Periodontol 2000. 2017 Oct;75(1):330-352. doi: 10.1111/prd.12159.
Supportive periodontal care is a crucial aspect of the management of chronic periodontitis and peri-implantitis and is inevitably a long-term commitment for both the clinician and the patient. The principal goals of supportive care are to achieve a high standard of plaque control, minimize bleeding and maintain pockets at less than 6 mm. Gain of attachment around natural teeth during supportive periodontal care has been reported, although gain of attachment and of bone during supportive care may be a more pragmatic and aspirational aim in the longer term. Furthermore, we occasionally see patients for whom, despite excellent home and professional care (surgical or nonsurgical), including the management of risk factors, supportive periodontal care appears to be failing and therefore for such patients the clinician needs to consider further management options. This review considers, in particular, the options of using local or systemically delivered antimicrobials to eradicate periodontal and peri-implant disease progression and discusses the extent to which culture and sensitivity testing before the prescription of systemically delivered antimicrobials may be a cost-effective alternative to prescribing 'blind'.
支持性牙周治疗是慢性牙周炎和种植体周围炎管理的重要方面，对于临床医生和患者来说，这不可避免地是一项长期的承诺。支持性护理的主要目标是达到高标准的菌斑控制，最大限度地减少出血，并将牙周袋保持在 6 毫米以下。据报道，在支持性牙周治疗期间，天然牙周围会有附着丧失，但在较长时间内，附着和骨的获得可能是更实际和理想的目标。此外，我们偶尔会看到一些患者，尽管接受了良好的家庭和专业护理（包括手术或非手术治疗），包括管理风险因素，但支持性牙周治疗似乎仍在失败，因此对于这些患者，临床医生需要考虑进一步的治疗选择。这篇综述特别考虑了使用局部或全身给予抗菌药物来消除牙周炎和种植体周围炎的疾病进展的选择，并讨论了在开具全身给予的抗菌药物之前进行培养和药敏试验是否可以作为一种比盲目开具药物更具成本效益的替代方案。
