Arweiler Nicole B, Pietruska Malgorzata, Skurska Ania, Dolińska Ewa, Pietruski Jan K, Bläs Maximilian, Auschill Thorsten M, Sculean Anton
Department of Periodontology, Center for Dentistry and Oral Medicine, Philipps University, Marburg, Germany.
Schweiz Monatsschr Zahnmed. 2013;123(6):532-44.
The aim of this randomized, controlled clinical study was to compare the short-term effects of nonsurgical periodontal therapy with the additional administration of systemic antibiotics (AB) and the same therapy with additional photodynamic therapy (PDT) in the treatment of patients with aggressive periodontitis (AP). Thirty-six patients with AP received full-mouth nonsurgical periodontal treatment (SRP) and were then randomly divided into two groups of 18 subjects each. Group AB received amoxicillin and metronidazole three times a day for 7 days. Group PDT received two applications of PDT on the day of SRP as well as at follow-up after 7 days. The following clinical parameters were measured at baseline and 3 months after therapy: plaque index (PLI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). After 3 months, PD was significantly reduced in both groups (from 5.0±0.8 mm to 3.2±0.4 mm with AB, and 5.1±0.5 mm to 4.0±0.8 mm with PDT; both p<0.001), while AB revealed significantly lower values compared to PDT (p = 0.001). In both groups, GR was not significantly changed. CAL was significantly reduced in both groups (PDT: 5.7±0.8 mm to 4.7±1.1 mm; p=0.011; AB: 5.5±1.1 mm to 3.9±1.0 mm; p<0.001) and differed significantly between the groups (p=0.025). The number of residual pockets (PD ≥4 mm) and positive BOP was reduced by AB from 961 to 377, and by PDT from 628 to 394. Pockets with PD ≥7 mm were reduced by AB from 141 to 7, and by PDT from 137 to 61. After 3 months, both treatments led to statistically significant clinical improvements. The systemic administration of antibiotics, however, resulted in significantly higher reduction of PD and a lower number of deep pockets compared to PDT.
这项随机对照临床研究的目的是比较非手术牙周治疗联合全身应用抗生素（AB）与联合光动力疗法（PDT）对侵袭性牙周炎（AP）患者的短期治疗效果。36例AP患者接受了全口非手术牙周治疗（SRP），然后随机分为两组，每组18例。AB组患者每天服用阿莫西林和甲硝唑3次，共7天。PDT组在SRP当天及7天后随访时接受两次PDT治疗。在基线和治疗后3个月测量以下临床参数：菌斑指数（PLI）、探诊出血（BOP）、探诊深度（PD）、牙龈退缩（GR）和临床附着水平（CAL）。3个月后，两组的PD均显著降低（AB组从5.0±0.8mm降至3.2±0.4mm，PDT组从5.1±0.5mm降至4.0±0.8mm；p均<0.001），但AB组的PD值显著低于PDT组（p = 0.001）。两组的GR均无显著变化。两组的CAL均显著降低（PDT组：从5.7±0.8mm降至4.7±1.1mm；p = 0.011；AB组：从5.5±1.1mm降至3.9±1.0mm；p<0.001），且两组间差异显著（p = 0.025）。AB组将残余牙周袋（PD≥4mm）和探诊出血阳性的数量从961个减少到377个，PDT组从628个减少到394个。PD≥7mm的牙周袋AB组从141个减少到7个，PDT组从137个减少到61个。3个月后，两种治疗方法均带来了具有统计学意义的临床改善。然而，与PDT相比，全身应用抗生素导致PD显著降低，深牙周袋数量减少。
