Oral Health Prev Dent. 2023 Aug 30;21:279-284. doi: 10.3290/j.ohpd.b4347453.
The adjunctive subgingival application of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid gels (high molecular weight) has been recently proposed as a novel modality to enhance the outcomes of non-surgical periodontal therapy. The aim of this prospective case series was to evaluate the clinical outcomes obtained following the subgingival application of a combination of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid (high molecular) gels in conjunction with non-surgical periodontal therapy.
Twenty-one systemically healthy, non-smoking patients diagnosed with stage II-III, grade A/B periodontitis underwent full-mouth subgingival debridement (SD) performed with ultrasonic and hand instruments. All sites with probing depths (PD) ≥ 4 mm were treated with additional repeated (i.e., 2-3 times) instillation of sodium hypochlorite/amino acid gel in the periodontal pockets prior to and during SRP. Following mechanical debridement, a mixture of natural and cross-linked hyaluronic acid (high molecular) gel was applied in the pockets. The primary outcome variable was PD reduction; changes in clinical attachment level (CAL) and bleeding on probing (BOP) were the secondary outcomes. The clinical parameters were assessed at baseline, 3 and 6 months after therapy.
Compared to baseline, a statistically significant mean reduction of PD values was obtained after 3 and 6 months, amounting to 2.6 ± 0.4 mm, and 2.9 ± 0.4 mm, respectively (p < 0.001). Mean CAL gain measured 2.3 ± 0.5 mm at 3 months and 2.6 ± 0.5 mm at 6 months in comparison to baseline (p < 0.001). Mean reduction of BOP values was 54.9 ± 16.9 % at 3 months and 65.6 ± 16.4 % at 6 months (p < 0.001). The number of moderate pockets (4-5 mm) decreased from 1808 at baseline to 274 at the 6-month evaluation, and the number of deep (≥ 6 mm) pockets dropped from 319 to 3, respectively.
The combination of sodium hypochlorite/amino acid and a mixture of natural and cross-linked hyaluronic acid (high molecular) adjunctive to subgingival debridement may represent a valuable approach to improve the outcomes of non-surgical periodontal treatment.
最近提出了一种将次氯酸钠/氨基酸和天然与交联透明质酸（高分子量）凝胶混合物联合应用于龈下的新方法，以增强非手术牙周治疗的效果。本前瞻性病例系列研究旨在评估在非手术牙周治疗中联合应用次氯酸钠/氨基酸和天然与交联透明质酸（高分子量）凝胶混合物后获得的临床效果。
21 名系统健康、不吸烟的患者被诊断为 II-III 期、A级/B 级牙周炎，接受了全口龈下刮治术（SD），采用超声和手动器械进行。所有探诊深度（PD）≥4mm 的部位均采用额外的重复（即 2-3 次）氯酸钠/氨基酸凝胶冲洗，在 SRP 之前和期间进行。机械清创后，在牙周袋中应用天然与交联透明质酸（高分子量）凝胶混合物。主要结局变量是 PD 减少；临床附着水平（CAL）和探诊出血（BOP）的变化为次要结局。治疗后 3 个月和 6 个月评估临床参数。
与基线相比，治疗后 3 个月和 6 个月时 PD 值的平均降低具有统计学意义，分别为 2.6±0.4mm 和 2.9±0.4mm（p<0.001）。与基线相比，3 个月时 CAL 平均增加 2.3±0.5mm，6 个月时增加 2.6±0.5mm（p<0.001）。BOP 值的平均降低率为 3 个月时 54.9±16.9%，6 个月时 65.6±16.4%（p<0.001）。中度（4-5mm）袋数从基线时的 1808 个减少到 6 个月时的 274 个，深度（≥6mm）袋数从 319 个减少到 3 个。
次氯酸钠/氨基酸与天然与交联透明质酸（高分子量）混合物联合应用于龈下清创可能是改善非手术牙周治疗效果的一种有价值的方法。
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