Vitaya C T
Faculty of Dentistry, Chulalongkorn University.
J Dent Assoc Thai. 1990 Mar-Apr;40(2):83-91.
The relationship between the periodontal microbiota and the threshold for periodontal disease is dependent on the specific bacterial composition of the plaque and the resistance of the host. Supragingival plaque is the cause of gingivitis and plays a primary role in the initiation of periodontitis. The 0.2% chlorhexidine mouthwash (twice a day) is safe and most effective antiplaque and anti-gingivitis agent. The use of adjunctive tetracycline for 2 week periods (1 gm daily) with root debridement is highly effective against Actinobacillus actinomycetemcomitans and many of suspected virulence microorganisms, the major etiological agents of juvenile periodontitis. For rapidly progressive periodontitis and refractory adult periodontitis, metronidazole for 1-2 week periods (600 mg.daily) has excellent activity against strictly anaerobic bacteria such as Bacteroides gingivalis, Spirochetes and others. Clinical use of antimicrobial agent in adjuvant with scaling, root planing, and personal oral hygiene instruction cause a significant improvement of the periodontium.
牙周微生物群与牙周疾病阈值之间的关系取决于菌斑的特定细菌组成和宿主的抵抗力。龈上菌斑是牙龈炎的病因，在牙周炎的起始过程中起主要作用。0.2%的氯己定漱口水（每天两次）是安全且最有效的抗牙菌斑和抗牙龈炎药物。在进行根面清创术时，辅助使用四环素2周（每日1克）对伴放线放线杆菌和许多可疑的致病微生物（青少年牙周炎的主要病原体）非常有效。对于快速进展性牙周炎和难治性成人牙周炎，使用甲硝唑1 - 2周（每日600毫克）对诸如牙龈拟杆菌、螺旋体等严格厌氧菌具有极佳的抗菌活性。抗菌剂与龈上洁治、根面平整及个人口腔卫生指导联合临床应用可使牙周组织显著改善。
