Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Programa de Biopatologia Bucal, Área de Periodontia, São José dos Campos, SP, Brasil.
Universidade de São Paulo (USP), Faculdade de Odontologia, Divisão de Periodontia, Departamento de Estomatologia, São Paulo, SP, Brasil.
J Appl Oral Sci. 2022 Mar 23;30:e20210583. doi: 10.1590/1678-7757-2021-0583. eCollection 2022.
This study assessed the efficacy of two adjunct therapies (antibiotic and probiotic) for periodontal treatment based on clinical and immunological parameters in patients with Stage II and III Grade B periodontitis.
45 patients were randomly allocated into three groups: control group (CG); antibiotic group (GAtb), in which 500 mg amoxicillin + 400 mg metronidazole were used; and probiotic group (GProb), for which Lactobacillus reuteri was used. Patients received medications after undergoing periodontal debridement. Clinical and immunological parameters were assessed at baseline, 30 days, and 90 days.
All therapies reduced bleeding on probing (BoP) in the evaluated periods, and the GAtb had a greater reduction at 90 days (p=0.03). The GProb group showed better results for plaque index (PI) and gingival recession (GR) compared to the GAtb at 90 days (p=0.0014; p=0.006). The area of inflammation (PISA Index) significantly decreased in all therapies in the evaluated periods. Therapies had no significant differences regarding moderate pockets. The GAtb had a greater reduction in probing depth (PD) for deep pockets (p=0.03) at 90 days and in the number of deep pocket sites at 30 days (p=0.04). The occurrence of adverse effects was commonly reported in the GAtb as a percentage per patient. The GAtb had a significant reduction in the concentration of interleukins IL-1β and IL-8 and an increase in IL-10 and TNF-α. The CG had a reduction in IL-6 and IL-1 β, whereas in the GProb there was no difference.
After three months, none of the adjuvant therapies provided any additional benefit for subgingival instrumentation.
本研究评估了两种辅助疗法（抗生素和益生菌）在患有 II 期和 III 级 B 型牙周炎的患者中基于临床和免疫参数的牙周治疗效果。
45 名患者被随机分配到三组：对照组（CG）；抗生素组（GAtb），使用 500mg 阿莫西林+400mg 甲硝唑；益生菌组（GProb），使用罗伊氏乳杆菌。患者在接受牙周清创术后使用药物。在基线、30 天和 90 天时评估临床和免疫参数。
所有治疗方法均减少了评估期间的探诊出血（BoP），而 GAtb 在 90 天时的减少更为明显（p=0.03）。GProb 组在 90 天时的菌斑指数（PI）和牙龈退缩（GR）方面优于 GAtb（p=0.0014；p=0.006）。在评估期间，所有治疗方法的炎症面积（PISA 指数）均显著减少。在中度袋方面，治疗方法之间无显著差异。GAtb 在 90 天时对深袋的探诊深度（PD）和深袋部位的数量有更大的减少（p=0.03），在 30 天时减少更明显（p=0.04）。GAtb 中报告了常见的不良反应，以每个患者的百分比表示。GAtb 显著降低了白细胞介素 IL-1β 和 IL-8 的浓度，增加了 IL-10 和 TNF-α的浓度。CG 降低了 IL-6 和 IL-1β，而 GProb 没有差异。
三个月后，辅助治疗方法对龈下器械治疗没有提供任何额外的益处。
