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不同牙周治疗对改变牙周炎患者龈下生物膜中古菌的患病率和水平的影响:一项随机对照临床试验的二次分析。

Effects of different periodontal treatments in changing the prevalence and levels of Archaea present in the subgingival biofilm of subjects with periodontitis: A secondary analysis from a randomized controlled clinical trial.

作者信息

Ramiro F S, de Lira Eag, Soares Gms, Retamal-Valdes B, Feres M, Figueiredo L C, Faveri M

机构信息

Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Brazil.

出版信息

Int J Dent Hyg. 2018 Nov;16(4):569-575. doi: 10.1111/idh.12347. Epub 2018 May 23.

Abstract

OBJECTIVE

The aim of this randomized double-blind and placebo-controlled study was to assess if periodontal treatment with or without systemic antibiotic would change the mean level of Archaea.

METHODS

Fifty-nine (59) subjects were randomly assigned to receive scaling and root planing (SRP) alone or combined with metronidazole (MTZ; 400 mg/TID) or either with MTZ and amoxicillin (AMX; 500 mg/TID) for 14 days. Clinical and microbiological examinations were performed at baseline and at 6 months post-SRP. Six subgingival plaque samples per subject were analysed for the presence and levels of Archaea using quantitative polymerase chain reaction.

RESULTS

Scaling and root planing alone or combined with MTZ or MTZ + AMX significantly reduced the prevalence of subjects colonized by Archaea at 6 months post-therapy, without significant differences among groups (P > .05). Both therapies led to a statistically significant decrease in the mean percentage of sites colonized by Archaea (P < .05). The MTZ and MTZ + AMX group had a significantly lower mean number of sites colonized by Archaea and lower levels of these micro-organisms at sites with probing depth ≥5 mm at 6 months compared with SRP group (P < .05).

CONCLUSION

Periodontal treatments including adjunctive MTZ or MTZ + AMX are more effective than mechanical treatment alone in reducing the levels and prevalence of sites colonized by Archaea in subjects with chronic periodontitis.

摘要

目的

本随机双盲安慰剂对照研究旨在评估单纯牙周治疗或联合全身应用抗生素是否会改变古菌的平均水平。

方法

59名受试者被随机分配接受单纯龈下刮治术和根面平整术(SRP),或联合甲硝唑(MTZ;400mg/每日三次),或联合MTZ和阿莫西林(AMX;500mg/每日三次),为期14天。在基线时和SRP后6个月进行临床和微生物学检查。使用定量聚合酶链反应分析每位受试者的6份龈下菌斑样本中古菌的存在情况和水平。

结果

单纯龈下刮治术和根面平整术,或联合MTZ或MTZ + AMX治疗后6个月,均显著降低了被古菌定植的受试者比例,各治疗组间无显著差异(P > 0.05)。两种治疗方法均使被古菌定植的位点平均百分比有统计学意义的下降(P < 0.05)。与SRP组相比,MTZ组和MTZ + AMX组在治疗6个月时,探诊深度≥5mm位点的古菌定植平均位点数量显著更低,且这些微生物的水平也更低(P < 0.05)。

结论

在慢性牙周炎患者中,包括辅助使用MTZ或MTZ + AMX的牙周治疗在降低古菌定植位点的水平和比例方面比单纯机械治疗更有效。

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