Bajaj Pavan, Pradeep A R, Agarwal Esha, Kumari Minal, Naik Savitha B
Department of Periodontics, Government Dental College and Research Institute, Bangalore, India.
J Investig Clin Dent. 2012 Nov;3(4):276-83. doi: 10.1111/j.2041-1626.2012.00168.x. Epub 2012 Sep 13.
Several epidemiologic studies have identified a greater incidence of periodontitis in patients with type 2 diabetes. Recent developments suggest that local delivery of antimicrobials into periodontal pockets improve periodontal health. The present study was designed to investigate the adjunctive effects of subgingivally delivered clarithromycin (CLM) (0.5% concentration) as an adjunct to scaling and root planing for treating chronic periodontitis in patients with well-controlled type 2 diabetes.
Sixty-three patients were categorized into two treatment groups: Group 1, scaling and root planing (SRP) plus 0.5% CLM; Group 2, SRP plus placebo gel. Clinical parameters were recorded at baseline, 1, 2, and 3 months; which included gingival index (GI), sulcus bleeding index (SBI), plaque index (PI), probing depth (PD), and periodontal attachment level (PAL).
Both therapies resulted in significant improvements. Using a subject-based analysis, patients in Group 1 treated with SRP + CLM showed enhanced reductions in PI, GI, SBI, and PD, and gains in PAL (P < 0.001) over a period of 6 months as compared to Group 2.
Although both treatment strategies seemed to benefit the patients, the adjunctive use of 0.5% CLM as a controlled drug delivery system enhanced the clinical outcome.
多项流行病学研究已证实2型糖尿病患者患牙周炎的几率更高。最近的研究进展表明,将抗菌药物局部输送到牙周袋中可改善牙周健康状况。本研究旨在调查龈下递送克拉霉素(CLM)(浓度为0.5%)作为辅助手段,联合龈上洁治和根面平整术,用于治疗血糖控制良好的2型糖尿病患者慢性牙周炎的附加效果。
63名患者被分为两个治疗组:第1组,龈上洁治和根面平整术(SRP)加0.5% CLM;第2组,SRP加安慰剂凝胶。在基线、1、2和3个月时记录临床参数,包括牙龈指数(GI)、龈沟出血指数(SBI)、菌斑指数(PI)、探诊深度(PD)和牙周附着水平(PAL)。
两种治疗方法均取得了显著改善。基于个体的分析显示,与第2组相比, 接受SRP + CLM治疗的第1组患者在6个月内PI、GI、SBI和PD降低更为明显,PAL增加(P < 0.001)。
虽然两种治疗策略似乎都使患者受益,但使用0.5% CLM作为控释给药系统的辅助治疗提高了临床疗效。