一次完成与分次完成龈下刮治的短期疗效观察

目的：比较一次完成和分次完成龈下刮治治疗牙周炎的短期临床疗效。方法：30例中度牙周炎患者，进行洁治和口腔卫生指导后随机分为两组，实验组为一次性完成龈下刮治，洗必泰含漱；对照组为传统的分4次完成龈下刮治，每次间隔1周。记录各组刮治前，治疗后6周的改良龈沟出血指数（SBI）、探诊深度（PD）、附着丧失（AL）等相关指标。结果：一次性和分次完成龈下刮治均使SBI、PD、AL等指标明显改善，但实验组与对照组相比较SBI、PD、AL等指标明无统计学差异。结论：一次和分次完成龈下刮治治疗牙周炎疗效肯定，一次性龈下刮治较传统的分次法治疗周期短，复诊次数少，提高患者的依从性，值得在临床上推广。     

全口超声龈下刮治两次法对轻中度慢性牙周炎老年患者的近期疗效观察

目的:观察全口超声龈下刮治两次法对轻中度牙周炎的治疗效果。方法:按病例纳入标准选择年龄60岁以上、轻中度牙周炎患者42例,经口腔卫生宣教、超声龈上洁治术后,进行基线检查:牙龈出血指数(GBI),探针出血(BOP)阳性位点,牙周探诊深度(PD)及附着水平(AL),然后进行两次全口超声龈下刮治。术后1个月、3个月复查。所得数据进行配对t检验,统计学分析各临床指标治疗前后的变化。结果:术后1个月的PD由治疗前平均3.18 mm减少至平均2.45 mm(P<0.05),附着水平由平均4.51 mm提高至平均3.34mm(P<0.05),术后3个月的PD及AL分别为2.37 mm(P<0.05)及3.27 mm(P<0.05)。GBI术前平均为3.17,术后一个月及三个月分别减少至1.67(P<0.05)及1.82(P<0.05)。BOP阳性率由术前的37.2%,在术后一个月及三个月分别下降至13.2%(P<0.05)和16.8%(P<0.05)。结论:全口超声龈下刮治两次法短期可改善老年轻中度牙周炎患者的牙龈出血及附着水平,牙周袋探诊深度也有减少的趋势,同时相对于传统的分区龈下刮治及根面平整术,可减少患者复诊次数。     

一次性全口龈下刮治和根面平整术治疗慢性牙周炎的近期疗效评价

目的：探讨一次性全口龈下刮治和根面平整术（full-mouth scaling and root planning,FM-SRP）治疗慢性牙周炎的效果,并与常规的分象限刮治（quadrant scaling and root planning,Q-SRP）效果进行比较。方法：将60例慢性牙周炎患者随机分为2组：FM-SRP组在1天内完成全口所有象限的刮治和根面平整。而Q-SRP组每周进行1个象限的刮治,连续4周完成全口治疗。分别在基线、3个月和6个月时,检测菌斑指数（plaque index,PI）、牙龈指数（gingival index,GI）、探诊出血（bleeding on probing,BOP）、探诊深度（probing depth。PD）及附着丧失（attachment loss,AL）的变化及患者的术后反应。所得结果分别进行秩和检验（PI、GI）、t检验（PD、AL）和X^2检验（BOP）。结果：与基线时相比,2种治疗方式在3个月和6个月时的所有临床牙周指数均有显著改善（P〈0．01）,但2组之间无显著性差异（P〉0．05）。在首次治疗24h,FM-SRP组的术后反应发生率显著高于Q-SRP组（P〈0.05）,但患者能够耐受。结论：FM-SRP和Q-SRP两种方法均可达到相同的临床效果,临床医生可根据实际需要,选择合适的治疗方式。     

一次性全口龈下刮治和根面平整术治疗慢性牙周炎的Meta分析

目的:评价比较一次性全口龈下刮治和根面平整术(FM-SRP)和传统的分象限刮治法(Q-SRP)治疗慢性牙周炎的疗效和安全性。方法:计算机检索Cochrane图书馆、MEDLINE、EMbase、CBM、CNKI、VIP等数据库,收集相关随机对照试验。由两名评价者独立评价研究质量和提取数据,对同质研究采用RevMan5.2软件进行Meta分析。结果:最终纳入10个RCT,Meta分析结果显示FM-SRP和Q-SRP在降低探诊深度、改善附着水平和探诊出血、以及术后反应发生率方面的差异无统计学意义。FM-SRP组患者的术后疼痛程度高于Q-SRP组,差异有统计学意义[MD=1.12,95%CI(0.60,1.64)]。结论:FM-SRP治疗慢性牙周炎的疗效与Q-SRP相当,但术后疼痛程度较高,医生应根据实际情况选择。     

一次性全口龈下刮治与分区龈下刮治的临床效果及术后全身反应的研究现状

龈下刮治及根面平整是牙周基础治疗的主要方法,可有效去除龈下病原微生物,改变龈下菌群生态环境,达到治疗目的。临床医生通常采用的是分区龈下刮治及根面平整（quadrant scaling and root planning Q-SRP）的方法,即将全口分为4个象限,间隔一定时间分次治疗。     

单独龈下超声刮治与结合人工刮治两种方法的临床效果比较

目的 比较单独应用龈下超声刮治与结合人工刮治两种治疗方式的临床效果.方法 选取36例慢性牙周病患者,采用半口对照的方法将患牙分为对照组(左半口)和实验组(右半口),先对所有患牙进行龈上洁治术,一周后对照组实行龈下超声刮治术,实验组实行龈下超声刮治结合人工刮治术.治疗前后1个月、3个月分别检查受试牙,并记录各项临床指标( BOP、PD、CAL).结果 在治疗结束后1个月和3个月,两组各项牙周临床指标均有明显改善(P＜0.05),实验组的改善优于对照组,且有显著性差异(P＜0.05).结论 龈下超声刮治后使用人工刮治,可以获得一个更加平整的根面,取得良好的临床效果.     

超声龈下刮治的临床疗效

超声龈下刮治的应用已有报道。我们将超声龈下刮治与手工刮治法进行疗效比较 ,报告如下 :从门诊选择成人牙周炎患者 32例 ,男 18例 ,女 14例 ,年龄 2 4～ 5 8岁。所选病例均无与牙周炎有关的全身性疾病 ,牙列完整 ,近 3个月未做任何牙周治疗 ,未服用抗生素。1　器械和方法1.1　器械超声治疗机和龈下超声工作头 1对 (丹麦产 )。手工刮治器 1套 7件及龈下锄形器、锉形器各 1对 (美国产 )。1.2　操作步骤纳入观察的病例在控制急性炎症后先行龈上洁治 ,指导患者掌握正确的刷牙方法 ,1周后再进行龈下刮治。每位患者均采用半口对照 ,即将每位患者…     

龈下刮治在伴牙周炎口腔扁平苔藓患者治疗中的意义和疗效评估

目的:探讨在伴牙周炎口腔扁平苔藓(oral lichen planus plus periodontitis,OLPP)患者系统性治疗中,是否行龈下刮治对口腔扁平苔藓整体疗效的影响.方法:纳入OLPP患者40例,其中糜烂型(erosive OLPP,EOLPP)与非糜烂型(non-erosive OLPP,NEOLPP...     

超声龈下刮治应用于慢性牙周炎的临床体会

治疗牙周炎的龈上洁治及龈下刮治有明确疗效及重要意义。但由于手工龈下刮治对于操作者的技术要求较高且费时、费力，故在广大基层医院并未得到有效开展。随着超声技术的发展，超声龈下刮治技术逐渐成为牙周治疗的主流。关于超声龈下刮治的应用已有报道，笔者于1999年7月～2002年7月，对91例慢性牙周炎患者采用超声波或手工龈下刮治术，取得了较好疗效。     

超声和手工龈下刮治对龈下微生物影响的研究

目的 :比较Perioproline超声龈下刮治和手工龈下刮治对龈下微生物的影响 ,评价Periopro line超声龈下刮治系统的临床疗效和工作效率。方法 :选取慢性成人牙周炎患者 7名 ,共 2 0个左右基本对称牙被纳入研究 ,随机分入实验组 (超声组 )和对照组 (手工组 )。记录治疗时间和治疗前、治疗后 0d、7d和 14d的PD ,BOP值 ,及采集龈下菌斑样本培养鉴定 ,观察比较总菌落形成单位 (CFU)和牙周可疑致病菌检出率及检出量的变化。结果 :两组在治疗后PD、BOP值及龈下菌斑总量 (CFU)和牙周可疑致病菌数量及检出率均显著下降 (P <0 .0 5) ;治疗前后各时段组间均无明显差别 ;超声组的治疗时间明显少于手工组 (P <0 .0 5)。结论 :Perioproline超声龈下刮治和手工龈下刮治均可有效减少龈下微生物的量 ,改善患牙的牙周临床状况 ,且两者间无差异 ,但Perioproline超声龈下刮治明显较手工刮治节省时间     

Clinical outcomes of quadrant root planing versus full-mouth root planing

OBJECTIVES: To determine the clinical effects of full mouth compared with quadrant wise scaling and root planing. METHOD: Twenty patients with chronic periodontitis (> or = 2 teeth per quadrant with probing pocket depths (PPD) > or = 5 mm and bleeding on probing (BOP) were randomized into a test group treated in two sessions with subgingival scaling and root planing within 24 h (full-mouth root planing (FMRP)) and a control group treated quadrant by quadrant in four sessions in intervals of 1 week (quadrant root planing (QRP)). PPD, relative attachment level (RAL) and BOP were recorded at baseline, 3 and 6 months. RESULTS: Analysing first quadrant data, in moderately deep pockets (5 mm < or = PPD < 7 mm) there was no evidence for a difference (FMRP-QRP) between both groups for PPD reduction (mean: -0.128 mm; CI: [-0.949, 0.693]; p=0.747), RAL gain (mean: 0.118 mm; CI: [-0.763, 1.000]; p=0.781), and BOP reduction (mean: -20.1%; CI: [-44.3, 4.2]; p=0.099). Likewise, no significant differences between treatments were found for initially deep pockets (PPD > or = 7 mm), neither for first quadrant nor for whole mouth data. CONCLUSION: The results of the present study demonstrated equally favourable clinical results following both treatment modalities.     

Quadrant root planing versus same-day full-mouth root planing. I. Clinical findings

OBJECTIVES: The aim of this study was to test the hypothesis that same-day full-mouth scaling and root planing (FM-SRP) resulted in greater clinical improvement compared to quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients over a period of 6 months. MATERIAL AND METHODS: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Whole-mouth clinical measurements were recorded with a manual periodontal probe at baseline (BAS) and at reassessment 1 (R1) (approximately 6 weeks after the completion of therapy), and at reassessment 2 (R2) (6 months after the initiation of therapy). Selected site analyses were performed on the deepest site in each quadrant before and after therapy (R1 and R2) and clinical indices were recorded with an electronic pressure sensitive probe. In addition, during the active phase of treatment clinical data were collected at 2-weekly intervals from the remaining untreated quadrants in the Q-SRP group only. RESULTS: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A continuous clinical improvement was seen for both treatment groups during the experimental period, which reached peak levels at 6 months (DeltaPD=1.8 mm, DeltaCAL=1.1 mm, p<0.001; PD: pocket depth; CAL: clinical attachment level). The selected-site analysis revealed no significant differences in any clinical index between the two treatment groups at R2 (DeltaPD=2.8 mm, DeltaRAL=1.1 mm; RAL: relative attachment level). At the selected sites, the analysis of the deep pockets (>7 mm) showed a significantly greater gain in RAL for the FM-SRP group compared to the Q-SRP group at R2 (p<0.05). The results of this analysis however, should be interpreted with care due to the small number of deep pockets. Data from the Q-SRP group provided an insight into how treated and untreated quadrants responded during the initiation of plaque control measures. There were significant reductions in PD, suppuration (SUP), modified gingival index (MGI) and plaque index (PI) in the remaining untreated quadrants in the Q-SRP group during the initial phase of treatment (p<0.05), while minimum changes in RALs and bleeding on probing (BOP) occurred. Nevertheless, the improvement in PD was clearly inferior to that seen after scaling and root planing. CONCLUSION: Following both therapeutic modalities, there were marked clinical improvements at both R1 and R2 (6 months) from baseline. The current study, in contrast to previous findings, failed to show that FM-SRP is a more efficacious periodontal treatment modality compared to Q-SRP. However, both modalities are efficacious and the clinician should select the treatment modality based on practical considerations related to patient preference and clinical workload.     

Quadrant root planing versus same-day full-mouth root planing. II. Microbiological findings

OBJECTIVES: The aim of this study was to test the hypothesis that over a period of 6 months, same-day full-mouth scaling and root planing (FM-SRP) resulted in greater reductions in the detection frequency of five putative periodontal pathogens compared with quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients. MATERIALS AND METHODS: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Selected-site analyses were performed on the deepest site in each quadrant before and after therapy, at approximately 3 and 6 months from baseline (R1 and R2) and clinical indices were recorded with an electronic pressure-sensitive probe. In addition, subgingival plaque samples were collected from these sites at baseline (BAS), at reassessment 1 (R1), approximately 6 weeks after the completion of therapy and at reassessment 2 (R2), 6 months from baseline. Polymerase chain reaction (PCR) was used to determine the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Treponema denticola and Bacteroides forsythus in plaque. RESULTS: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A marked reduction in the presence of all candidate periodontal pathogens was noted after both treatment modalities, reaching statistical significance for the majority of the test organisms. These improvements were maintained over a period of 6 months. When the two treatment groups were compared, a significantly higher percentage of Q-SRP patients was positive for P. intermedia at R1 compared with FM-SRP patients (p<0.05). In addition, a greater reduction in the patient prevalence for T. denticola was found for the FM-SRP group than the Q-SRP group at R1 and R2 from baseline (p<0.005), but the significance of this is questionable given the skewed detection frequency of this organism at baseline between the two treatments (p<0.01). CONCLUSION: This study failed to confirm that same-day FM-SRP resulted in greater microbiological improvements compared with Q-SRP at 2-weekly intervals over a 6-month period, as determined by PCR.     

光动力疗法联合龈下刮治术治疗慢性牙周炎疗效观察

目的 观察光动力疗法联合龈下刮治和根面平整术治疗慢性牙周炎的临床效果.方法 选择中、重度慢性牙周炎患者30例,随机分为3组,每组10人.A组:单纯龈下刮治和根面平整术治疗;B组:龈下刮治和根面平整术治疗后即刻行光动力疗法;C组:龈下刮治和根面平整术治疗后1周行光动力疗法.治疗前、龈下刮治和根面平整术治疗后6周、12周时分别记录牙周袋探诊深度及探诊出血的阳性牙位点,并进行统计学分析.结果 龈下刮治和根面平整术后6周和12周结果显示,3组牙周袋探诊深度和探诊出血情况较术前均有改善(P＜0.05).B组和C组的牙周袋探诊深度和探诊出血情况改善效果均优于A组(P＜0.05);B组与C组间差异无统计学意义(P＞0.05).结论 对中、重度慢性牙周炎患者应用光动力疗法联合龈下刮治和根面平整术治疗,较单独使用龈下刮治和根面平整术治疗效果更佳.光动力疗法可作为新的辅助治疗手段用于牙周病的治疗.     

Quadrant root planing versus same-day full-mouth root planing

OBJECTIVES: The aim of this study was to determine whether same-day full-mouth scaling and root planing (FM-SRP) and quadrant scaling and root planing (Q-SRP) resulted in variations in the systemic humoral immune response dynamics (antibody titres and avidity) during active treatment and 3 and 6 months post-therapy. MATERIALS AND METHODS: Forty patients with chronic periodontitis were recruited into this study. Subjects were randomised into two groups and received either scaling and root planing quadrant by quadrant at 2-weekly intervals (Q-SRP group) or same-day full-mouth scaling and root planing (FM-SRP group). Clinical measurements and serum samples were obtained at baseline and approximately 6 weeks after the last clinical intervention (R1) and 6 months after the initiation of therapy (R2). Furthermore, serum samples were obtained from each patient undergoing therapy (Q-SRP and FM-SRP) at 3 bi-weekly instances so as to determine the short-term effects of each session of scaling and root planing on the dynamics of the humoral immune response. Serum antibody titre was assayed by enzyme-linked immunosorbent assay (ELISA) and antibody avidity was measured by thiocyanate dissociation against five putative periodontal pathogens: Porphyromonas gingivalis; Actinobacillus actinomycetemcomitans; Prevotella intermedia; Treponema denticola and Bacteroides forsythus. RESULTS: Both therapies resulted in similar antibody titre reductions against the majority of the organisms tested and although there was a distinct trend for antibody avidity to increase following therapy, this was not found to be statistically significant, reflecting marked inter-individual variation. In addition, no evidence emerged from this study to support increased antibody titres following the active phases of both treatment approaches due to an inoculation effect. Nevertheless, significant short-term increases in antibody avidity to most test bacteria were noted for both treatment strategies. CONCLUSION: Both therapies were associated with a reduction in antibody titres and an increase in the binding ability or avidity of antibodies, but there was a marked inter-subject variability and statistical significance was reached for only some of the test bacteria. No significant differences in the humoral antibody dynamics were found between the two treatment approaches.     

Clinical effects of scaling and root planing on untreated teeth

OBJECTIVE: The aim of this report is to examine whether scaling and root planing (SRP) in one area of the mouth may affect periodontal improvement in untreated areas in the same patient, possibly through systemic effects of treatment. MATERIAL AND METHODS: Twenty patients diagnosed with generalized aggressive periodontitis were randomized into treatment (n=11) and no treatment (n=9) groups. Within the treatment group, three quadrants were treated by SRP at week 0, 3, 12, and 24, while a single experimental quadrant remained untreated throughout the study. The outcome for all teeth was assessed using clinical parameters, subtraction radiography, and pathogenic bacteria levels in the subgingival flora over the 24-week study period. RESULTS: Compared with sites in no treatment patients, the treated sites in the treated patients showed a 1 mm decrease in probing depth (PD) (p<0.01) and a 0.5 mm increase in bone height (p<0.01) by 24 weeks. In untreated sites within treated subjects, however, PDs tended to improve (p=0.09) but at a reduced rate compared with treated sites. The levels of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythensis (Bacteroides forsythus) remained unchanged in untreated sites while levels of Prevetolla intermedia and Treponema denticola tended to decrease as compared with controls but did not reach significance. CONCLUSIONS: This study indicates that untreated sites in treated periodontitis patients show a trend towards clinical improvement and exhibit reductions in some but not all periodontopathic bacterial species tested.     

One‐stage full‐mouth disinfection versus quadrant and full‐mouth root planing

Objective: The aim of this study was to test the hypothesis that the one‐stage full‐mouth disinfection (FMD) provides greater clinical and microbiological improvement compared with full‐mouth scaling and root planing (FM‐SRP) within 24 h and quadrant scaling and root planing (Q‐SRP) in patients with generalized chronic periodontitis. Material & Methods: Twenty‐eight patients were randomized into three groups. 25 patients completed the study and were the basis for analysis. The Q‐SRP group was scaled quadrant‐wise at 1‐week intervals. The other groups received a one‐stage full‐mouth scaling with (FMD) and without (FM‐SRP) chlorhexidine. At baseline, after 1, 2, 4 and 8 months clinical parameters were recorded and microbiological analysis was performed. Results: All three treatment modalities resulted in significant clinical improvement at any time. There were only group differences after 1 and 2 months: in the FM‐SRP group was a significantly higher reduction of probing depth and bleeding on probing compared with the other two groups. The bacteria could be reduced in every group although this reduction was only significant for Prevotella intermedia in the FMD group 8 months after treatment. Conclusion: All three treatment modalities lead to an improvement of the clinical and microbiological parameters, however, without significant group differences after 8 months.     

Clinical and microbiological features of subjects with adult periodontitis who responded poorly to scaling and root planing

Abstract In a previous report, it was shown that scaling and root planing (SRP) decreased mean pocket depth and attachment level in subjects with adult periodontitis, as well as the levels and prevalence of Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola. However, a subset of subjects in that study exhibited mean loss of attachment following SRP. The purpose of the present investigation was to seek clinical and microbiological differences between subjects who responded well or poorly to SRP. 57 subjects with adult periodontitis were treated by full-mouth SRP under local anaesthetic. Clinical assessments of plaque, redness, suppuration, BOP, pocket depth and attachment level were made at 6 sites per tooth prior to and 3 months post-SRP. Attachment level measurements were repeated at each visit and differences in means between visits used to assess change. 18 subjects showed mean attachment loss 3 months post-SRP (poor response group), while 39 showed mean attachment level gain (good response group). The prevalence and levels of 40 subgingival taxa in subgingival plaque samples from the mesiobuccal site of each tooth (maximum 28 sites) in each subject prior to and 3 months post-SRP were assessed using checkerboard DNA-DNA hybridization. The prevalence of each species was computed for each subject and averaged across subjects in the 2 treatment-response groups at each visit. Differences between groups were sought using the Mann-Whitney test. There were no statistically significant differences between the 2 response groups in any clinical parameter prior to therapy. Subjects in the good response group showed more attachment level gain at sites with baseline pocket depths of < 4 mm, 4–6 and > 6 mm than poor response subjects. Of 40 species evaluated. A. naeslundii genospecies 2 (A. viscosus), T. denticola, C. gracilis and C. rectus were significantly higher and more prevalent pre-therapy in the good response subjects. Mean attachment level change post SRP could be predicted using multiple linear regression with A. naeslundii genospecies 2 (A. viscosus) and T. denticola as the predictor variables (r²=0.373, p < 0.00001). Sites that gained ≥ 2 mm of attachment post therapy showed a significant decrease in the counts of P. gingivalis (7.5±3.5 to 0.2±0.2×10⁵), T. denticola (8.2±3.5 to 1.8±1.1×10⁵) and B. forsythus (11.1 ± 5.7 to 0.3±0.2×10⁵). The data of the present investigation indicate that SRP is most effective in subjects and sites with high levels of the subgingival species that this therapy affects.