Brägger U, Mühle T, Fourmousis I, Lang N P, Mombelli A
University of Berne, School of Dental Medicine, Switzerland.
J Periodontal Res. 1997 Oct;32(7):575-82. doi: 10.1111/j.1600-0765.1997.tb00934.x.
The aim of the present experiment was to assess the effect of the administration of the NSAID flurbiprofen (Froben) on tissue healing after periodontal surgery. Sites from patients with the same treatment modality (modified Widman flap) but receiving a placebo drug and sites within each patient not exposed to surgery served as controls. Nineteen patients suffering from moderate to severe periodontal disease were recruited and they signed informed consent forms. These patients required periodontal surgery as assessed at the periodontal re-evaluation. The sites chosen for the study were all diagnosed with PPD > or = 5 mm and were bleeding on probing. During the healing phase 10 patients received 50 mg Froben 3 times per day for 30 d whereas 9 patients received a placebo drug. Two sites with PPD > or = 5 mm after initial therapy and bleeding on probing served as surgical sites, whereas 2 similar sites were not exposed to surgery. The study design was set up double-blind. The radiographic examination consisted of 2-4 standardized vertical bitewings obtained at the periodontal re-evaluation (BL) at 1, 3 and 6 months post-surgically for digital subtraction and computer assisted densitometric image analysis (CADIA). The regions of interest analysed were mesial or distal crestal sites. Minimal remodelling activity was observed radiographically after periodontal surgery in both patient groups. There were no statistically significant differences between the four groups of sites regarding the mean changes in density when analysing the pairs of radiographs 0-1, 0-3, 0-6 months. A frequency analysis was performed to list the number of sites with different ranges of density change. No differences in the distributions of the numbers of sites were observed when comparing the 4 site groups (Kolmogorov-Smirnov, p > 0.05). A significant reduction of the probing pocket depth and a significant amount of clinical attachment gain was noted at the surgically treated sites irrespective of whether the patients had used flurbiprofen or placebo. Whereas the pathways leading to bone resorption in periodontally diseased sites have been shown, in other studies, to be influenced by NSAID, the results of the present study could not justify general administration of Froben for the purpose of reduction of bone resorption after periodontal surgical procedures in patients with adult periodontitis.
本实验的目的是评估非甾体抗炎药氟比洛芬（Froben）给药对牙周手术后组织愈合的影响。采用相同治疗方式（改良Widman瓣）但接受安慰剂药物治疗的患者部位，以及每位患者未接受手术的部位作为对照。招募了19名患有中度至重度牙周病的患者，他们签署了知情同意书。根据牙周再评估，这些患者需要进行牙周手术。所选研究部位均诊断为探诊深度（PPD）≥5mm且探诊出血。在愈合阶段，10名患者每天3次服用50mg Froben，持续30天，而9名患者服用安慰剂药物。初始治疗后PPD≥5mm且探诊出血的2个部位作为手术部位，而2个类似部位未接受手术。研究设计采用双盲法。影像学检查包括在术后1、3和6个月进行牙周再评估（基线）时获得的2 - 4张标准化垂直咬合翼片，用于数字减法和计算机辅助密度测量图像分析（CADIA）。分析的感兴趣区域是近中或远中牙槽嵴部位。两组患者在牙周手术后影像学上均观察到最小程度的重塑活动。在分析0 - 1、0 - 3、0 - 6个月的成对X线片时，四组部位在密度平均变化方面无统计学显著差异。进行频率分析以列出密度变化范围不同的部位数量。比较4组部位时，未观察到部位数量分布的差异（Kolmogorov - Smirnov检验，p＞0.05）。无论患者使用氟比洛芬还是安慰剂，手术治疗部位的探诊袋深度均显著降低，且有显著的临床附着获得。虽然在其他研究中已表明，导致牙周病部位骨吸收的途径受非甾体抗炎药影响，但本研究结果无法证明为减少成人牙周炎患者牙周手术后的骨吸收而普遍使用Froben是合理有效的。
