Müller H P, Müller R F, Lange D E
Dtsch Zahnarztl Z. 1989 Apr;44(4):293-7.
In 15 adult patients with severely advanced periodontal disease unrelated to localized juvenile periodontitis high numbers of A. actinomycetemcomitans (A. a.) were identified in samples of subgingival plaque (median log CFU 5.13). In order to correlate clinical conditions with bacteriological findings, in every patient 2 deep periodontal pockets were treated with a 3-phase regimen of minocycline administration, mechanical, and surgical periodontal therapy. A. a. was eliminated by minocycline alone in 2 cases. Minocycline in combination with subgingival scaling resulted in 6 patients in A. a. negative samples. Following termination of minocycline therapy, frequently increasing numbers of A. a. were observed. Patients showed significant gain in clinical attachment or reduction of probing pocket depth during different phases of therapy, but only if A. a. was suppressed close to or below the lower limit of detection (5 CFU/ml). Considerable problems with elimination of A.a. may be connected with frequently observed recurrent periodontal disease in these patients.
在15例与局限性青少年牙周炎无关的重度晚期牙周病成年患者中，在龈下菌斑样本中发现了大量伴放线放线杆菌（A.a.）（中位对数CFU 5.13）。为了将临床情况与细菌学结果相关联，对每位患者的2个深牙周袋采用米诺环素给药、机械和手术牙周治疗的三阶段方案进行治疗。仅米诺环素就使2例患者的A.a.被清除。米诺环素与龈下刮治相结合，使6例患者的样本中A.a.呈阴性。在米诺环素治疗终止后，经常观察到A.a.数量增加。患者在治疗的不同阶段临床附着有显著增加或探诊袋深度减小，但前提是A.a.被抑制至接近或低于检测下限（5 CFU/ml）。在这些患者中，消除A.a.存在相当大的问题，这可能与经常观察到的复发性牙周病有关。
