克林霉素作为优化牙周治疗的替代选择。

Clindamycin as an Alternative Option in Optimizing Periodontal Therapy.

作者信息

Luchian Ionut, Goriuc Ancuta, Martu Maria Alexandra, Covasa Mihai

机构信息

Department of Periodontology, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania.

Department of Biochemistry, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania.

出版信息

Antibiotics (Basel). 2021 Jul 4;10(7):814. doi: 10.3390/antibiotics10070814.

Abstract

Periodontal disease is an oral infectious and inflammatory disease caused by microorganisms that determine the host-mediated destruction of soft and hard periodontal tissues, which ultimately leads to tooth loss. Periodontitis affects a large part of the population, with various degrees of severity. Treatment consists of etiologic therapy: the removal of biofilm through mechanical debridement plus microbial elimination by supplementary measures. Antibiotic administration, either systemically or through local delivery, has been shown to improve clinical outcomes after mechanical periodontal treatment. Clindamycin is a lincosamide with a broad spectrum, being active against aerobic, anaerobic, and β-lactamase-producing bacteria. This antibiotic offers several advantages and some disadvantages and has been used in periodontal treatment both systemically and locally with various degrees of success. Among the properties that recommend it for periodontal treatment is the bacteriostatic effect, the inhibition of bacterial proteins synthesis, the enhancement of neutrophil chemotaxis, phagocytosis and the oxidative burst-oxidative stress storm. Furthermore, it is easily absorbed at the level of oral tissues in a considerable amount. This substantial tissue penetration, especially inside the bone, is synergistic with a stimulating effect on the host immune system. The aim of this review is to explore the applicability of this antibiotic agent and to evaluate its antimicrobial potential and limitations at the level of the oral biofilm associated with periodontal disease.

摘要

牙周病是一种由微生物引起的口腔感染性和炎症性疾病,这些微生物会导致宿主介导的牙周软硬组织破坏,最终导致牙齿脱落。牙周炎影响着很大一部分人群,严重程度各不相同。治疗包括病因治疗:通过机械清创去除生物膜,并通过补充措施消除微生物。全身或局部应用抗生素已被证明可改善机械性牙周治疗后的临床效果。克林霉素是一种林可酰胺类抗生素,具有广谱抗菌活性,对需氧菌、厌氧菌及产β-内酰胺酶的细菌均有作用。这种抗生素有一些优点和缺点,已在牙周治疗中全身和局部使用,取得了不同程度的成功。推荐其用于牙周治疗的特性包括抑菌作用、抑制细菌蛋白质合成、增强中性粒细胞趋化性、吞噬作用以及氧化爆发(氧化应激风暴)。此外,它在口腔组织中能被大量吸收。这种显著的组织穿透性,尤其是在骨内,与对宿主免疫系统的刺激作用协同发挥效应。本综述的目的是探讨这种抗生素药物的适用性,并评估其在与牙周病相关的口腔生物膜水平上的抗菌潜力和局限性。

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