López N J, Gamonal J A
Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago.
J Periodontol. 1998 Nov;69(11):1291-8. doi: 10.1902/jop.1998.69.11.1291.
A randomized, double-blind, clinical study was done to assess the microbiological and clinical effects of metronidazole plus amoxicillin (M+A) as the only therapy in 46 patients with moderate to advanced progressive adult periodontitis. Patients were included in the study after at least 2 sites showed > or =2 mm clinical attachment loss. Bleeding on probing, probing depth, and clinical attachment level were measured using on automated probe. The percentage of surfaces with plaque was recorded at day 0, and at 2 and 4 months after therapy. No effort was made to change the oral hygiene habits of patients. Identification of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia was assessed utilizing DNA technology at day 0 and 2 months after therapy. Twenty-three patients received metronidazole 250 mg plus amoxicillin 500 mg, 3 times/day for a week and 23 a placebo. Two patients in the placebo group were dropped at 2 months because they had taken antibiotics for medical reasons. Statistical analyses of differences between groups was done using the Mann-Whitney test, and the differences within each group were tested with ANOVA. There were no significant changes in surfaces with plaque in either group after therapy. The percentage of bleeding sites decreased significantly from baseline to 2 and 4 months in the M+A group (P = 0.001), and increased in the placebo group. Differences in bleeding on probing between groups were significant at 2 (P = 0.018), and 4 months (P = 0.005). The mean attachment level values at 2 and 4 months post-therapy improved significantly in the M+A group compared to the placebo group (P = 0.001). Treatment with M+A resulted in a significant mean reduction in probing depth at 2 and 4 months compared to baseline values (P = 0.001). The M+A group showed a significant reduction of sites with high levels of Pg (P = 0.001) at 2 months compared with baseline values, and there was a significant reduction of sites with Pg and Pi in the M+A group compared with the placebo group. The results showed that a combined M+A treatment as the only therapy changes the proportion of some subgingival microorganisms and allows a significant improvement in clinical conditions.
一项随机、双盲临床研究旨在评估甲硝唑加阿莫西林（M+A）作为唯一治疗方法对46例中重度进展型成人牙周炎患者的微生物学和临床疗效。至少有2个部位临床附着丧失≥2mm的患者被纳入研究。使用自动探针测量探诊出血、探诊深度和临床附着水平。在治疗前第0天以及治疗后2个月和4个月记录有菌斑表面的百分比。未对患者的口腔卫生习惯进行干预。在治疗前第0天和治疗后2个月，利用DNA技术评估伴放线放线杆菌、牙龈卟啉单胞菌和中间普氏菌的鉴定情况。23例患者接受甲硝唑250mg加阿莫西林500mg，每日3次，共1周，另外23例接受安慰剂治疗。安慰剂组有2例患者在2个月时退出，因为他们因医疗原因服用了抗生素。采用Mann-Whitney检验对组间差异进行统计学分析，采用方差分析对每组内的差异进行检验。治疗后两组有菌斑表面均无显著变化。M+A组从基线到2个月和4个月时，出血部位百分比显著降低（P = 0.001），而安慰剂组则升高。两组间探诊出血差异在2个月时显著（P = 0.018），4个月时也显著（P = 0.005）。与安慰剂组相比，M+A组治疗后2个月和4个月时的平均附着水平值显著改善（P = 0.001）。与基线值相比，M+A治疗在治疗后2个月和4个月时探诊深度平均显著降低（P = 0.001）。与基线值相比，M+A组在2个月时Pg高水平部位显著减少（P = 0.001），与安慰剂组相比，M+A组Pg和Pi阳性部位显著减少。结果表明，M+A联合治疗作为唯一治疗方法可改变一些龈下微生物的比例，并使临床状况得到显著改善。
