Dental Research Division, Department of Periodontology, Guarulhos University, São Paulo, São Paulo, Brazil.
J Clin Periodontol. 2012 Apr;39(4):368-76. doi: 10.1111/j.1600-051X.2012.01860.x. Epub 2012 Feb 13.
This study evaluated the effects of surgical (SD) and non-surgical (NSD) debridements, associated with systemic antimicrobials, on clinical and immunological outcomes of residual pockets [RP; probing depth (PD) ≥5 mm with bleeding on probing] in type 2 diabetics.
A split-mouth, randomized controlled trial was conducted in 21 subjects presenting at least two RP per contralateral quadrant. Subjects received metronidazole plus amoxicillin for 10 days and, contralateral quadrants were assigned to receive SD or NSD. Clinical parameters and local levels of interferon-γ, interleukin (IL)-17, IL-23 and IL-4 were assessed at baseline, 3 and 6 months post-therapies.
Overall, the mean number, PD and clinical attachment level (CAL) of RP improved significantly after therapies (p < 0.05), without differences between groups at any time-point (p > 0.05). At quadrant level, only SD produced significant reductions in the mean CAL. Also, SD promoted higher reduction in PD from baseline to 6 months than NSD (p < 0.05). Levels of all cytokines were increased after SD compared with NSD (p < 0.05).
SD and NSD associated with systemic antimicrobials did not differ in terms of clinical benefits for RP in diabetics up to 6 months post-therapies. RP treated by SD presented increased levels of cytokines.
本研究评估了手术（SD）和非手术（NSD）清创术联合全身抗菌药物对 2 型糖尿病患者残留袋（RP；探诊深度 [PD]≥5mm 且探诊出血）的临床和免疫结局的影响。
在 21 名受试者中进行了一项分口、随机对照试验，这些受试者每侧各有至少两个 RP。受试者接受甲硝唑加阿莫西林治疗 10 天，对侧象限被分配接受 SD 或 NSD。在基线、治疗后 3 个月和 6 个月评估临床参数和局部干扰素-γ、白细胞介素（IL）-17、IL-23 和 IL-4 水平。
总体而言，治疗后 RP 的平均数量、PD 和临床附着水平（CAL）均显著改善（p<0.05），但各时间点组间无差异（p>0.05）。在象限水平上，只有 SD 可显著降低平均 CAL。此外，SD 从基线到 6 个月时 PD 的降低幅度大于 NSD（p<0.05）。与 NSD 相比，SD 后所有细胞因子水平均升高（p<0.05）。
在治疗后 6 个月内，SD 和 NSD 联合全身抗菌药物在糖尿病患者的 RP 临床获益方面没有差异。SD 治疗的 RP 表现出更高的细胞因子水平。
