局部给予强力霉素对牙周再生前骨内缺损临床和分子炎症状态的影响：一项双盲随机对照试验。

Influence of locally delivered doxycycline on the clinical and molecular inflammatory status of intrabony defects prior to periodontal regeneration: A double-blind randomized controlled trial.

机构信息

Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.

Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.

出版信息

J Periodontal Res. 2023 Oct;58(5):1096-1104. doi: 10.1111/jre.13174. Epub 2023 Aug 8.

DOI:10.1111/jre.13174

PMID:37553767

Abstract

OBJECTIVES

To test the effect of locally delivered doxycycline (DOX) administered 2 weeks prior to minimally invasive periodontal regeneration in terms of presurgical inflammatory status and cytokine expression profile in the gingival crevicular fluid (GCF). Secondary aim was to assess the early wound healing index (EHI) at 2 weeks after surgery.

BACKGROUND

It is hypothesized that healing after periodontal regeneration is dependent on preoperative soft tissue condition, and that local antibiotics may improve the site-specific inflammatory status at short time.

METHODS

Sites associated with periodontal intrabony defects requiring regenerative surgery and showing bleeding on probing (BoP) were included. At T0, experimental sites were randomly treated with subgingival instrumentation with or without topic DOX application. After 2 weeks (T1), defects were approached by means of minimally invasive surgical technique. GCF was sampled at both T0 and T1 for inflammatory biomarker analysis. Two weeks after surgery, the EHI was evaluated (T2).

RESULTS

Forty-four patients were included. At T1, the number of BoP+ sites was statistically significantly less in the test group (27.3% vs. 72.7%; p < .01). The total amount of interleukin (IL)-1β (p < .001), matrix-metalloproteinases (MMP)-8 (p < .001), and MMP-9 (p = .010) in the GCF significantly decreased in the test group at T1, with relevant differences compared to controls. At T2, the EHI had an average value of 1.45 ± 0.86 in the test group while in the control, it was 2.31 ± 1.43 (p = .027). A statistically significantly positive correlation was observed between the amount of IL-1β and MMP-9 and EHI scores.

CONCLUSIONS

Within the limitations of this study, sites treated with DOX showed improved clinical and molecular inflammatory parameters before surgery, as well as soft tissue healing 2 weeks after surgery.

摘要

目的

检测在微创牙周再生术前 2 周局部给予强力霉素（DOX）对龈沟液（GCF）中术前炎症状态和细胞因子表达谱的影响。次要目的是评估术后 2 周时的早期伤口愈合指数（EHI）。

背景

假设牙周再生后的愈合取决于术前软组织状况，局部抗生素可能会在短时间内改善特定部位的炎症状态。

方法

纳入与牙周内骨缺损相关且探诊出血（BoP）的位点。在 T0 时，实验组随机接受龈下器械治疗和/或局部 DOX 应用。2 周后（T1），采用微创外科技术处理缺损。在 T0 和 T1 时采集 GCF 样本进行炎症生物标志物分析。术后 2 周评估 EHI（T2）。

结果

共纳入 44 名患者。在 T1 时，实验组 BoP+位点的数量明显少于对照组（27.3%比 72.7%；p<0.01）。实验组 GCF 中白细胞介素（IL）-1β（p<0.001）、基质金属蛋白酶（MMP）-8（p<0.001）和 MMP-9（p=0.010）的总量在 T1 时显著降低，与对照组相比有显著差异。在 T2 时，实验组 EHI 的平均得分为 1.45±0.86，而对照组为 2.31±1.43（p=0.027）。IL-1β和 MMP-9的量与 EHI 评分之间存在显著正相关。