Chin J Dent Res. 2021 Sep 7;24(3):191-198. doi: 10.3290/j.cjdr.b1965015.
To investigate various factors affecting the clinical outcome of nonsurgical periodontal treatment and evaluate the treatment effects of adjunctive amoxicillin and metronidazole (AMX + MET) in patients with generalised aggressive periodontitis (GAgP).
Forty-two patients with GAgP were recruited and randomly assigned to three groups: scaling and root planing (SRP) only, AMX + MET after SRP, and AMX + MET during SRP. The patients were assessed every 2 months post-therapy. Periodontal clinical and subgingival microbiological parameters were analysed at baseline and 6 months post-therapy. The impacts of different covariates on pocket probing depth (PD) reduction were evaluated.
A multilevel analysis revealed that 58% of the variability in PD reduction was attributed to site-level parameters, 27.3% to patient-level parameters and 18.7% to tooth-level parameters. Greater PD reduction can be expected at initially deeper PD sites and sites with intrabony defects, and in patients with adjunctive use of AMX + MET. Persistent Tannerella forsythia infection and tooth mobility after treatment were negatively associated with PD reduction.
The clinical outcomes of nonsurgical periodontal treatment were mainly influenced by site-level parameters, and adjunctive use of AMX + MET can lead to better clinical results in patients with GAgP in a short time.
探讨影响非手术牙周治疗临床效果的各种因素，并评估阿莫西林和甲硝唑（AMX+MET）辅助治疗广泛性侵袭性牙周炎（GAgP）患者的疗效。
招募了 42 名 GAgP 患者，并将其随机分为三组：仅行牙周洁治和根面平整术（SRP）、SRP 后使用 AMX+MET、SRP 时使用 AMX+MET。治疗后每 2 个月评估一次患者。在基线和治疗后 6 个月时分析牙周临床和龈下微生物学参数。评估不同协变量对牙周袋探诊深度（PD）减少的影响。
多水平分析显示，PD 减少的可变性有 58%归因于位点水平参数，27.3%归因于患者水平参数，18.7%归因于牙齿水平参数。初始 PD 较深的位点和存在骨内缺损的位点以及辅助使用 AMX+MET 的患者，PD 减少幅度更大。治疗后持续存在福赛坦纳菌感染和牙齿松动与 PD 减少呈负相关。
非手术牙周治疗的临床效果主要受位点水平参数的影响，短期内辅助使用 AMX+MET 可使 GAgP 患者获得更好的临床效果。
