Soeroso Y, Akase T, Sunarto H, Kemal Y, Salim R, Octavia M, Viandita A, Setiawan J, Bachtiar B M
Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia; Oral Sciences Research Center, Universitas Indonesia, Jakarta, Indonesia.
R&D, Oral Care Company, Sunstar Group, Takatsuki City, Japan.
Ther Clin Risk Manag. 2017 Mar 10;13:307-314. doi: 10.2147/TCRM.S130257. eCollection 2017.
The aim of this study was to evaluate the clinical and microbiological effects of local application minocycline HCl 2% gel, used as an adjunct to scaling and root planing (SRP) for treatment of chronic periodontitis (CP). CP is an inflammation of periodontal tissue that is caused mainly by bacterial infection, where periodontal destruction such as loss of attachment and bone destruction occurred.
A total of 81 subjects with moderate to severe periodontitis whose baseline clinical attachment loss (CAL) was ≥4 mm were randomly assigned to receive SRP alone (control group, N=39) or SRP followed by four times of local application of minocycline HCl gel (Periocline) once a week (test group, N=42). Pocket depth, CAL, and papilla bleeding index were examined at baseline, 21 days, 2, 3, and 6 months. Subgingival plaque samples were collected with sterile curettes and were analyzed by real-time polymerase chain reaction for the presence of three periodontal pathogens ( [P.g.], [T.f.], and [T.d.]) at baseline, 2, 3, and 6 months.
The number of bacteria was reduced in both groups at 2 months after baseline (SRP treatment). The changes (2-6 months) in T.d. and T.f. counts in the test group were significantly lower than those in the control group. In the control group, a significant regrowth of P.g., T.f., and T.d. was observed from 2 to 6 months and of P.g. and T.f. from 3 to 6 months. On the other hand, in the test group, the number of the three bacteria did not significantly increase during the 6-month period.
The results showed that local application of minocycline, used as an adjunct to SRP, was effective for suppressing regrowth of periodontal pathogens, suggesting its risk reduction of recurrent periodontal pathogens in CP.
本研究的目的是评估2%盐酸米诺环素凝胶局部应用作为龈下刮治和根面平整(SRP)辅助治疗慢性牙周炎(CP)的临床和微生物学效果。CP是一种主要由细菌感染引起的牙周组织炎症,会发生诸如附着丧失和骨破坏等牙周组织破坏。
总共81名中度至重度牙周炎患者,其基线临床附着丧失(CAL)≥4mm,被随机分配单独接受SRP(对照组,N = 39)或SRP后每周局部应用4次盐酸米诺环素凝胶(派丽奥)(试验组,N = 42)。在基线、21天、2、3和6个月时检查牙周袋深度、CAL和龈乳头出血指数。用无菌刮匙收集龈下菌斑样本,并通过实时聚合酶链反应分析在基线、2、3和6个月时三种牙周病原体(牙龈卟啉单胞菌、具核梭杆菌和齿垢密螺旋体)的存在情况。
在基线(SRP治疗)后2个月时,两组中的细菌数量均减少。试验组中齿垢密螺旋体和具核梭杆菌数量的变化(2 - 6个月)显著低于对照组。在对照组中,观察到牙龈卟啉单胞菌、具核梭杆菌和齿垢密螺旋体在2至6个月时有显著的再生长,牙龈卟啉单胞菌和具核梭杆菌在3至6个月时有显著的再生长。另一方面,在试验组中,这三种细菌的数量在6个月期间没有显著增加。
结果表明,盐酸米诺环素局部应用作为SRP的辅助手段,对于抑制牙周病原体的再生长是有效的,提示其可降低CP中牙周病原体复发的风险。