Frandsen E V, Sander L, Arnbjerg D, Theilade E
Department of Oral Biology, Royal Dental College, Faculty of Health Sciences, University of Aarhus, Denmark.
J Periodontol. 1994 Oct;65(10):921-8. doi: 10.1902/jop.1994.65.10.921.
The bacteriological colonization of healing periodontal defects was investigated after treatment with guided tissue regeneration using expanded polytetrafluoroethylene membranes together with local metronidazole gel (25%, 250 mg/g). Twelve patients, each with one pair of comparable defects, had the test defect treated with the membrane plus metronidazole gel and the control defect treated with the membrane alone. Thirty weeks after removal of the membrane, the median gain in probing attachment level as a percentage of the initial defect depth was 92% for the test defects and 50% for the control defects (P = 0.001). The median number of cultivable bacteria decreased from 1.2 x 10(6) at the presurgical examination to 3.0 x 10(5) at the one week examination in the test group (P = 0.02), whereas an increase was observed in the control group. Similarly, a lower median proportion of black-pigmented Gram-negative anaerobic rods was observed one week postsurgically in the test group (0.004%) compared to the control group (3.5%) (P = 0.02). Two weeks after membrane insertion, and at all following examinations, no microbiological differences between test and control group were observed. Consequently, the influence of the metronidazole gel on the treatment result appears to have been confined to the initial regeneration phase. Despite the good clinical results in the test group, all membranes from both test and control pockets were heavily colonized with bacteria at the time of removal. To ensure maximal periodontal regeneration with formation of bone, future research in this area should concentrate on reducing the microbial colonization of the wound area.
采用膨体聚四氟乙烯膜联合局部甲硝唑凝胶（25%，250mg/g）进行引导组织再生治疗后，对愈合期牙周缺损的细菌定植情况进行了研究。12例患者，每人有一对可比较的缺损，试验缺损采用膜加甲硝唑凝胶治疗，对照缺损仅采用膜治疗。去除膜30周后，试验缺损的探诊附着水平增加量占初始缺损深度的百分比中位数为92%，对照缺损为50%（P = 0.001）。试验组可培养细菌的数量中位数从术前检查时的1.2×10⁶降至术后1周检查时的3.0×10⁵（P = 0.02），而对照组则观察到数量增加。同样，术后1周试验组黑色色素革兰氏阴性厌氧杆菌的比例中位数（0.004%）低于对照组（3.5%）（P = 0.02）。植入膜2周后及随后的所有检查中，试验组和对照组之间未观察到微生物学差异。因此，甲硝唑凝胶对治疗结果的影响似乎仅限于初始再生阶段。尽管试验组临床效果良好，但去除膜时试验组和对照组牙周袋内的所有膜均被大量细菌定植。为确保通过骨形成实现最大程度的牙周再生，该领域未来的研究应集中于减少伤口区域的微生物定植。
