Feres Magda
Department of Periodontology, Guarulhos University, São Paulo, Brazil.
Ann R Australas Coll Dent Surg. 2008 Jun;19:37-44.
The starting point for defining a therapy, whether in dentistry or the various areas of medicine, is to understand the aetiology and progression of the different illnesses. In this context, it is worth pointing out that periodontal diseases are a group of infections whose primary aetiological factor is the bacteria present in the oral cavity, especially those that colonize the supra- and subgingival tooth surfaces. Many advances, mainly those occurring over the last two decades, greatly facilitated understanding of the aetiopathogenesis of periodontitis, including the microbiota related to each type of disease and the host response. This knowledge has made it easier to indicate more specific therapy, including the use of systemic antibiotics. Systemically administered metronidazole, and especially the combination of metronidazole, amoxicillin and scaling and root planing (SRP) leads to a beneficial change in the composition of the subgingival microbiota by reducing pathogens and allowing the growth of host-compatible species. In addition, the combination of systemic antibiotics and a strict control of supragingival plaque during the active phase of therapy has been showing promising results in the treatment of chronic periodontitis.
定义一种治疗方法的起点，无论是在牙科还是在医学的各个领域，都是了解不同疾病的病因和发展过程。在这种情况下，值得指出的是，牙周疾病是一组感染性疾病，其主要病因是口腔中存在的细菌，尤其是那些在龈上和龈下牙表面定植的细菌。许多进展，主要是过去二十年中取得的进展，极大地促进了对牙周炎发病机制的理解，包括与每种疾病类型相关的微生物群和宿主反应。这些知识使得更容易指明更具体的治疗方法，包括使用全身用抗生素。全身给予甲硝唑，特别是甲硝唑、阿莫西林联合龈下刮治和根面平整（SRP），通过减少病原体并允许宿主相容性物种生长，导致龈下微生物群组成发生有益变化。此外，在治疗的活跃期，全身用抗生素与严格控制龈上菌斑相结合，在慢性牙周炎的治疗中已显示出有希望的结果。
