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微创非手术治疗(MINST)在牙周炎 III 期患者中的应用:一项随机对照临床试验的 6 个月结果。

Minimally invasive non-surgical therapy (MINST) in stage III periodontitis patients: 6-month results of a split-mouth, randomised controlled clinical trial.

机构信息

Public Health Centre Celje, Gregorčičeva 5, 3000, Celje, Slovenia.

Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski Trg 6, 1000, Ljubljana, Slovenia.

出版信息

Clin Oral Investig. 2023 May;27(5):2075-2087. doi: 10.1007/s00784-023-04994-4. Epub 2023 Apr 4.

Abstract

OBJECTIVES

To determine if minimally invasive non-surgical therapy (MINST) outperforms classical non-surgical periodontal therapy for stage III periodontitis with primarily suprabony (horizontal) type defects.

MATERIALS AND METHODS

In a split-mouth randomised controlled trial, 20 patients' dental quadrants were randomly assigned to MINST or classical non-surgical treatment. The primary outcome variable was the number of sites with probing pocket depth ≥ 5 mm and BOP. Treatment method, tooth type, smoking status, and gender were evaluated using a multivariate multilevel logistic regression model.

RESULTS

After 6 months, the percentage of sites with PD ≥ 5 mm and BOP that healed (MINST = 75.5%; control group = 74.1%; p = 0.98), and the median number of persisting sites (MINST: 6.5, control group: 7.0; p = 0.925) were similar in both groups. In the test and control groups, respectively, median probing pocket depths (2.0 mm vs. 2.1 mm) and clinical attachment level (1.7 mm vs. 2.0 mm) changed significantly (p < 0.05) but similarly. Significantly less gingival recession occurred in the MINST group's deep molar pockets compared to the control group (p = 0.037). Men (OR = 0.52, p = 0.014) and non-molars (OR = 3.84, p 0.001) had altered odds for healing of sites with PD ≥ 5 mm and BOP.

CONCLUSIONS

MINST reduces gingival recession associated with molar teeth, although it performs similarly to traditional non-surgical therapy in treating stage III periodontitis with predominately horizontal-type defects.

CLINICAL RELEVANCE

MINST performs similarly to non-surgical periodontal therapy in stage III periodontitis with predominantly suprabony defects.

TRIAL REGISTRATION

Clinicaltrials.gov (NCT04036513) on June 29, 2019.

摘要

目的

确定微创非手术治疗(MINST)是否优于传统非手术牙周治疗,用于治疗主要为超骨(水平)型缺损的 III 期牙周炎。

材料和方法

在一项分侧随机对照试验中,将 20 名患者的牙弓象限随机分配至 MINST 或经典非手术治疗。主要结局变量是探诊袋深度≥5mm 和探诊出血(BOP)的位点数量。使用多变量多级逻辑回归模型评估治疗方法、牙齿类型、吸烟状况和性别。

结果

6 个月后,MINST 组 PD≥5mm 和 BOP 愈合的位点百分比(MINST=75.5%;对照组=74.1%;p=0.98)和持续存在的位点中位数(MINST:6.5,对照组:7.0;p=0.925)在两组之间相似。MINST 组和对照组的探诊袋深度中位数(2.0mm 与 2.1mm)和临床附着水平中位数(1.7mm 与 2.0mm)均显著变化(p<0.05),但相似。MINST 组深磨牙袋的牙龈退缩明显少于对照组(p=0.037)。男性(OR=0.52,p=0.014)和非磨牙(OR=3.84,p<0.001)的位点 PD≥5mm 和 BOP 愈合的可能性改变。

结论

MINST 减少了与磨牙相关的牙龈退缩,尽管在治疗主要为水平型缺损的 III 期牙周炎方面,MINST 的表现与传统非手术治疗相似。

临床相关性

MINST 在治疗主要为超骨缺损的 III 期牙周炎时,与非手术牙周治疗的表现相似。

试验注册

Clinicaltrials.gov(NCT04036513)于 2019 年 6 月 29 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b5f/10160166/30a2ecf3d86a/784_2023_4994_Fig1_HTML.jpg

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