Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11 8032, Zurich, Switzerland.
Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Clin Oral Investig. 2020 Mar;24(3):1091-1100. doi: 10.1007/s00784-020-03198-4. Epub 2020 Jan 15.
Gingival recessions inevitably occur during healing after scaling and root planing, but synoptic data on this topic is still lacking. This review compared the recession formation with and without the administration of systemic antibiotics.
To evaluate the formation of recession with and without the administration of antibiotics during the healing after scaling and root planing.
This study re-analyzed publications that reported clinical attachment levels (CAL) and probing pocket depths (PD) up to January 2019, including the pivotal review by Zandbergen and co-workers (2013). Whereas these studies traditionally focused on PD and CAL, the present analysis compared recession formation (ΔREC) after adjunctive systemic administration of amoxicillin (amx) and metronidazole (met) during scaling and root planing (SRP) and SRP alone. The mean increase in ΔREC, if not reported, was calculated from CAL and PD values and statistically analyzed. Recession formation was compared after 3 and 6 months after therapy. Results were separately reported for chronic periodontitis (CP) as well as aggressive periodontitis (AP) cases.
Recessions increased consistently between baseline and follow-up. In the AP group, median ΔREC was 0.20 mm after 3 months, irrespective of whether antibiotics were administered or not. After 6 months, median ΔREC increased to 0.35 mm after AB and remained stable at 0.20 mm with SRP alone. In the CP group, after 3 months with and without antibiotics, median ΔREC accounted for 0.30 mm and 0.14 mm, respectively. After 6 months, median ΔREC accounted for 0.28 mm (with AB) and 0.20 mm (without AB). The quantitative assessment by meta-analyses also yielded small values (≤ 0.25 mm) for the estimated differences in recession formation between AB and noAB; however, none of them reached statistical significance.
Although a slight tendency towards higher recession formation after SRP in combination with AB could be observed in many studies, quantitative meta-analyses showed no clinically relevant difference in recession formation due to the administration of AB. In general, the description and discussion of recessions in the literature seems not to be a major focus so far.
Since the preservation of gingival tissues is important by preventive and therapeutic means, e.g., when avoiding postoperative root sensitivity or performing regenerative surgery, these aspects should not be neglected. We thus suggest to report REC measurements along with PD and CAL values for more direct recession formation (ΔREC) assessments in the future.
在牙周刮治和根面平整后，牙龈退缩不可避免，但目前仍缺乏这方面的综合数据。本综述比较了在牙周刮治和根面平整过程中应用全身抗生素与不应用抗生素后，牙龈退缩的形成情况。
评估牙周刮治和根面平整后应用和不应用抗生素时的牙龈退缩形成情况。
本研究重新分析了截至 2019 年 1 月发表的报告临床附着水平（CAL）和探诊深度（PD）的文献，其中包括 Zandbergen 等人的关键性综述（2013 年）。这些研究传统上侧重于 PD 和 CAL，而本分析比较了牙周刮治和根面平整（SRP）过程中附加全身应用阿莫西林（amx）和甲硝唑（met）与单独 SRP 后（ΔREC）的牙龈退缩形成情况。如果未报告，则从 CAL 和 PD 值计算并统计分析 ΔREC 的平均增加。分别报告了慢性牙周炎（CP）和侵袭性牙周炎（AP）病例 3 个月和 6 个月后的结果。
基线至随访时，牙龈退缩持续增加。在 AP 组中，3 个月时无论是否使用抗生素，中位数 ΔREC 为 0.20mm。6 个月时，AB 后中位数 ΔREC 增加至 0.35mm，单独 SRP 时稳定在 0.20mm。CP 组中，3 个月时使用和不使用抗生素的中位数 ΔREC 分别为 0.30mm 和 0.14mm。6 个月时，中位数 ΔREC 分别为 0.28mm（AB）和 0.20mm（无 AB）。荟萃分析的定量评估也表明，AB 和无 AB 之间的牙龈退缩形成差异估计值较小（≤0.25mm）；但均无统计学意义。
尽管许多研究中观察到在 SRP 联合 AB 治疗后牙龈退缩形成有轻微的趋势，但定量荟萃分析表明，由于应用 AB，牙龈退缩形成没有临床相关差异。总的来说，到目前为止，文献中对牙龈退缩的描述和讨论似乎不是一个主要关注点。
由于通过预防性和治疗性手段（例如避免术后根敏感或进行再生性手术）保存牙龈组织很重要，因此不应忽视这些方面。因此，我们建议在未来的研究中，除了报告 PD 和 CAL 值外，还应报告 REC 测量值，以便更直接地评估牙龈退缩形成情况（ΔREC）。
