mouth disinfection) may reduce the need for supplementary therapies. The aim of this study was to evaluate the clinical benefit of amoxicillin and metronidazole administered immediately after completion of full-mouth periodontal debridement in patients with chronic periodontitis.
This was a single-center, double-masked, placebo-controlled, randomized longitudinal study of 6 months' duration. Fifty-one patients received full-mouth periodontal debridement, performed within 48 hours. Twenty-five subjects received metronidazole, 500 mg, and amoxicillin, 375 mg, three times a day for 7 days; 26 subjects received a placebo.
Forty-seven patients could be followed up to month 6. No differences in clinical parameters were noted before treatment. The overall mean probing depth decreased from 4.3 +/- 0.4 mm to 3.0 +/- 0.2 mm in the test group and from 4.4 +/- 0.4 mm to 3.1 +/- 0.3 mm in the control group (P = 0.05, difference between groups). More importantly, test subjects had a significantly lower mean number of persisting pockets >4 mm and bleeding on probing that required further treatment (P = 0.005): 6 months after full-mouth debridement plus antibiotics, only 0.4 +/- 0.8 persisting pockets were still present, whereas 3.0 +/- 4.3 persisting pockets were still present in the control group. The protective risk of the antibiotics for having more than one pocket deeper than 4 mm and bleeding on probing per subject after 6 months was 8.85.
Systemic metronidazole and amoxicillin significantly improved the 6-month clinical outcomes of full-mouth non-surgical periodontal debridement, thus significantly reducing the need for additional therapy.
有人提出在数小时内对所有牙周袋进行刮治和根面平整以及洗必泰治疗（全口消毒）可能会减少辅助治疗的需求。本研究的目的是评估在慢性牙周炎患者全口牙周清创术后立即给予阿莫西林和甲硝唑的临床益处。
这是一项为期6个月的单中心、双盲、安慰剂对照、随机纵向研究。51例患者在48小时内接受了全口牙周清创术。25名受试者每天3次接受500毫克甲硝唑和375毫克阿莫西林治疗，持续7天；26名受试者接受安慰剂治疗。
47例患者可随访至第6个月。治疗前临床参数无差异。试验组的总体平均探诊深度从4.3±0.4毫米降至3.0±0.2毫米，对照组从4.4±0.4毫米降至3.1±0.3毫米（P = 0.05，组间差异）。更重要的是，试验组中持续存在的深度>4毫米且探诊出血需要进一步治疗的牙周袋平均数量显著更低（P = 0.005）：在全口清创加抗生素治疗6个月后，试验组仅存在0.4±0.8个持续牙周袋，而对照组仍有3.0±4.3个持续牙周袋。6个月后，抗生素对于每位受试者出现一个以上深度超过4毫米且探诊出血牙周袋的保护风险为8.85。
全身应用甲硝唑和阿莫西林显著改善了全口非手术牙周清创术6个月的临床疗效，从而显著减少了额外治疗的需求。
