Addy M, Langeroudi M
J Clin Periodontol. 1984 Jul;11(6):379-86. doi: 10.1111/j.1600-051x.1984.tb01336.x.
In the management of chronic periodontitis, there has been a renewed interest in the local delivery of antimicrobial drugs into periodontal pockets. This study assessed the effects of the acrylic strip delivery system containing chlorhexidine, metronidazole or tetracycline on subgingival microflora assessed by dark field microscopy. Strips containing 40% chlorhexidine, metronidazole or tetracycline were placed for 2 to 3 days into pockets greater than 6 mm which bled on probing. Plaque samples were obtained before and after treatment and counts of morphological and motile groups of organisms were made by dark field microscopy. Prior to treatment, the dark field microscopic counts were similar to those previously reported for diseased sites with motile bacteria, in particular spirochaetes, present in high numbers. Following treatment, all 3 antimicrobial drugs produced a significant increase in the proportion of cocci and significant decreases in all other types of organisms. Motile organisms, in particular, were markedly reduced and spirochaetes could not be recovered from some sites treated with metronidazole and tetracycline. Metronidazole was significantly more effective than tetracycline or chlorhexidine on spirochaetes. The results indicate that acrylic strips may be useful in the management of chronic periodontitis as an adjunct to routine mechanical methods.
在慢性牙周炎的治疗中，局部将抗菌药物输送到牙周袋内再次引起了人们的关注。本研究评估了含氯己定、甲硝唑或四环素的丙烯酸条带输送系统对通过暗视野显微镜评估的龈下微生物群的影响。将含40%氯己定、甲硝唑或四环素的条带放置在探诊出血的大于6mm的牙周袋内2至3天。在治疗前后获取菌斑样本，并通过暗视野显微镜对生物体的形态和活动群体进行计数。治疗前，暗视野显微镜计数与先前报道的有活动细菌（特别是大量存在的螺旋体）的患病部位相似。治疗后，所有3种抗菌药物均使球菌比例显著增加，而所有其他类型的生物体显著减少。特别是活动生物体明显减少，在用甲硝唑和四环素治疗的一些部位无法检测到螺旋体。甲硝唑对螺旋体的作用明显优于四环素或氯己定。结果表明，丙烯酸条带作为常规机械方法的辅助手段，可能在慢性牙周炎的治疗中有用。
