Radvar M, Pourtaghi N, Kinane D F
Periodontal Unit, Adult Dental Care Department, Glasgow Dental Hospital and School, Scotland.
J Periodontol. 1996 Sep;67(9):860-5. doi: 10.1902/jop.1996.67.9.860.
The aim of this study was to evaluate the efficacy of 3 commercially available periodontal systems for local delivery of antibiotics as adjuncts to scaling and root planing in treatment of sites with persistent periodontal lesions following a course of scaling and root planing. Fifty-four patients with 4 pockets > or = 5 mm and bleeding on probing and/or suppuration were randomized in 4 treatment groups including: scaling and root planing plus application of 25% tetracycline fiber (S + Tet) (13 patients), scaling and root planing plus application of 2% minocycline gel (S + Min) (14 patients), scaling and root planing plus application of 25% metronidazole gel (S + Met) (14 patients), and scaling and root planing alone (S) (13 patients). Clinical measurements were taken at baseline and 6 weeks after the end of treatment periods. All treatments were applied using the distributors' recommended protocols and resulted in significant improvement in probing depth, attachment level, bleeding on probing and the modified gingival index (MGI) scores. The improvements in clinical parameters were greater in all three adjunctive treatment groups than scaling and root planing alone. The mean probing depth reductions were: S + Tet = 1.35 mm, S + Met = 0.95 mm, S + Min = 0.87 mm and S = 0.60 mm. The probing depth reduction was significantly greater in the scaling plus tetracycline fiber group than the scaling and root planing alone group (P = 0.002). The difference between groups in improvement of attachment level or bleeding on probing was not significant Scaling plus tetracycline fiber treatment resulted in the greatest reduction in the MGI scores which was significantly greater than all other groups. While the frequency of sites with suppuration was markedly reduced following all treatments, it reached zero in the scaling plus tetracycline fiber group. No serious adverse effects were observed or reported for any treatment. While all three locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regimen of scaling and root planing plus tetracycline fiber replacement gave the greatest advantage in the treatment of persistent periodontal lesions at least during the 6-week period following treatment.
本研究的目的是评估3种市售牙周治疗系统局部递送抗生素作为龈下刮治和根面平整辅助治疗手段，用于治疗经过一个疗程龈下刮治和根面平整后仍有持续性牙周损害部位的疗效。54例有4个牙周袋≥5mm且探诊出血和/或有溢脓的患者被随机分为4个治疗组，包括：龈下刮治和根面平整加用25%四环素纤维（S + Tet）（13例患者）、龈下刮治和根面平整加用2%米诺环素凝胶（S + Min）（14例患者）、龈下刮治和根面平整加用25%甲硝唑凝胶（S + Met）（14例患者），以及单纯龈下刮治和根面平整（S）（13例患者）。在基线时以及治疗期结束后6周进行临床测量。所有治疗均按照经销商推荐的方案进行，结果显示探诊深度、附着水平、探诊出血以及改良牙龈指数（MGI）评分均有显著改善。所有三个辅助治疗组临床参数的改善均大于单纯龈下刮治和根面平整组。平均探诊深度减少量分别为：S + Tet = 1.35mm，S + Met = 0.95mm，S + Min = 0.87mm，S = 0.60mm。加用四环素纤维的龈下刮治组探诊深度减少量显著大于单纯龈下刮治和根面平整组（P = 0.002）。各组间附着水平改善或探诊出血情况的差异不显著。加用四环素纤维的龈下刮治治疗使MGI评分降低幅度最大，显著大于所有其他组。虽然所有治疗后溢脓部位的频率均显著降低，但加用四环素纤维的龈下刮治组降至零。未观察到或报告任何治疗有严重不良反应。虽然所有三种局部应用抗菌系统似乎都比单纯龈下刮治和根面平整有一定优势，但至少在治疗后的6周内，龈下刮治和根面平整加用四环素纤维替代的治疗方案在治疗持续性牙周损害方面具有最大优势。
