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非手术性牙周治疗前的专业洁牙:一项随机临床试验。

Professional tooth cleaning prior to non-surgical periodontal therapy: A randomized clinical trial.

机构信息

Center for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Leipzig, Germany.

Private Dental Practice, Drei Gleichen, Germany.

出版信息

J Periodontol. 2020 Feb;91(2):174-182. doi: 10.1002/JPER.19-0023. Epub 2019 Sep 15.

Abstract

BACKGROUND

This study was aimed to investigate if professional oral prophylaxis before scaling and root planing (SRP) has an effect on the outcome of non-surgical periodontal treatment in patients with chronic periodontitis.

METHODS

Fifty-two individuals with chronic periodontitis receiving non-surgical periodontal therapy by SRP with (test) and without (control) two appointments of professional tooth cleaning but with motivation and instruction were monitored for clinical variables, four selected microorganisms and two biomarkers at baseline, before SRP as well as 3 and 6 months after SRP. Statistical analysis included non-parametric tests for intra- and intergroup comparisons.

RESULTS

Probing depth (PD), attachment level, bleeding on probing (BOP), and interproximal plaque index (API) were significantly improved in both groups 3 and 6 months after SRP. PD, BOP, API, and the number of sites with PD ≥5 mm were significantly lower in the test group than in the control group at the appointment immediately before SRP. Tannerella forsythia was significantly reduced in both groups at 3 and 6 months, Porphyromonas gingivalis only in the test group. Interleukin-1β was significantly reduced in the control group 3 and 6 months after SRP, matrix metalloproteinase-8 level decreased in the test group 3 months after SRP. There was no significant difference of any clinical and non-clinical variable between both groups at 3 and 6 months after SRP.

CONCLUSIONS

Professional tooth cleaning before the SRP does not improve the clinical results of the SRP. It has no obvious long-lasting effects on major periodontopathogens in the subgingival biofilm as well as on biomarkers in the gingival crevicular fluid after SRP.

摘要

背景

本研究旨在探讨在接受龈下刮治和根面平整(SRP)非手术牙周治疗的慢性牙周炎患者中,专业口腔洁治在 SRP 之前是否会影响牙周治疗的效果。

方法

52 名患有慢性牙周炎的患者接受了 SRP 非手术牙周治疗,其中(试验组)在 SRP 前有两次专业洁牙,(对照组)没有,但接受了动机和指导,在基线、SRP 前、SRP 后 3 个月和 6 个月时监测临床变量、四种选定的微生物和两种生物标志物。统计分析包括非参数检验用于组内和组间比较。

结果

SRP 后 3 个月和 6 个月时,两组的探诊深度(PD)、附着水平、探诊出血(BOP)和探诊龈下菌斑指数(API)均显著改善。在 SRP 前的预约中,试验组的 PD、BOP、API 和 PD≥5mm 的位点数量均显著低于对照组。两组在 3 个月和 6 个月时,福赛坦纳菌的数量均显著减少,只有试验组的牙龈卟啉单胞菌数量减少。对照组在 SRP 后 3 个月和 6 个月时白细胞介素-1β水平显著降低,试验组在 SRP 后 3 个月时基质金属蛋白酶-8水平降低。SRP 后 3 个月和 6 个月时,两组间无任何临床和非临床变量的差异有统计学意义。

结论

在 SRP 之前进行专业洁治并不能改善 SRP 的临床效果。它对龈下生物膜中的主要牙周致病菌以及 SRP 后龈沟液中的生物标志物没有明显的长期影响。

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