Noyan U, Yilmaz S, Kuru B, Kadir T, Acar O, Büget E
Marmara University Dental Faculty, Periodontology Department, Istanbul, Turkey.
J Clin Periodontol. 1997 Mar;24(3):158-65. doi: 10.1111/j.1600-051x.1997.tb00485.x.
The present study describes results on selected clinical and microbiological parameters obtained by treatment with local (Elyzol) and systemic (Flagyl) use of metronidazole alone and/or mechanical subgingival debridement in adult periodontitis. Patients were randomly divided into local and systemic treatment groups each comprising 5 individuals in each of whom 4 sites (one site/ quadrant) with a probing depth of > or = 5 mm were selected and treated with separate treatment modalities. The overall treatment design provided 6 different test groups. Groups of quadrants received: (1) scaling and root planing; (2) local metronidazole treatment; (3) systemic metronidazole treatment; (4) local metronidazole combined with scaling and root planing; (5) systemic metronidazole combined with scaling and root planing; (6) no treatment. The microbiological and clinical effects of treatment modalities were monitored over a period of 42 days. All treatments resulted in clinical improvements (gingivitis, probing pocket depth, attachment level) except for the untreated group. Parallel to the clinical changes, all treatments reduced the number of total bacteria and proportions of obligately anaerobic microorganisms. Although both of the combined treatment groups responded to therapy with better resolution of infection that the pure mechanical and pure metronidazole treatments, local metronidazole in combination with scaling and root planing seems to be more effective in terms of producing both clinical and microbial improvements.
本研究描述了在成人牙周炎患者中，单独局部（Elyzol）和全身（Flagyl）使用甲硝唑以及/或者进行机械性龈下刮治所获得的选定临床和微生物学参数的结果。患者被随机分为局部治疗组和全身治疗组，每组各5人，每组中均选择4个探诊深度≥5mm的位点（每个象限1个位点），并采用不同的治疗方式进行治疗。整体治疗设计提供了6个不同的试验组。各象限组接受：（1）龈上洁治和根面平整；（2）局部甲硝唑治疗；（3）全身甲硝唑治疗；（4）局部甲硝唑联合龈上洁治和根面平整；（5）全身甲硝唑联合龈上洁治和根面平整；（6）不治疗。在42天的时间内监测各种治疗方式的微生物学和临床效果。除未治疗组外，所有治疗均带来了临床改善（牙龈炎、探诊袋深度、附着水平）。与临床变化平行，所有治疗均减少了总细菌数量以及专性厌氧微生物的比例。尽管两个联合治疗组在感染消退方面比单纯机械治疗和单纯甲硝唑治疗的反应更好，但局部甲硝唑联合龈上洁治和根面平整在产生临床和微生物学改善方面似乎更有效。
