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辅助光活化消毒和益生菌对牙周治疗中临床及微生物学参数的影响:一项随机对照临床试验研究

Effects of adjunctive light-activated disinfection and probiotics on clinical and microbiological parameters in periodontal treatment: a randomized, controlled, clinical pilot study.

作者信息

Patyna Michael, Ehlers Vicky, Bahlmann Benjamin, Kasaj Adrian

机构信息

Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.

出版信息

Clin Oral Investig. 2021 Jun;25(6):3967-3975. doi: 10.1007/s00784-020-03727-1. Epub 2021 Feb 4.

Abstract

OBJECTIVES

The aim of this pilot study was to evaluate the clinical and microbiological outcomes of light-activated disinfection (LAD) alone or combined with probiotics as an adjunct to non-surgical periodontal treatment.

MATERIALS AND METHODS

In this single-blinded, randomized, controlled clinical pilot study, 48 patients (28 females and 20 males) with untreated periodontitis (stages II and III, grade B) were included. Using a parallel-group design, patients were randomly assigned into 3 groups to receive subgingival debridement (SD) alone (group 1, n = 16), SD with LAD (group 2, n = 16), or SD with LAD plus probiotic treatment (group 3, n = 16). Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), gingiva-index simplified (GIs), plaque-control record (PCR), and subgingival microbiological samples were analyzed at baseline, 3 months, and 6 months of follow-up.

RESULTS

All treatment modalities demonstrated clinical improvements in PPD and CAL at 6 months compared to baseline but without a statistical significant difference between the groups. The combination of SD + LAD + probiotic treatment (group 3) demonstrated significantly greater reductions in BOP, GIs, and red complex bacteria P. gingivalis and T. forsythia compared with other groups at 6 months (p < 0.05).

CONCLUSIONS

A single application of LAD as an adjunct to SD provided no additional clinical and microbiological benefits compared to SD alone. The combination of SD + LAD + probiotic treatment in group 3 led to further improvements of the inflammatory parameters.

CLINICAL RELEVANCE

The additional use of probiotics in periodontal treatment can be a useful approach to support inflammation and infection control of periodontal tissues. Further studies are necessary to determine the extent of added benefit for this treatment approach.

摘要

目的

本初步研究的目的是评估单独使用光活化消毒(LAD)或联合益生菌作为非手术牙周治疗辅助手段的临床和微生物学效果。

材料与方法

在这项单盲、随机、对照临床初步研究中,纳入了48例未经治疗的牙周炎患者(28例女性和20例男性,II期和III期,B级)。采用平行组设计,将患者随机分为3组,分别接受单纯龈下刮治(SD)(第1组,n = 16)、SD联合LAD(第2组,n = 16)或SD联合LAD加益生菌治疗(第3组,n = 16)。在基线、随访3个月和6个月时,分析探诊深度(PPD)、临床附着水平(CAL)、探诊出血(BOP)、简化牙龈指数(GIs)、菌斑控制记录(PCR)和龈下微生物样本。

结果

与基线相比,所有治疗方式在6个月时PPD和CAL均有临床改善,但各组之间无统计学显著差异。与其他组相比,SD + LAD +益生菌治疗组合(第3组)在6个月时BOP、GIs以及红色复合体细菌牙龈卟啉单胞菌和福赛坦氏菌的减少更为显著(p < 0.05)。

结论

与单独使用SD相比,单次应用LAD作为SD的辅助手段未提供额外的临床和微生物学益处。第3组中SD + LAD +益生菌治疗组合使炎症参数进一步改善。

临床相关性

在牙周治疗中额外使用益生菌可能是支持牙周组织炎症和感染控制的一种有用方法。需要进一步研究来确定这种治疗方法的额外益处程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d561/8137479/624730423d84/784_2020_3727_Fig1_HTML.jpg

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