Mombelli A, Tonetti M, Lehmann B, Lang N P
University of Bern, Switzerland.
J Clin Periodontol. 1996 Oct;23(10):906-13. doi: 10.1111/j.1600-051x.1996.tb00510.x.
The purpose of this study was to determine the distribution of black-pigmenting Gram-negative bacteria in the dentition of 10 adult periodontitis patients before and after treatment by local delivery of tetracycline. The subjects were selected based on a screening for high counts of Porphyromonas gingivalis and multiple deep pockets. Subgingival microbial samples were taken from the mesial and distal aspect of every tooth (44 to 56 sites per patient) before treatment, and after one and two months. Therapy included full mouth scaling and root planing, chlorhexidine mouth rinsing and placement of tetracycline HCl fibers (Actisite) on all teeth. 63.4% of 524 baseline samples yielded total anaerobic viable counts > or = 10(6) CFU/ml; P. gingivalis was found in 59.2% and Prevotella intermedia in 56.9%. One month after treatment, the % of samples with > or = 10(6) CFU/ml was reduced to 9.4%, 5.3% were P. gingivalis- and 5.1% P. intermedia- positive. After 2 months, 9.6% samples yielded > or = 10(6) CFU/ml, 5.2% were P. gingivalis- and 9.4% P. intermedia- positive. 20 of the 39 sites with a persistence of P. gingivalis were located on second molars. Logistic regression models were utilized to explain the persistence of P. gingivalis, using site location and other clinical parameters as independent variables. These analyses indicated a strong association of site location, pocket depth and bleeding on sampling with persistence of P. gingivalis. The study shows that local delivery of tetracycline is highly effective in reducing the prevalence and proportions of black-pigmenting anaerobes within a dentition. Bleeding deep pockets of second molars have an increased risk for persistence of these anaerobes.
本研究的目的是确定10名成年牙周炎患者在局部应用四环素治疗前后牙列中产生黑色色素的革兰氏阴性菌的分布情况。研究对象是根据牙龈卟啉单胞菌数量高和多个深牙周袋进行筛选的。在治疗前、治疗1个月和2个月后，从每颗牙齿的近中面和远中面采集龈下微生物样本（每位患者44至56个位点）。治疗包括全口洁治和根面平整、洗必泰漱口水漱口以及在所有牙齿上放置盐酸四环素纤维（Actisite）。524个基线样本中有63.4%的总厌氧活菌计数≥10⁶CFU/ml；牙龈卟啉单胞菌检出率为59.2%，中间普氏菌检出率为56.9%。治疗1个月后，总厌氧活菌计数≥10⁶CFU/ml的样本百分比降至9.4%，牙龈卟啉单胞菌阳性样本为5.3%，中间普氏菌阳性样本为5.1%。2个月后，9.6%的样本总厌氧活菌计数≥10⁶CFU/ml，牙龈卟啉单胞菌阳性样本为5.2%，中间普氏菌阳性样本为9.4%。在持续存在牙龈卟啉单胞菌的39个位点中，有20个位于第二磨牙。采用逻辑回归模型来解释牙龈卟啉单胞菌的持续存在情况，将位点位置和其他临床参数作为自变量。这些分析表明，位点位置、牙周袋深度和探诊出血与牙龈卟啉单胞菌的持续存在密切相关。该研究表明，局部应用四环素在降低牙列中产生黑色色素厌氧菌的患病率和比例方面非常有效。第二磨牙的深牙周袋探诊出血时，这些厌氧菌持续存在的风险增加。
