Subgingival metronidazole in dialysis tubing and subgingival chlorhexidine irrigation in the control of chronic inflammatory periodontal disease

The present investigation compared subgingival metronidazole in dialysis tubing and subgingival chlorhexidine irrigation in the control of chronic inflammatory periodontal disease. 10 patients with 4 mm or deeper periodontal pockets were divided into 2 groups. Both received baseline scaling, root planing, subcontact area cleaning and instruction in the Bass technique of tooth brushing, but not in interdental cleaning. One group with 80 pockets received 0.2% chlorhexidine subgingival irrigation for 28 days and the other with 86 pockets received 0.5% metronidazole solution incorporated in subgingivally placed dialysis tubing. The tubings were replaced with freshly filled ones at days 7, 14 and 21. Active treatment ceased at day 28. Plaque Index, Sulcus Bleeding Index, pocket depth and gingival shrinkage were recorded at days 0, 7, 14, 21, 28, 56 and 84. Subgingival 0.5% metronidazole in dialysis tubing and 0.2% chlorhexidine irrigation were found to be equally effective in reducing chronic periodontitis. Metronidazole reduced Plaque Index less but pocket depth more than chlorhexidine. Improvements were maintained significantly below baseline levels for at least 8 weeks after the end of the 4-week treatment period.     

Subgingival metronidazole in acrylic resin vs. chlorhexidine irrigation in the control of chronic periodontitis

After initial scaling, root planing and cleaning of subcontact areas, chronic periodontitis patients received oral hygiene instruction consisting of Bass toothbrushing using a sodium fluoride toothpaste, but without stress on interdental cleaning. They were then assigned to two groups, one of which self-administered 0.2% chlorhexidine solution subgingivally, once daily for 4 weeks, while the other was subjected to subgingival application of acrylic resin strips containing 40% metronidazole once weekly for 4 weeks. Plaque Index, Sulcus Bleeding Index, probeable pocket depth and gingival shrinkage were assessed for this treatment period and for a further 8 weeks. Highly significant improvements compared with baseline values were achieved and maintained to the end of the study. There were no significant differences between the groups at any time, except for Sulcus Bleeding Index which at Days 56 and 84 showed metronidazole to be superior. It was concluded that the regimens selected were equally effective in improving periodontal health over a 3-month period.     

The effects of subgingival irrigation with low dosage metronidazole on periodontal inflammation

The effects on chronic periodontitis of a simplified oral hygiene regimen combined with subgingival irrigation with 0.5% metronidazole were investigated. 19 patients, with 548 pockets greater than or equal to 4 mm, completed a 3-month randomised double-blind placebo-controlled trial. At day 0, prior to treatment, and at days 7, 28, 56 and 84, plaque index, sulcus bleeding index and probable pocket depth were recorded. The simplified oral hygiene regimen consisted of (1) one episode of root debridement, removal of subgingival approximal overhangs on restorations and subcontact area debridement with abrasive strips and polishing, and (2) instruction in Bass brushing (twice daily) with no stress on interdental cleaning. After baseline debridement, patients were allocated 0.5% metronidazole or a placebo. They were instructed to irrigate subgingivally once daily for 28 days. Treatment resulted in marked improvement in both groups and proportionately more sites improved in the metronidazole group at 28, 56 and 84 days. There were no significant differences between the procedures at any time. It was concluded that a simplified oral hygiene regimen combined with daily subgingival irrigation with 0.5% metronidazole or a placebo was effective in reducing periodontitis for at least a further 8 weeks, and that proportionately more sites improved in the metronidazole group.     

甲硝唑凝胶在治疗侵袭性牙周炎中的临床观察

目的观察牙周袋内使用甲硝唑凝胶治疗侵袭性牙周炎的临床效果。方法侵袭性牙周炎患者56例（256颗牙）,随机分成2组,均采用龈上洁治、龈下刮治术,治疗组采用甲硝唑凝胶牙周袋内注射治疗（注满约10mg）,每周1次,共4次;对照组口服罗红霉素片（每日2次,每次1片0.15g）和甲硝唑片（每日3次,每次1片0.1g）,每周连续服用3日,共4周。记录并分析治疗前后2周、停药2周、停药4周后的出血指数（BI）、牙体松动度、牙周袋探诊深度（PD）和牙体附着水平（CAL）。结果治疗组和对照组在治疗前牙周水平基线一致,治疗后,治疗组BI、PD、CAL均较对照组明显改善（P〈0.05）。结论牙周袋内局部应用甲硝唑凝胶能提高侵袭性牙周炎的治疗效果,是值得临床广泛应用的局部治疗侵袭性牙周炎的药物。     

Experimental use of a slow release device employing chlorhexidine gluconate in areas of acute periodontal inflammation

Abstract Eleven patients suffering acute exacerbations of chronic periodontitis were treated by the insertion into affected periodontal pockets of dialysis tubing containing 20% chlorhexidine gluconate. After 7 days, 9 of the 11 patients exhibited greatly reduced crevicular fluid flow, relief of discomfort and the cessation of bleeding on probing.     

Subgingival plaque control by a simplified oral hygiene regime plus local chlorhexidine or metronidazole

This study determined the effects of a simplified oral hygiene regime plus local applications of metronidazole or chlorhexidine on the subgingival microflora. Twenty-one patients, with periodontal pockets 4 mm or deeper, underwent one session of scaling, root planing, and oral hygiene instruction (Bass method but without emphasis on interdental cleaning). Eight patients performed once daily subgingival irrigation with 0.2% chlorhexidine gluconate solution for 28 days. Thirteen patients had either 0.5% metronidazole in dialysis tubings or 40% metronidazole in acrylic resin strips inserted subgingivally once weekly, also for four weeks.
For each subject, subgingival plaque was obtained from two chemically treated (test) and one non-chemically treated (control) pockets at days 0 (prior to scaling and root planing), 7, 14, 21, 28, 56, and 84. The subgingival microflora was assessed using darkfield microscopy. Bacteria were characterized as cocci, motile organisms, spirochaetes, and others (straight and curved rods, filaments and fusiforms).
Both chlorhexidine and metronidazole groups showed beneficial change still apparent at the end of the study (3 months). Great increases in proportions of cocci and reductions in spirochaetes and all other forms of bacteria were observed. Metronidazole reduced spirochaetes more but, unlike chlorhexidine, had a variable effect on motiles. Root planing alone had less effect. Generally, metronidazole and chlorhexidine appeared equally beneficial. It was concluded that in spirochaete-dominated plaque, metronidazole may be preferred agent. Where motiles predominate, chlorhexidine may be the topical agent of choice.     

Effects of subgingival antimicrobial irrigation in chronic periodontitis--clinical observation

One week prior to the establishment of baseline records, 144 sites with a probing pocket depth of 5-7 mm in 13 periodontitis patients were treated with plaque control and root planning. Sites with periodontitis involvement in each patient were divided, by split mouth design, into 4 quadrants. Each quadrant was irrigated subgingivally with either 0.05% metronidazole or 0.05% ornidazole, or 0.2% chorhexidine, or 0.9% normal saline (control) once every 2-3 days for 4 weeks. The plaque index, sulcus bleeding index, probable pocket depth and gingival index were assessed at the baseline and at 4 weeks, 8 weeks and 12 weeks following initial preparation. All 4 clinical parameters in the ornidazole treated group showed significant improvement as compared with baseline values, but the improvements were not maintained to the end of the study. Except for improvement in the sulcus bleeding index and the gingival index in the ornidazole group, which was superior to that of the metronidazole group at the 4th week, there were no significant differences in other parameters between the ornidazole, metronidazole and chlorhexidine groups at the irrigation sites. From these data we can tentatively conclude that subgingival irrigation with ornidazole in deep pockets is more effective than metronidazole or chlorhexidine in nonsurgical periodontal therapy.     

维持性透析患者牙周炎与微炎症状态关系初探

目的初步探讨牙周炎与维持性透析患者微炎症状态的关系以及牙周治疗在患有牙周炎的维持性透析患者治疗中的临床意义。方法选择患有牙周炎的维持性透析患者48例作为阳性组,非牙周炎的维持性透析患者38例作为阴性组,比较两组血清C反应蛋白(CRP)、血清前白蛋白(PA)水平及血液血红蛋白(Hb)浓度的差别,以及阳性组经系统牙周治疗后上述指标的变化情况。结果治疗前阳性组血清CRP较阴性组高(P<0.01),而血清PA水平及Hb水平均较阴性组低(P<0.05);系统牙周治疗后CRP显著降低(P<0.05),而血清PA水平及血液Hb水平有不同程度上升,但治疗前后Hb水平差异无统计学意义(P>0.05)。结论牙周炎是引起部分维持性透析患者微炎症状态的促进因素之一,系统牙周治疗有可能减轻患者的微炎症状态,从而降低营养不良及贫血等并发症发生的几率。     

Comparison of interdental cleaning methods: a randomized controlled trial

BACKGROUND: Although interdental cleaning is an integral component of home plaque control for periodontally involved patients, limited data exist on the periodontal benefits of commonly used interdental cleaning methods before definitive root surface debridement is undertaken. Therefore, the aim of this study was to compare the effects of a customized interdental brushing technique and a customized flossing technique on clinical periodontal outcomes prior to root surface debridement in chronic periodontitis cases. METHODS: This was a single-blind, randomized controlled clinical trial. Seventy-seven patients with chronic periodontitis were measured for plaque, relative interdental papillae level, Eastman interdental bleeding index, probing depths, and bleeding on probing at interdental sites and underwent a 10-minute hand scaling to remove easily accessible calculus deposits. Before group allocation, patients were advised on toothbrushing and instructed in two customized methods of interdental cleaning involving dental floss and precurved interdental brushes. Materials were supplied after random allocation. Participants were recalled at 6 and 12 weeks for clinical measurements, reinforcement of instructions, and fresh materials. RESULTS: There were significant reductions from baseline for all indices in both groups (P <0.01). At 6 weeks, the interdental brush group improved more than the floss group in every parameter (P <0.05). By 12 weeks, the changes in plaque, papillae level, and probing depths were significantly greater in the interdental brush group than the floss group (P <0.01). CONCLUSION: This trial demonstrated that patients were able to improve clinical periodontal outcomes by interdental cleaning, particularly with interdental brushes, even before thorough root surface debridement was undertaken.     

Serial doxycycline and metronidazole in prevention of recurrent periodontitis in high-risk patients.

The efficacy of metronidazole and doxycycline in preventing recurrent periodontitis was studied in 23 patients. After treatment in the previous 7 months with either bimonthly scaling and 3 weeks of systemic doxycycline (11 subjects) or scaling and placebo (12 subjects), patients were monitored for recurrent periodontitis and were scaled every 2 months. When either a periodontal abscess or greater than 2 mm loss of gingival attachment was observed, metronidazole was administered (250 mg every 8 hours) for 10 days. In the placebo plus metronidazole group, 5 patients (42%) exhibited recurrent periodontitis after the metronidazole regimen compared with only one (9%) in the doxycycline plus metronidazole group (P less than 0.096). Subgingival plaque samples at study and healthy control sites were screened for the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Eikenella corrodens, and Fusobacterium nucleatum by immunofluorescence and for spirochetes using Ryu's stain. Presence/absence analysis of the sum of scores of the 6 individual pathogens demonstrated large reductions (P less than 0.005) in the frequency of detection of pathogens in the former doxycycline compared with the placebo plus metronidazole group at both study and control sites before and one month after metronidazole. By 7 months after metronidazole, there was no detectable difference between groups. These results indicate that prevention of recurrent periodontitis with metronidazole may be enhanced by previous treatment with doxycycline.     

The effect of systemic ibuprofen on gingival inflammation in humans

Abstract This clinical trial investigated the influence of short-term ibuprofen therapy on the early phase of the treatment of adult chronic periodontitis. The subjects were 17 patients in good general health referred for specialist periodontal treatment, having moderate chronic adult periodontitis. A series of assessments were made every 2 weeks over an 8-week period, including evaluations of oral hygiene, gingival inflammation and probing pocket depths. All participants received oral hygiene instruction, and following baseline examinations, had half the dentition, chosen at random, treated by scaling and root planing. The patients were randomly distributed into 2 groups, a test group receiving a 14-day course of 800 mg ibuprofen daily, in 4 divided doses, and a control group who did not receive any drug regime. At the 2-week assessment following the drug regime, significantly greater reduction in gingival bleeding, colour and pocketing was detected in the test compared with the control group. The beneficial effects were less evident thereafter. Although clinical application of the regime used in this study would not be justified by these results, further research into anti-inflammatory agents as an adjunct in the treatment of periodontal diseases could be considered, in the light of the beneficial effect on gingivitis in the early phase of periodontal treatment reported.     

Efficacy of local drug delivery of 0.5% clarithromycin gel as an adjunct to non-surgical periodontal therapy in the treatment of current smokers with chronic periodontitis: a randomized controlled clinical trial

Background: The relationship between cigarette smoking and periodontal disease has been examined extensively. Local delivery of antimicrobials into periodontal pockets improves periodontal health. The present study is designed to investigate the adjunctive effects of subgingivally delivered 0.5% clarithromycin (CLM) as an adjunct to scaling and root planing for treating chronic periodontitis in smokers. Methods: Sixty‐one patients were randomized and categorized into two treatment groups: group 1, in which 31 individuals received scaling and root planing plus 0.5% CLM, and group 2, in which 30 individuals received scaling and root planing plus placebo gel. Clinical parameters were recorded at baseline and at 1, 3, and 6 months; they included plaque index (PI), modified sulcus bleeding index (mSBI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL). The mean concentration of 0.5% CLM in gingival crevicular fluid (GCF) was estimated by reverse‐phase high‐performance liquid chromatography. Results: Both therapies resulted in significant improvements. At the end of 6 months, the mean GI, PI, mSBI, PD, and CAL for the CLM group were 1.06 ± 0.28, 2.82 ± 0.64, 1.36 ± 0.24, 4.64 ± 0.63, and 4.90 ± 0.46, respectively, versus 1.38 ± 0.41, 3.22 ± 0.57, 1.44 ± 0.27, 6.07 ± 0.88, and 5.69 ± 0.46, respectively, for the placebo group. Using an individual‐based analysis, individuals in group 1 showed enhanced clinical outcome (P <0.05) over a period of 6 months compared with those in group 2. CLM was detected in GCF until a period of 7 weeks after the local drug delivery. Conclusion: Although both treatment strategies seemed to benefit the individuals, the adjunctive use of 0.5% CLM as a controlled drug delivery system enhanced the clinical outcome.     

Metronidazole plus amoxycillin in the treatment of Actinobacillus associated periodontitis

The potential use of an adjunctive therapy of metronidazole plus amoxycillin for the subgingival elimination of Actinobacillus actinomycetemcomitans in periodontitis patients was investigated. 22 patients participated in this study, 11 with localized juvenile periodontitis (LJP) and 11 with rapidly progressive periodontitis (RPP). 14 patients had received periodontal treatment in the past. All patients were subgingivally infected with A. actinomycetemcomitans. After mechanical subgingival debridement in combination with the antibiotic treatment, elimination of A. actinomycetemcomitans was achieved in all patients but one. With this one exception, clinical improvements were observed in all patients, resulting in reduced pocket probing depths as well as in a significant reduction in bleeding on probing. Re-examination of 16 patients after 9-11 months revealed that A. actinomycetemcomitans was still undetectable and further clinical improvement was observed. It was concluded that the combination of metronidazole plus amoxycillin is a valuable adjunct to mechanical therapy in A. actinomycetemcomitans associated periodontal infections.     

Clinical and microbiological effects of different antimicrobials on generalized aggressive periodontitis

AIM: To evaluate and compare the effects of adjunctive metronidazole plus amoxicillin, doxycycline and metronidazole on clinical and microbiological parameters in patients with generalized aggressive periodontitis. MATERIAL AND METHODS: Forty-three patients participated in this randomized clinical trial divided into four groups. Six weeks after scaling and root planning (SRP), groups 1-3 received adjunctive metronidazole, plus amoxicillin, doxycycline and metronidazole respectively, and group 4 acted as controls. Clinical recordings concerning probing depth, probing attachment level and bleeding on probing were performed at baseline, 6 weeks after SRP and 6 months from baseline. Subgingival samples were analysed using the 'checkerboard' DNA-DNA hybridization for Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Tannerella forsythia and Treponema denticola. Results: All treatments resulted in improvement of clinical parameters (ANOVA p > 0.05). Systemic administration of metronidazole plus amoxicillin or metronidazole resulted in statistically significant greater reduction of the proportion of sites > 6 mm than SRP (z-test, p < 0.05). These antimicrobials yielded a significant effect on levels of important periodontal pathogens for 6 months. CONCLUSION: Adjunctive metronidazole plus amoxicillin or metronidazole alone (when A.actinomycetemcomitans is not involved) is effective in deep pockets of aggressive periodontitis patients.     

Does periodontal disease reflect atherosclerosis in continuous ambulatory peritoneal dialysis patients?

BACKGROUND: Chronic infection and inflammation, including periodontitis, are linked to an increased risk for atherosclerosis. To investigate the possible adverse effects of periodontitis in continuous ambulatory peritoneal dialysis (CAPD) patients, we compared periodontal severity with inflammation and malnutrition, which are associated with poor atherosclerotic outcome in CAPD patients. METHODS: A total of 110 CAPD patients were included in this study to evaluate their clinical periodontal status by using the plaque index, gingival index, and periodontal disease index. Values for nutritional and inflammatory markers and atherosclerotic risk factors were included for analysis with the periodontal index. Analysis of variance, post hoc Tukey's honestly significant difference, univariate and multivariate linear regression analysis, Pearson correlation analysis, and chi2 analysis were used in the evaluation of the data. RESULTS: Poor oral health status was exhibited by 85.5% of our CAPD patients with periodontal disease. We found that age and longer dialysis duration were associated with the severity of periodontitis. Parameters of malnutrition and inflammation and atherosclerotic risk factors also were associated with poor periodontal status. We carried out multiple regression analysis and found that age, albumin level, and duration of dialysis were associated independently with the severity of periodontitis in CAPD patients. A higher percentage of patients in the severe periodontitis group had malnutrition (chi2 = 59.4; P < 0.001), inflammation (chi2 = 60; P < 0.001), and atherosclerosis (chi2 = 65.6; P < 0.001). CONCLUSIONS: Periodontal health is poor in CAPD patients and correlates with markers of malnutrition, inflammation, and atherosclerosis. The diagnosis and treatment of periodontal diseases require better awareness.     

Adjunctive subantimicrobial dose doxycycline: effect on clinical parameters and gingival crevicular fluid transforming growth factor-beta levels in severe, generalized chronic periodontitis

BACKGROUND: At present there is limited data concerning the efficacy of non-surgical periodontal therapy supplemented with subantimicrobial dose doxycycline (SDD) in the treatment of severe, generalized periodontitis. The purpose of the present study was to evaluate the effect of adjunctive SDD therapy on clinical periodontal parameters and gingival crevicular fluid (GCF) transforming growth factor-beta1 (TGF-beta1) levels in patients with severe, generalized chronic periodontitis over a 6-month period. METHODS: Thirty-five patients with severe, generalized periodontitis and 11 periodontally healthy subjects were included in the present study. Patients received full-mouth supragingival debridment at baseline and randomized to take either SDD b.i.d. or placebo b.i.d. for 3 months. Patients received root planing and oral hygiene instruction once a week for four consecutive weeks. Clinical measurements including probing depth (PD), clinical attachment level, papilla bleeding index and plaque index and GCF sampling were performed at baseline, 3 and 6 months. The GCF TGF-beta1 levels were analysed by enzyme-linked immunosorbent assay. RESULTS: Thirteen patients in both study groups completed the 6-month trial. Following scaling and root planing (SRP) plus SDD and SRP plus placebo therapy significant improvements in clinical periodontal parameters of both groups were observed (p<0.025). In the SDD group a significantly higher percentage (%73.4) of deep pockets resolved (PD reduction > or =3 mm from baseline) when compared with placebo group (%49.7) at 6 months (p<0.05). At baseline there were no significant differences in GCF TGF-beta1 levels between three groups. Both total amount and concentration of GCF TGF-beta1 in SDD and placebo groups increased when compared with baseline at 3 months. However, only GCF TGF-beta1 levels of SDD group was significantly higher than baseline (p<0.025) and placebo group (p<0.017) at 3 months. At 6 months GCF TGF-beta1 levels of both groups were similar to baseline levels (p<0.025). CONCLUSIONS: These data indicate that combination of SDD with non-surgical therapy improves clinical parameters of periodontal disease and increases GCF TGF-beta1 levels together with a decrease in prevalence of residual pockets in patients with severe, generalized chronic periodontitis. Increased GCF TGF-beta1 levels following SDD therapy might suggest a novell pleiotrophic mechanism for tetracyclines to inhibit connective tissue breakdown.     

慢性阻塞性肺病急性加重与牙周炎的相关性研究

目的：探讨牙周健康状况对慢性阻塞性肺病急性加重的影响。方法：对呼吸内科住院的81例慢性阻塞性肺病伴有慢性牙周炎的患者随机分成两组,实验组在接受慢性阻塞性肺病规范化治疗的同时进行牙周非手术治疗,对照组只接受慢性阻塞性肺病规范化治疗,不予以牙周病治疗,随访1年,测量并比较患者牙周治疗前、后的菌斑指数（PLI）、龈沟出血指数（SBI）、牙周探诊深度（PD）、牙周附着水平（AL）、FEV1／FVC、FEV 1％pred．、急性加重次数,对急性加重次数与牙周健康指数行相关分析和多元线性逐步回归分析。结果：实验组牙周健康指数明显优于对照组（P＜0．05）,且急性加重次数低于对照组（P＜0．05）;牙周健康指数PLI、SBI、PD、AL与急性加重次数呈显著正相关（分别r＝0．864,r＝0．866,r＝0．926,r＝0．905）,多元线性逐步回归分析显示急性加重次数与PD、PLI呈正相关。结论：改善慢性阻塞性肺病患者的牙周健康状况,可以降低患者的急性发作频率。     

牙周非手术治疗对2型糖尿病伴牙周炎患者糖代谢及血清白细胞介素6的影响

目的 观察牙周非手术治疗对2型糖尿病伴慢性牙周炎(chronic periodontitis,CP)患者牙周状况、糖代谢及血清白细胞介素6(IL-6)的影响,探讨其可能的影响机制.方法 选取2型糖尿病伴慢性牙周炎(type 2 diabetes mellitus with chronic periodontitis,DMCP组)和不伴有全身系统性疾病的CP患者(CP组)各55例进行牙周非手术治疗,其中DMCP组中糖化血红蛋白(glycated hemoglobin,HbA1c)＜7.00%的患者为血糖控制较好组(A1组),HbAlc≥7.00%的为血糖控制较差组(A2组).在治疗前及治疗后6周、3个月时分别记录全口探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、出血指数(beeding index,BI)和菌斑指数(plaque index,PLI),并检测空腹血糖(fasting plasma glucose,FPG)、HbA1c及血清IL-6水平.结果 DMCP组和CP组PD、AL、BI、PLI和血清IL-6水平在治疗后6周及3个月时均显著降低(P＜0.05),其中DMCP组血清IL-6从(3.47±0.33)ng/L(治疗前)显著降至(3.21±0.66)ng/L(治疗后6周),再降至(3.03±0.54)ng/L(治疗后3个月).DMCP组治疗后3个月HbA1c水平[(6.80±1.21)%]与治疗前[(7.35±1.73)%]相比显著降低(P＜0.05),其中A2组HbA1c水平从治疗前的(8.72±1.51)%显著降至治疗后3个月的(7.59±1.28)%(P＜0.05),而A1组HbA1c水平则无明显变化(P＞0.05).结论 牙周非手术治疗能够降低DMCP患者血清IL-6水平,并在一定程度上改善患者糖代谢状况;该治疗能显著改善血糖控制较差者的糖代谢,而对血糖控制较好者的糖代谢则无明显影响.

Abstract：

Objective To evaluate the effect of non-surgical periodontal therapy on periodontal status, glycemic control and the level of serum interleukin(IL)-6 in type 2 diabetic patients with chronic periodontitis (DMCP). Methods Fifty-five DMCP and 55 systemically healthy patients with chronic periodontitis(CP) were recruited in this study. The diabetes were classified into two groups, the wellcontrolled group [glycated hemoglobin (HbA1c) ＜ 7.00%]and the poorly controlled group (HbA1c ≥7.00%). All subjects received non-surgical periodontal therapy. Periodontal clinical parameters including periodontal probing depth (PD), attachment loss (AL), bleeding index (BI) and plaque index (PLI) were recorded at baseline, 6 weeks and 3 months after the treatment. Fasting plasma glucose(FPG), HbA1c and the concentration of serum IL-6 were measured. Results At 6 weeks and 3 months after treatment, PD,AL, BI, PLI and the concentration of serum IL-6 of both groups significantly reduced(P ＜ 0. 05). The level of IL-6 in diabetic patients reduced significantly from (3.47 ±0.33) ng/L to (3.21 ±0.66) ng/L and to (3.03 ± 0. 54) ng/L. The HbA1c of diabetic patients reduced significantly 3 months after treatment [(6.80±1.21%]compared with the baseline[(7.35 ± 1.73)%, P ＜0.05]. HbA1c of the poorly controlled group reduced significantly(P ＜0. 05), while HbA1c of the well-controlled diabetes did not show any apparent reduction (P ＞ 0. 05). Conclusions Non-surgical periodontal therapy can effectively reduce the concentration of serum IL-6, thereby improving glycemic control in type 2 diabetes patients with chronic periodontitis. However, there was no any significant reduction of HbA1c in the well-controlled diabetes.     

Supportive periodontal therapy and periodontal biotype as prognostic factors in implants placed in patients with a history of periodontitis

Objectives: To evaluate bone loss around implants placed in patients with a history of treated chronic periodontitis and who did or did not attend supportive periodontal therapy, after one year in function. Furthermore, the influence of periodontal biotype and level of plaque was also evaluated. Material and Methods: Forty-nine patients participated voluntarily in the study. All subjects had a history of chronic periodontitis, which had been previously treated. After the active treatment, 27 patients attended supportive periodontal therapy (SPT) and the rest did not (No SPT). The O’Leary plaque index and periodontal biotype were recorded for each subject and 246 Astra Tech® OsseospeedTM implants were radiographically analysed (123 placed in SPT patients and 123 in No SPT patients) at the time of loading and one year later, measuring marginal bone loss with the program Dental Studio NX 6.0®. The statistical analysis was performed with Windows SPSS, applying Pearson’s correlation index and the Kruskal-Wallis and U-Mann Whitney non-parametric tests. Results: Six patients were found to have periimplantitis and sixteen mucositis. The survival rate was 99.59% (100% SPT and 99.18% No SPT). Mean bone loss was 0.39 mm (range [-0.71 - 8.05]). Among SPT patients, 95% of the implants had losses less than or equal to the mean (mean bone loss of 0.16 mm) compared to 53.7% for the No SPT group (mean bone loss of 0.62 mm). A statistically significant relationship was demonstrated between bone loss around the implant and the patient’s periodontal biotype and plaque index. Conclusions: The marginal bone loss around implants in patients with treated chronic periodontitis is minimal if they are in a controlled SPT programme and there is individual control of plaque index. Moreover, the presence of a thin periodontal biotype represents a risk factor for additional bone loss. Key words:Peri-implantitis, chronic periodontitis, bacterial plaque, periodontal biotype.     

伴糖尿病的慢性牙周炎患者牙周基础治疗效果研究

目的研究牙周基础治疗对伴有糖尿病的慢性牙周炎患者的治疗效果。方法选择伴Ⅱ型糖尿病的老年慢性牙周炎患者(糖尿病组)与不伴糖尿病的老年慢性牙周炎患者(非糖尿病组)各20例行牙周基础治疗,记录并比较两组患者在基线和术后3、6、12个月的菌斑指数、牙龈指数、探诊出血、探诊深度、附着丧失等指标。结果牙周基础治疗对两组患者均有较好的治疗效果,各项指标均明显改善,与基线水平比较差异有统计学意义(P<0.01),而两组间各项牙周指数的改善在术后3、6、12个月差异均无统计学意义(P>0.05)。结论牙周基础治疗对伴有糖尿病的老年慢性牙周炎患者在短期内(12个月)有良好的治疗效果。