Jung DongYeol, Cha Jae-Kook, Kim Young-Taek, Kim Chang-Sung
Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
Department of Periodontology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
J Periodontal Implant Sci. 2024 Jun;54(3):149-160. doi: 10.5051/jpis.2300800040. Epub 2023 Sep 11.
The objective of this retrospective clinical study was to provide evidence supporting the adjunctive local application of doxycycline solution or minocycline ointment, in conjunction with drainage, for the treatment of acute periodontal abscesses.
The study included 63 patients who had received treatment for acute periodontal abscesses through drainage supplemented with 1 of 3 types of adjunctive medications during their initial visit (visit 1; baseline): 1) saline irrigation (the control group), 2) 2% minocycline ointment (the TM group), or 3) 300 mg/mL doxycycline irrigation (the TD group). The same adjunctive medication was administered at visit 2, which took place 1 week after visit 1. Probing depth (PD), bleeding on probing (BOP), plaque index, gingival recession, clinical attachment level, and tooth mobility were clinically evaluated at visits 1, 2, and a third visit (visit 3; 4 weeks after visit 1). Statistical significance was considered to be indicated by values <0.05.
By visit 3, all clinical indices and tooth mobility had significantly decreased in each group. At this visit, PD and BOP on the abscess side were significantly lower in the TM and TD groups compared to the control group. The TD group showed a significantly greater improvement than the TM group, with mean PD reductions of 1.09 mm in the control group, 1.88 mm in the TM group, and 2.88 mm in the TD group. Similarly, mean BOP reductions were 45% in the control group, 73.02% in the TM group, and 95.45% in the TD group.
Local and adjunctive administration of doxycycline and minocycline in combination with drainage exhibited clinical advantages over drainage alone in improving PD and BOP. Notably, a doxycycline solution of 300 mg/mL was more effective than a 2% minocycline ointment.
这项回顾性临床研究的目的是提供证据，支持在引流的基础上局部应用强力霉素溶液或米诺环素软膏，用于治疗急性期牙周脓肿。
该研究纳入了63例在首次就诊（就诊1；基线）时接受过通过引流加三种辅助药物之一治疗急性牙周脓肿的患者：1）生理盐水冲洗（对照组），2）2%米诺环素软膏（TM组），或3）300mg/mL强力霉素冲洗（TD组）。在就诊1后1周的就诊2时给予相同的辅助药物。在就诊1、2和第三次就诊（就诊3；就诊1后4周）时对探诊深度（PD）、探诊出血（BOP）、菌斑指数、牙龈退缩、临床附着水平和牙齿松动度进行临床评估。P值<0.05被认为具有统计学意义。
到就诊3时，每组的所有临床指标和牙齿松动度均显著降低。在此次就诊时，TM组和TD组脓肿侧的PD和BOP显著低于对照组。TD组的改善明显大于TM组，对照组的平均PD降低1.09mm，TM组为1.88mm，TD组为2.88mm。同样，对照组的平均BOP降低45%，TM组为73.02%，TD组为95.45%。
强力霉素和米诺环素局部辅助给药联合引流在改善PD和BOP方面比单纯引流具有临床优势。值得注意的是，300mg/mL的强力霉素溶液比2%的米诺环素软膏更有效。
