治疗慢性牙周炎应该使用抗生素吗？
Should Antibiotics Be Prescribed to Treat Chronic Periodontitis?
作者信息
Walters John, Lai Pin-Chuang
机构信息
Division of Periodontology, College of Dentistry, The Ohio State University, 3015 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210, USA.
Division of Periodontology, College of Dentistry, The Ohio State University, 3015 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210, USA; Division of Biosciences, College of Dentistry, The Ohio State University, 3015 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210, USA.
出版信息
Dent Clin North Am. 2015 Oct;59(4):919-33. doi: 10.1016/j.cden.2015.06.011. Epub 2015 Aug 1.
Abstract
Although scaling and root planing is a cost-effective approach for initial treatment of chronic periodontitis, it fails to eliminate subgingival pathogens and halt progressive attachment loss in some patients. Adjunctive use of systemic antibiotics immediately after completion of scaling and root planing can enhance the degree of clinical attachment gain and probing depth reduction provided by nonsurgical periodontal treatment. This article discusses the rationale for prescribing adjunctive antibiotics, reviews the evidence for their effectiveness, and outlines practical issues that should be considered before prescribing antibiotics to treat chronic periodontitis.
摘要
尽管龈上洁治和根面平整是慢性牙周炎初始治疗的一种经济有效的方法，但在一些患者中，它无法消除龈下病原体并阻止附着丧失的进展。在龈上洁治和根面平整完成后立即辅助使用全身抗生素，可以提高非手术牙周治疗所带来的临床附着增加程度和探诊深度减少程度。本文讨论了开具辅助抗生素的基本原理，回顾了其有效性的证据，并概述了在开具抗生素治疗慢性牙周炎之前应考虑的实际问题。
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本文引用的文献
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Int J Antimicrob Agents. 2015 Feb;45(2):99-105. doi: 10.1016/j.ijantimicag.2014.10.003. Epub 2014 Nov 3.
2
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J Dent Res. 2014 Nov;93(11):1045-53. doi: 10.1177/0022034514552491. Epub 2014 Sep 26.
3
The impact of horizontal gene transfer on the adaptive ability of the human oral microbiome.水平基因转移对人类口腔微生物群适应能力的影响。
Front Cell Infect Microbiol. 2014 Sep 8;4:124. doi: 10.3389/fcimb.2014.00124. eCollection 2014.
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J Periodontal Res. 2015 Jun;50(3):294-314. doi: 10.1111/jre.12221. Epub 2014 Aug 21.
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J Periodontol. 2014 Feb;85(2):343-8. doi: 10.1902/jop.2013.130167. Epub 2013 May 9.
9
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