1 Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.
2 Department of Applied Life Science, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, South Korea.
J Dent Res. 2019 Mar;98(3):288-295. doi: 10.1177/0022034518818479. Epub 2019 Jan 9.
The purpose of this study was to determine the clinical, microbial, and radiographic effects of local minocycline combined with surgical treatment of peri-implantitis. Fifty patients with peri-implantitis were recruited, and surgical treatment with the local application of either minocycline or placebo ointment was performed. The application of minocycline was repeated with supragingival debridement at 1, 3, and 6 mo postoperatively. Plaque index, gingival index (GI), probing pocket depth (PPD), and bleeding/suppuration on probing were measured at baseline and 1-, 3-, and 6-mo evaluations. The change in supporting bone level (SBL) measured with cone beam computed tomography was analyzed between baseline and 6 mo. Microbial analysis was performed with real-time polymerase chain reaction. Both groups exhibited improvements in clinical and radiographic measurements after surgical treatment. There was a significant difference in the changes of mean PPD between the test and control groups (2.68 ± 1.73 and 1.55 ± 1.86 mm, respectively, P = 0.039). The changes of mean GI and SBL differed significantly between the groups (ΔGI: 0.83 ± 0.60 and 0.40 ± 0.68; ΔSBL: 0.72 ± 0.56 and 0.31 ± 0.49 mm, respectively, P = 0.026 and 0.014). Treatment success rates (defined as PPD <5 mm, absence of bleeding/suppuration on probing, and no further bone loss) were 66.7% and 36.3% in the test and control groups, respectively. The count of red complex bacteria tended to decrease in both groups until 6 mo; however, no significant intergroup difference was found. None of the patients in the test group carried Porphyromonas gingivalis or Tannerella forsythia at 6 mo. These findings indicate that the repeated local delivery of minocycline combined with surgical treatment provides significant benefits in terms of clinical parameters and radiographic bone fill, with a higher treatment success rate in the short healing period (cris.nih.go.kr KCT0002844).
本研究旨在探讨局部米诺环素联合手术治疗种植体周围炎的临床、微生物和影像学效果。共招募了 50 例种植体周围炎患者，分别采用局部应用米诺环素或安慰剂软膏进行手术治疗。术后 1、3 和 6 个月时，在进行龈上洁治术的同时重复应用米诺环素。在基线和术后 1、3 和 6 个月时，测量菌斑指数、牙龈指数（GI）、探诊深度（PPD）和探诊出血/溢脓。采用锥形束 CT 分析基线至 6 个月时支持骨水平（SBL）的变化。采用实时聚合酶链反应进行微生物分析。两组患者在手术治疗后临床和影像学测量均有改善。试验组和对照组的平均 PPD 变化差异有统计学意义（分别为 2.68 ± 1.73 和 1.55 ± 1.86 mm，P = 0.039）。两组间平均 GI 和 SBL 的变化差异有统计学意义（ΔGI：0.83 ± 0.60 和 0.40 ± 0.68；ΔSBL：0.72 ± 0.56 和 0.31 ± 0.49 mm，P = 0.026 和 0.014）。试验组和对照组的治疗成功率（定义为 PPD<5 mm、探诊无出血/溢脓和无进一步骨丢失）分别为 66.7%和 36.3%。两组的红色复合体细菌计数均呈下降趋势，但组间差异无统计学意义。试验组患者在第 6 个月时均未检出牙龈卟啉单胞菌或福赛斯坦纳菌。这些结果表明，重复局部给予米诺环素联合手术治疗在临床参数和影像学骨填充方面具有显著益处，在短期愈合期内具有更高的治疗成功率（cris.nih.go.kr KCT0002844）。
