Shah Mishal Piyush, Gujjari Sheela Kumar, Chandrasekhar Veerendrakumar Siddhpur
Department of Periodontology, Narsinhbhai Patel Dental College and Hospital , Visnagar, Gujarat, India .
J Clin Diagn Res. 2013 Mar;7(3):595-600. doi: 10.7860/JCDR/2013/5225.2834. Epub 2013 Mar 1.
The purpose of the present study was to evaluate the effect of a probiotic (Inersan®) alone, a combination of the probiotic with doxycycline and doxycycline alone on aggressive periodontitis patients.
Thirty patients who satisfied the inclusion and exclusion criteria, were assigned to one of the above mentioned three groups by using block randomization. The clinical and the microbiological parameters were recorded on day 0, at 2 weeks and at 2 months. On day 0, before recording the clinical parameters, 0.5 ml of unstimulated saliva was collected for the evaluation of the microbiological parameters. The clinical parameters which were recorded were the plaque index, the gingival index, the probing pocket depth and the clinical attachment level. The microbiological parameters which were recorded were Lactobacilli and Aggregatibacter actinomycetemcomitans. After this, Scaling and Root Planing (SRP) was performed on day 0. Two weeks after the SRP, the patients were recalled for the saliva sample collection and for the evaluation of the clinical parameters. On the same day, medications were given to the patients to be taken for fourteen days according to the group which they belonged to (Group A - probiotic alone, Group B - a combination of the probiotic with doxycycline, Group C - doxycycline alone). The patients were then recalled at two months for the saliva sample collection and for the evaluation of the clinical parameters.
The administration of the probiotic alone, a combination of the probiotic with doxycycline and doxycycline alone, resulted in a decrease in the plaque index, the gingival index, the probing pocket depth and the clinical attachment level at 2 months, which was statistically significant (p < 0.05). The A. actinomycetemcomitans count tended to decrease in all the three groups at 2 months, which was statistically non-significant (p > 0.05). The Lactobacilli count tended to increase significantly in the probiotic alone group (p < 0.05).
Probiotics have a future in the treatment of aggressive periodontitis, as antibiotics are prescribed most of the time. These antibiotics can lead to the emergence of drug resistant micro-organisms and they can also disturb the beneficial microflora of the body. Thus, as an alternative to antibiotics, probiotics can be used, as they repopulate the beneficial microflora and reduce the pathogenic bacteria.
本研究的目的是评估单独使用益生菌(Inersan®)、益生菌与强力霉素联合使用以及单独使用强力霉素对侵袭性牙周炎患者的影响。
30名符合纳入和排除标准的患者,通过区组随机化被分配到上述三组中的一组。在第0天、2周和2个月时记录临床和微生物学参数。在第0天,在记录临床参数之前,收集0.5毫升非刺激性唾液用于评估微生物学参数。记录的临床参数有菌斑指数、牙龈指数、探诊深度和临床附着水平。记录的微生物学参数有乳酸杆菌和伴放线聚集杆菌。在此之后,在第0天进行龈上洁治和根面平整(SRP)。SRP两周后,召回患者收集唾液样本并评估临床参数。在同一天,根据患者所属组(A组 - 单独使用益生菌,B组 - 益生菌与强力霉素联合使用,C组 - 单独使用强力霉素)给予患者药物服用14天。然后在两个月时召回患者收集唾液样本并评估临床参数。
单独使用益生菌、益生菌与强力霉素联合使用以及单独使用强力霉素,在2个月时均导致菌斑指数、牙龈指数、探诊深度和临床附着水平降低,具有统计学意义(p < 0.05)。在2个月时,所有三组中的伴放线聚集杆菌数量均有下降趋势,但无统计学意义(p > 0.05)。单独使用益生菌组的乳酸杆菌数量有显著增加趋势(p < 0.05)。
由于大多数时候都开抗生素,益生菌在侵袭性牙周炎的治疗中有前景。这些抗生素会导致耐药微生物的出现,还会扰乱人体有益微生物群。因此,作为抗生素的替代品,可以使用益生菌,因为它们能重新填充有益微生物群并减少病原菌。