Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
J Periodontol. 2012 Aug;83(8):988-98. doi: 10.1902/jop.2012.110513. Epub 2012 Jan 30.
The aim of the present study is to assess clinical, microbiologic, and immunologic benefits of amoxicillin/metronidazole (AM) when performing full-mouth ultrasonic debridement (FMUD) in generalized aggressive periodontitis (GAgP) treatment.
Twenty-four GAgP patients were divided into two groups: the FMUD group (n = 12), which received FMUD plus placebo, and the FMUD+AM group (n = 12), which received FMUD and 375 mg amoxicillin plus 250 mg metronidazole for 7 days. The following clinical outcomes were tested: plaque and bleeding on probing indices, pocket probing depth (PD), relative gingival margin position (GMP), and relative clinical attachment level (CAL). Total amount of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Tannerella forsythia (Tf), and gingival crevicular fluid (GCF) concentration of interleukin (IL)-10 and IL-1β were also determined. All clinical, microbiologic, and immunologic parameters were assessed at baseline and at 3 and 6 months post-therapy. The ANOVA/Tukey test was used for statistical analysis (α = 5%).
Amoxicillin/metronidazole used as an adjunct to the FMUD protocol added clinical and microbiologic benefits to GAgP treatment (P <0.05). FMUD+AM groups presented an additional PD reduction in initially deep PDs at the 3-month follow-up (3.99 ± 1.16 mm and 3.09 ± 0.78 mm for FMUD+AM and FMUD, respectively; P <0.05), a lower number of residual pockets at the 3- and 6-month follow-ups, and a statistical reduction in amounts of Aa (P <0.05). Analysis of Tf and Pg amounts, as well as IL-10 and IL-1β GCF concentrations failed to demonstrate a difference between the groups (P >0.05).
It may be concluded that amoxicillin/metronidazole improves clinical and microbiologic results of FMUD in GAgP treatment.
本研究旨在评估在广泛性侵袭性牙周炎(GAgP)治疗中进行全口超声洁治术(FMUD)时,阿莫西林/甲硝唑(AM)的临床、微生物学和免疫学获益。
将 24 名 GAgP 患者分为两组:FMUD 组(n = 12),接受 FMUD 加安慰剂;FMUD+AM 组(n = 12),接受 FMUD 和 375mg 阿莫西林加 250mg 甲硝唑,共 7 天。测试以下临床结果:菌斑和探诊出血指数、牙周袋探诊深度(PD)、相对牙龈边缘位置(GMP)和相对临床附着水平(CAL)。还测定了牙龈卟啉单胞菌(Pg)、伴放线放线杆菌(Aa)、福赛坦纳菌(Tf)的总量和龈沟液(GCF)中白细胞介素(IL)-10 和 IL-1β 的浓度。所有临床、微生物学和免疫学参数均在基线和治疗后 3 个月和 6 个月进行评估。采用方差分析/Tukey 检验进行统计学分析(α = 5%)。
阿莫西林/甲硝唑作为 FMUD 方案的辅助用药,为 GAgP 治疗带来了临床和微生物学获益(P <0.05)。在 3 个月的随访中,FMUD+AM 组在初始深 PD 中进一步降低了 PD(FMUD+AM 组为 3.99 ± 1.16mm,FMUD 组为 3.09 ± 0.78mm;P <0.05),在 3 个月和 6 个月的随访中,残留牙周袋数量减少,Aa 数量减少(P <0.05)。Tf 和 Pg 数量以及 GCF 中 IL-10 和 IL-1β 浓度的分析未显示两组之间存在差异(P >0.05)。
可以得出结论,阿莫西林/甲硝唑可改善 FMUD 在 GAgP 治疗中的临床和微生物学效果。