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盐酸米诺环素微球辅助龈下刮治和根面平整对牙周致病菌及临床效果的影响:一项随机临床试验。

Effect of scaling and root planing with and without minocycline HCl microspheres on periodontal pathogens and clinical outcomes: A randomized clinical trial.

机构信息

Department of Primary Dental Care, Division of Dental Hygiene, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA.

Department of Primary Dental Care, Division of Dental Therapy, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA.

出版信息

J Periodontol. 2023 Sep;94(9):1133-1145. doi: 10.1002/JPER.23-0002. Epub 2023 May 16.

Abstract

BACKGROUND

This study tests the effects of scaling and root planing (SRP) versus SRP plus minocycline hydrochloride microspheres (SRP+MM) on 11 periodontal pathogens and clinical outcomes in Stage II-IV Grade B periodontitis participants.

METHODS

Seventy participants were randomized to receive SRP (n = 35) or SRP+MM (n = 35). Saliva and clinical outcomes were collected for both groups at baseline before SRP, 1-month reevaluation, and at 3- and 6-month periodontal recall. MM were delivered to pockets ≥5 mm immediately after SRP and immediately after the 3-month periodontal maintenance in the SRP+MM group. A proprietary saliva test was utilized to quantitate 11 putative periodontal pathogens. Microorganisms and clinical outcomes were compared between groups using generalized linear mixed-effects models with fixed effects and random effects terms. Mean changes from baseline were compared between groups via group-by-visit interaction tests.

RESULTS

Significant reduction in Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia, Parvimonas micra, and Eikenella corrodens were identified at the 1-month reevaluation after SRP+MM. Six months after SRP with a re-application of MM 3 months after SRP, Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Eikenella corrodens were significantly reduced. SRP+MM participants had significant clinical outcome reductions in pockets ≥5 mm at the reevaluation, 3- and 6-month periodontal maintenance, and clinical attachment loss gains at the 6-month periodontal maintenance.

CONCLUSION

MM delivered immediately after SRP and reapplication at 3 months appeared to contribute to improved clinical outcomes and sustained decreased numbers of Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Eikenella corrodens at 6 months.

摘要

背景

本研究旨在测试牙周炎患者在接受牙周深度刮治(SRP)和 SRP 联合盐酸米诺环素微球(SRP+MM)治疗后,11 种牙周致病菌和临床疗效的变化。

方法

将 70 名患者随机分为 SRP 组(n=35)和 SRP+MM 组(n=35)。两组患者均在接受 SRP 治疗前、1 个月复查时以及 3 个月和 6 个月牙周维护时采集唾液样本和临床疗效数据。MM 被立即应用于 SRP 后和 3 个月牙周维护后≥5mm 的牙周袋中。采用专利唾液检测方法定量检测 11 种可疑牙周致病菌。采用固定效应和随机效应项的广义线性混合效应模型比较两组间的微生物和临床疗效。通过组间访视交互检验比较两组间的平均变化。

结果

SRP+MM 组在接受治疗 1 个月后,Tannerella forsythia、Treponema denticola、Fusobacterium nucleatum、Prevotella intermedia、Parvimonas micra 和 Eikenella corrodens 的数量显著减少。在 SRP 后 6 个月,再次应用 MM 3 个月后,Fusobacterium nucleatum、Prevotella intermedia、Campylobacter rectus 和 Eikenella corrodens 的数量显著减少。在复查、3 个月和 6 个月牙周维护以及 6 个月牙周维护时,SRP+MM 组的临床疗效显著改善,牙周袋深度≥5mm 显著减少,临床附着丧失显著增加。

结论

SRP 后立即应用 MM,并在 3 个月时再次应用,似乎有助于改善临床疗效,并在 6 个月时持续减少 Fusobacterium nucleatum、Prevotella intermedia、Campylobacter rectus 和 Eikenella corrodens 的数量。

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