Tonetti M S, Cortellini P, Carnevale G, Cattabriga M, de Sanctis M, Pini Prato G P
J Clin Periodontol. 1998 Sep;25(9):728-36. doi: 10.1111/j.1600-051x.1998.tb02514.x.
The aim of this randomized single-blind multicenter controlled clinical trial was to clinically evaluate the effectiveness of adjunctive local controlled drug delivery in the control of bleeding on probing in mandibular class II furcations during maintenance care. 127 patients presenting with a class II mandibular furcation with bleeding on probing were included in the study. They had been previously treated for periodontitis and were participating in supportive care programs in periodontal specialty practices. Treatments consisted of scaling and root planing with oral hygiene instructions (control) and scaling and root planing and oral hygiene combined with local controlled drug delivery with tetracycline fibers (test). The following outcomes were evaluated at baseline and 3 and 6 months after therapy at the furcation site: bleeding on controlled force probing (BOP), probing pocket depth (PD) and clinical attachment levels (CAL). Levels of oral hygiene and smoking status were also assessed. Both test and controls resulted in significant improvements of BOP and PD at 3 and 6 months. The test treatment, however, resulted in significantly better improvements: BOP decreased by 52% in the control group and by 70% in the test group at 3 months; at 6 months, however, the difference was no longer significant. The test treatment resulted in a 0.5 mm greater reduction of PD than the control at 3 months, the improvement was highly significant but its duration did not extend until the 6 months evaluation. No differences were observed in terms of changes in CAL. These data indicate that addition of tetracycline fibers to mechanical therapy alone resulted in improved control of periodontal parameters during periodontal maintenance of class II mandibular furcations. Short duration of the effect, however, requires further investigations to optimize conservative treatment of these challenging defects.
这项随机单盲多中心对照临床试验的目的是，在维护治疗期间，临床评估辅助局部控释给药在控制下颌II类根分叉探诊出血方面的有效性。127例存在下颌II类根分叉且探诊出血的患者被纳入研究。他们之前已接受过牙周炎治疗，正在牙周专科诊所参与支持性护理项目。治疗包括龈上洁治和根面平整并给予口腔卫生指导（对照组），以及龈上洁治和根面平整、口腔卫生指导并联合使用四环素纤维进行局部控释给药（试验组）。在基线以及治疗后3个月和6个月时，对根分叉部位的以下指标进行评估：控制用力探诊出血（BOP）、探诊袋深度（PD）和临床附着水平（CAL）。还评估了口腔卫生水平和吸烟状况。试验组和对照组在3个月和6个月时，BOP和PD均有显著改善。然而，试验组的改善效果明显更好：3个月时，对照组BOP降低了52%，试验组降低了70%；但在6个月时，差异不再显著。试验组在3个月时PD的降低幅度比对照组大0.5mm，改善非常显著，但这种改善并未持续到6个月评估时。在CAL变化方面未观察到差异。这些数据表明，在单纯机械治疗基础上添加四环素纤维，可在II类下颌根分叉的牙周维护期间改善牙周参数的控制。然而，效果持续时间较短，需要进一步研究以优化对这些具有挑战性缺损的保守治疗。
