Boia Simina, Stratul Ştefan Ioan, Boariu Marius, Ursoniu Sorin, Goţia Smaranda Laura, Boia Eugen Radu, Borza Claudia
Department of Endodontics, Faculty of Dental Medicine, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania;
Rom J Morphol Embryol. 2018;59(4):1107-1113.
This study aims to evaluate the oxidative stress changes in patients with chronic periodontitis (CP) undergoing non-surgical periodontal therapy alone, compared with non-surgical periodontal therapy with adjunctive systemic antibiotic therapy. Sixteen patients with CP, randomly assigned into two equal groups, were treated either with scaling and root planing (SRP) + Amoxicillin + Metronidazole, each 500 mg, three times daily, for seven days (test group), or with SRP + placebo for seven days (control group). Venous blood and unstimulated saliva samples were collected. Non-surgical periodontal therapy was performed simultaneously with antibiotics administration. Oxidative stress balance was evaluated by measuring derivatives of reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) in plasma. After the microscopic evaluation of the pathological aspect of the epithelial cells (ECs), their number, viability and the presence of C-reactive protein (CRP) were reevaluated from saliva at seven days, while reduced glutathione (GSH) level, d-ROMs and BAP at three months. Wilcoxon and Kruskal-Wallis rank-tests were used for statistics. At three months, statistical significant reductions of mean periodontal pocket depth (PPD) and clinical attachment level (CAL) gains (both p=0.01) were found in test group. Full-mouth plaque score (FMPS) decreased statistically significant in control group (p=0.02), d-ROMs decreased statistically significant in test group (mean difference 116.24±107.6 U CARR, p=0.01). Mean GSH, BAP level, number of ECs, their viability and CRP were statistically non-significant. In test group patients, oxidative stress status changed from a very high level to a medium one, suggesting that adjunctive use of antibiotics could have contributed to the reduction of reactive oxygen metabolites, along with significant clinical improvements.
本研究旨在评估单纯接受非手术牙周治疗的慢性牙周炎（CP）患者与接受非手术牙周治疗并辅助全身抗生素治疗的患者的氧化应激变化。16例CP患者被随机分为两组，每组人数相等，一组接受龈上洁治和根面平整（SRP）+阿莫西林+甲硝唑治疗，各500mg，每日3次，共7天（试验组），另一组接受SRP+安慰剂治疗7天（对照组）。采集静脉血和非刺激性唾液样本。非手术牙周治疗与抗生素给药同时进行。通过测量血浆中活性氧代谢产物衍生物（d-ROMs）和生物抗氧化潜力（BAP）来评估氧化应激平衡。在对上皮细胞（ECs）的病理状况进行显微镜评估后，7天时从唾液中重新评估其数量、活力以及C反应蛋白（CRP）的存在情况，3个月时评估还原型谷胱甘肽（GSH）水平、d-ROMs和BAP。采用Wilcoxon和Kruskal-Wallis秩和检验进行统计学分析。3个月时，试验组的平均牙周袋深度（PPD）和临床附着水平（CAL）增益有统计学意义的降低（均p = 0.01）。对照组的全口菌斑评分（FMPS）有统计学意义的降低（p = 0.02），试验组的d-ROMs有统计学意义的降低（平均差值116.24±107.6 U CARR，p = 0.01）。平均GSH、BAP水平、ECs数量、其活力和CRP无统计学意义。试验组患者的氧化应激状态从非常高的水平变为中等水平，这表明抗生素的辅助使用可能有助于减少活性氧代谢产物，同时带来显著的临床改善。
