Chandra Chetan, Valavalkar Narayan, Vandana K L
Department of Periodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India.
J Indian Soc Periodontol. 2011 Jul;15(3):221-7. doi: 10.4103/0972-124X.85664.
Prevention of the periodontal disease progression is the primary goal of periodontal therapy. When conventional therapy is found inadequate to attain periodontal health in chronic periodontitis, local antimicrobial agents have been used as an adjunct with scaling and root planning (SRP) which has reproduced encouraging results. Hence, this study was undertaken to evaluate the new sustained released local drug Chlosite clinically and microbiologically in smokers and non-smokers.
The patients were grouped into experimental group A treated with SRP plus Chlosite (SRP + CHL), experimental group B treated with Chlosite alone (CHL), and control group C treated only with SRP alone. A total number of 141 sites from six patients (67 sites from three non-smoker patients and 74 sites from three smoker patients) participated in this study. The clinical parameters, Plaque index (PI), Gingival index (GI), Bleeding index (BI), and Relative attachment level (RAL), were recorded and subgingival plaque samples were collected and subjected to microbiological analysis.
On comparison of smokers and non-smokers, in SRP group, non-smokers showed a higher reduction in BI and GI and smokers showed a higher reduction in PI. There was no significant gain in RAL of both smokers and non-smokers. In SRP + CHL group, non-smokers showed a higher reduction in relation to BI and GI and smokers showed a higher reduction in relation to PI. There was no significant gain in RAL of both smokers and non-smokers. In CHL group, both smokers and non-smokers showed a nonsignificant reduction in BI, GI, and RAL, but smokers showed a significant reduction in PI as compared with non-smokers. All the groups showed reduction in the microbial count of Fusobacterium nucleatum, Porphyromonas gingivalis, and Tannerella forsythia which were found to be statistically not significant when it was compared between non-smokers and smokers.
In this study, all treatment groups were found to be efficacious in the treatment of periodontal disease as demonstrated by improvement in PI, GI, BI, and RAL. Combination of SRP and Chlosite resulted in added benefits compared with the two treatment groups.
预防牙周疾病进展是牙周治疗的首要目标。当发现传统治疗方法不足以使慢性牙周炎患者达到牙周健康时，局部抗菌药物已被用作龈下刮治和根面平整术（SRP）的辅助治疗手段，并取得了令人鼓舞的效果。因此，本研究旨在对新型缓释局部用药氯己定在吸烟者和非吸烟者中进行临床和微生物学评估。
患者被分为三组，A实验组接受SRP加氯己定治疗（SRP + CHL），B实验组仅接受氯己定治疗（CHL），C对照组仅接受SRP治疗。共有来自6名患者的141个位点（3名非吸烟患者的67个位点和3名吸烟患者的74个位点）参与了本研究。记录临床参数，包括菌斑指数（PI）、牙龈指数（GI）、出血指数（BI）和相对附着水平（RAL），并收集龈下菌斑样本进行微生物学分析。
在吸烟者和非吸烟者的比较中，在SRP组，非吸烟者的BI和GI降低幅度更大，吸烟者的PI降低幅度更大。吸烟者和非吸烟者的RAL均无显著增加。在SRP + CHL组，非吸烟者的BI和GI降低幅度更大，吸烟者的PI降低幅度更大。吸烟者和非吸烟者的RAL均无显著增加。在CHL组，吸烟者和非吸烟者的BI、GI和RAL均有不显著的降低，但与非吸烟者相比，吸烟者的PI有显著降低。所有组中具核梭杆菌、牙龈卟啉单胞菌和福赛坦纳菌的微生物数量均有减少，在非吸烟者和吸烟者之间进行比较时，差异无统计学意义。
在本研究中，所有治疗组在治疗牙周疾病方面均显示出疗效，表现为PI、GI、BI和RAL的改善。与两个单一治疗组相比，SRP和氯己定联合使用带来了额外的益处。
