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辅助使用甲硝唑加阿莫西林对广泛性侵袭性牙周炎患者微生物谱和临床参数的短期益处。

Short-term benefits of the adjunctive use of metronidazole plus amoxicillin in the microbial profile and in the clinical parameters of subjects with generalized aggressive periodontitis.

机构信息

Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.

出版信息

J Clin Periodontol. 2010 Apr;37(4):353-65. doi: 10.1111/j.1600-051X.2010.01538.x.

Abstract

AIM

The aim of this study was to evaluate the clinical and microbiological effects of scaling and root planing (SRP) alone or combined with metronidazole (MTZ) and amoxicillin (AMX) in the treatment of subjects with generalized aggressive periodontitis (GAgP).

MATERIALS AND METHODS

A double-blind, placebo-controlled, randomized clinical trial was conducted in 30 subjects receiving SRP alone or combined with MTZ (400 mg 3 x per day) and AMX (500 mg 3 x per day) for 14 days. Clinical and microbiological examinations were performed at baseline and 3 months post-SRP. Nine subgingival plaque samples per subject were analysed using checkerboard DNA-DNA hybridization.

RESULTS

Subjects receiving MTZ and AMX showed the greatest improvements in the mean full-mouth probing depth and clinical attachment level and at initially intermediate and deep sites. The most beneficial changes in the microbial profile were also observed in the MTZ+AMX group, which showed the lowest proportions of the red complex as well as a significant decrease in the proportions of the orange complex after treatment. The antibiotic therapy also reduced the levels of Aggregatibacter actinomycetemcomitans at initially deep sites.

CONCLUSION

Subjects with GAgP significantly benefit from the adjunctive use of MTZ and AMX. The short-term advantages are observed in the clinical and microbiological parameters.

摘要

目的

本研究旨在评估单独进行牙周刮治和根面平整术(SRP)以及联合使用甲硝唑(MTZ)和阿莫西林(AMX)治疗广泛性侵袭性牙周炎(GAgP)患者的临床和微生物学效果。

材料和方法

进行了一项双盲、安慰剂对照、随机临床试验,共有 30 名接受 SRP 治疗的患者被随机分为单独接受 SRP 治疗或联合接受 MTZ(400mg,每日 3 次)和 AMX(500mg,每日 3 次)治疗 14 天。在基线和 SRP 治疗后 3 个月进行临床和微生物学检查。每个患者采集 9 个龈下菌斑样本,使用斑点杂交 DNA-DNA 技术进行分析。

结果

接受 MTZ 和 AMX 联合治疗的患者在全口探诊深度和临床附着水平以及初始中度和深度位点上的改善最为显著。在微生物谱方面,MTZ+AMX 组也观察到了最有益的变化,该组红色复合体的比例最低,治疗后橙色复合体的比例也显著下降。抗生素治疗还降低了初始深度位点的伴放线放线杆菌的水平。

结论

GAgP 患者从 MTZ 和 AMX 的辅助治疗中显著获益。短期优势体现在临床和微生物学参数上。

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