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广泛侵袭性牙周炎:非手术治疗中的微生物组成及临床参数

Generalized aggressive periodontitis: microbiological composition and clinical parameters in non-surgical therapy.

作者信息

Usin María M, Tabares Sandra M, Menso Julieta, de Albera Estela R, Sembaj Adela

机构信息

Periodontology B Department, School of Dentistry, National University of Cordoba, Argentina.

Biochemistry and Molecular Biology, School of Medical Science, National Universityof Cordoba, Argentina.

出版信息

Acta Odontol Latinoam. 2016 Dec;29(3):255-261.

Abstract

The aim of this study was to determine the variations in periodontal parameters and microbiological composition in periodontal pockets at the baseline and 3 and 6 months post treatmentin patients with Generalized Aggressive Periodontitis(GAP) undergoing non surgical periodontal treatment combined with chlorhexidine and systemic antibiotics. Medical and dental history was taken from 10 subjects, average age 30.6±2.7 years, diagnosed with GAP. A non surgical periodontal treatment combined with 0.12% chlorhexidine, 875 mg amoxicillin and 500 mg metronidazole every 12 hours for ten days was conducted. At each visit, the following measurements wererecorded: bacterial plaque (BP), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), hypermobility, and furcation lesions, and a sample of subgingivalplaque was taken from the site of the deepest probing depth of each sextant to identify Porphyromonas gingivalis, Treponemadenticola, Tannerella forsythia, Prevotella intermedia and Aggregatibacter actinomycetemcomitans using molecular biology techniques. After 6 months, the Wilcoxon test showed an increase of 0.97 mm in CAL (p=0.0047) and 2.54 mm in PD(p=0.009). A healthy site was defined as having a PD <5 mm, negative BOP and no pathogenic bacteria detected at 6 months, indicating significant improvement (p=0.008), with OR (95%CI) =4.7 (1.102220.11).With the treatment protocol used in this study, 6 months after treatment, patients had an approximately 4- fold higher possibility of presenting PD <5 mm and periodontal pockets without periodontal pathogenic bacteria.

摘要

本研究的目的是确定接受非手术牙周治疗联合洗必泰和全身用抗生素的广泛性侵袭性牙周炎(GAP)患者在基线、治疗后3个月和6个月时牙周袋内牙周参数和微生物组成的变化。收集了10名平均年龄为30.6±2.7岁、诊断为GAP的受试者的医学和牙科病史。进行了非手术牙周治疗,联合使用0.12%洗必泰、每12小时875毫克阿莫西林和500毫克甲硝唑,持续10天。每次就诊时,记录以下测量值:菌斑(BP)、探诊出血(BOP)、探诊深度(PD)、临床附着水平(CAL)、牙齿松动度和根分叉病变,并从每个象限最深探诊深度处采集龈下菌斑样本,使用分子生物学技术鉴定牙龈卟啉单胞菌、齿垢密螺旋体、福赛坦氏菌、中间普氏菌和伴放线聚集杆菌。6个月后,Wilcoxon检验显示CAL增加了0.97毫米(p=0.0047),PD增加了2.54毫米(p=0.009)。健康部位定义为6个月时PD<5毫米、BOP阴性且未检测到病原菌,表明有显著改善(p=0.008),OR(95%CI)=4.7(1.102220.11)。采用本研究中的治疗方案,治疗6个月后,患者出现PD<5毫米且牙周袋内无牙周病原菌的可能性大约高出4倍。

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