Goené R J, Winkel E G, Abbas F, Rodenburg J P, van Winkelhoff A J, de Graaff J
Department of Periodontology Amsterdam, Academic Center for Dentistry, (ACTA), The Netherlands.
J Periodontol. 1990 Jan;61(1):61-4. doi: 10.1902/jop.1990.61.1.61.
The purpose of this report is to illustrate the use of microbiology in the diagnosis and treatment in four cases of severe adult periodontitis. All four patients were subgingivally infected with Actinobacillus actinomycetemcomitans which was the basis for an adjunct minocycline therapy. Scaling and root planing plus minocycline were not able to establish a clinically stable periodontal condition. A. actinomycetemcomitans was not eliminated from the pockets in any of the patients. Good clinical and microbiological results were obtained after continuous conventional treatment with an adjunct therapy of metronidazole plus amoxycillin. With a 7 day course of this antibiotic therapy, the pockets of all four patients became free of A. actinomycetemcomitans and were still negative on repeated sampling on recall visits. Microbiological monitoring of severe periodontitis in adults seems to be a valuable adjunct to clinical examination. Furthermore, effective antibiotic therapy in A. actinomycetemcomitans-associated periodontitis appears of paramount importance in obtaining a stable periodontal situation.
本报告旨在阐述微生物学在4例重度成人牙周炎诊断和治疗中的应用。所有4例患者龈下均感染伴放线放线杆菌，这是辅助米诺环素治疗的依据。龈上洁治术、根面平整术加米诺环素未能建立临床稳定的牙周状况。所有患者的牙周袋中均未清除伴放线放线杆菌。采用甲硝唑加阿莫西林辅助治疗并持续进行常规治疗后，取得了良好的临床和微生物学效果。经过7天的抗生素治疗疗程，所有4例患者的牙周袋中均未检测到伴放线放线杆菌，复诊时重复采样仍为阴性。对成人重度牙周炎进行微生物学监测似乎是临床检查的一项有价值的辅助手段。此外，在伴放线放线杆菌相关性牙周炎中，有效的抗生素治疗对于获得稳定的牙周状况似乎至关重要。
