Bisphosphonate therapy improves the outcome of conventional periodontal treatment: results of a 12-month, randomized, placebo-controlled study

BACKGROUND: Bone loss in periodontitis results from inflammatory reactions that stimulate osteoclastic bone resorption. Bisphosphonates inhibit bone resorption and increase bone mass. This study evaluated the effect of bisphosphonate therapy as an adjunct to non-surgical periodontal treatment in patients with moderate to severe chronic periodontitis. METHODS: Patients were randomized (2:1) to one of two bisphosphonate therapies or placebo for 1 year. All patients received non-surgical periodontal treatment (scaling, root planing) and periodontal maintenance therapy every 3 months. Clinical assessments at baseline and 6 and 12 months included clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Periodontal bone mass was assessed by dental radiographs at baseline and 12 months using fractal analysis and digital subtraction radiography (DSR). RESULTS: Seventy patients were randomized, 43 to the bisphosphonate group and 27 to the placebo group. Bisphosphonate therapy significantly improved CAL, PD, and BOP relative to the placebo group during the 6- to 12-month period (CAL, P = 0.0002; PD, P = 0.0156; BOP, P = 0.0079). There was no difference in the change in periodontal bone mass between the bisphosphonate and placebo groups as measured by fractal analysis and DSR. CONCLUSION: These data suggest that bisphosphonate treatment improves the clinical outcome of non-surgical periodontal therapy and may be an appropriate adjunctive treatment to preserve periodontal bone mass.     

Interviews and assessments of returning non-compliant periodontal maintenance patients

BACKGROUND: Periodontal therapy without a maintenance programme has been shown to be of doubtful value. Most studies show a low-level of compliance with periodontal maintenance therapy. Many suggestions as to the reasons for this have been put forward, but it has been difficult to confirm these, as the patients are not available to be interviewed. AIM: To identify, interview and assess returning non-compliant periodontal maintenance patients. METHOD: All patients who had undergone periodontal therapy between 1986 and 2004 but not complied with the maintenance therapy were interviewed and assessed when they later returned to the specialist office for treatment. RESULTS: Sixty-one patients with an average age of 56.4 years (SD 11,1) were studied. There were 18 males and 43 females. The patients were compliant for 3.4 years (SD 3.2) before leaving and returning after 5.5 years (SD 3.3) of non-compliance. Average tooth loss while non-compliant was 1.6 teeth (SD 2.8). The interviews revealed that 37 patients attended their own dentist's office exclusively for maintenance therapy, eight patients gave health reasons and seven patients lack of motivation or failure to cooperate. Thirty-six patients were re-referred by their own dentist, 13 changed dentist and were referred by this dentist, while 12 patients contacted the specialist office directly. Fifty-three patients claimed to have been fully compliant with their own dentist while non-compliant with the specialist office. CONCLUSION: The main reason for non-compliance was that the patients did attend their own dentist exclusively for maintenance therapy. Tooth loss and periodontal deterioration was more marked in this group than patients who in addition attended the specialist office for maintenance therapy.     

Effect of triclosan on healing following non-surgical periodontal therapy in smokers

BACKGROUND: Tobacco smoking is an established risk factor for periodontitis, and is associated with periodontal attachment and tooth loss. Clinical studies have indicated that smoking may adversely affect and impede healing following periodontal therapy. Adjunctive antimicrobials, on the other hand, have been shown to enhance the effect of non-surgical periodontal therapy. The objective of this study was to evaluate the effect of a triclosan/copolymer/fluoride dentifrice on healing following non-surgical periodontal therapy in smokers. METHODS: Sixty smokers (aged 35-59 years; 23 females) with chronic periodontal disease volunteered to participate in a double-blind, randomized, controlled, clinical trial. The subjects were randomly assigned to use a triclosan/copolymer/fluoride (30 subjects) or a standard fluoride (30 subjects) dentifrice and received detailed information on proper techniques for self-performed plaque control. The participants then received non-surgical periodontal therapy followed by periodontal maintenance care every 6 months over 24 months. Clinical recordings included evaluation of oral hygiene standards, gingival health, and periodontal status. RESULTS: Subjects using the triclosan/copolymer/fluoride dentifrice exhibited significantly improved oral hygiene conditions, gingival health, and periodontal status compared with those using the standard fluoride dentifrice over the 24-month maintenance interval. CONCLUSIONS: The results suggest that an oral hygiene regimen including a triclosan/copolymer/fluoride dentifrice may sustain the short-term effect of non-surgical periodontal therapy in smokers.     

牙周非手术治疗对硝苯地平导致的老年人牙龈增生的疗效观察

目的:评价牙周非手术治疗对硝苯地平导致的老年人牙龈增生的治疗效果。方法:选取硝苯地平导致的牙龈增生患者18例,在基线和牙周非手术治疗后1个月、3个月、6个月、12个月分别记录菌斑指数、探诊深度、出血指数和牙龈增生指数。18例患者共13例完成了12个月的观察。结果:在观察期间,各指数持续改善(P<0.05),牙龈炎症持续减轻,牙龈增生状况明显改善。结论:牙周非手术治疗可改善硝苯地平引起的老年人牙龈增生的程度。     

药物性牙龈增生牙周非手术治疗的疗效观察

目的 评价单纯牙周非手术治疗对钙拮抗荆类药物导致的牙龈增生的临床疗效.方法 选取钙拮抗剂类药物导致的牙龈增生患者18例,男11例,女7例,在未停药的情况下进行牙周非手术治疗,在牙周非手术治疗前和治疗后1个月、3个月、6个月记录牙龈增生指数、茵斑指数、出血指数和探诊深度并与初诊时对照观察疗效.结果 牙周非手术治疗1个月后与基线相比,探诊深度、出血指数和牙龈增生指数出现了较明显的改善.经统计学检验有显著差异(P<0.01).茵斑指数无显著差异(P>0.05).牙周非手术治疗3个月、6个月后与基线相比牙龈增生指数、茼斑指数、出血指数和探诊深度均有显著性差异(P<0.05或P相似文献   

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目的 探讨牙周基础治疗对伴发冠心病的牙周炎患者外周血及局部超敏-C反应蛋白（ hs-CRP）水平的影响。方法 选择2007年2月至2011年9月来中国医科大学口腔医学院牙周病科就诊的慢性中、重度牙周炎并发冠心病（稳定期）患者40例。随机分为试验组（25例）和对照组（15例）。试验组患者接受内科维持治疗及牙周基础治疗,对照组患者仅接受内科维持治疗。两组患者分别在治疗前及治疗后1个月行牙周检查,检查指标为全口菌斑指数（PLI）、牙周探诊深度 （PD）,并采集静脉血及龈沟液样本,检测其中hs-CRP的含量。结果 治疗前试验组与对照组间各牙周检查指标（PLI、PD）及静脉血和龈沟液中的hs-CRP含量差异均无统计学意义（P＞0.05）;经过1个月治疗,试验组各牙周检查指标（PLI、PD）及静脉血和龈沟液中的hs-CRP含量均明显低于对照组,差异有统计学意义（P 〈 0.05）;试验组治疗前后疗效对比结果显示,各牙周检查指标（PLI、PD）及静脉血和龈沟液中的hs-CRP含量均有明显的降低,差异有统计学意义（P 〈 0.05）。结论 牙周基础治疗可改善机体的炎症状态,减少全身炎性因子hs-CRP的含量,降低冠心病再发的风险。     

MMP-13 promoter polymorphisms in patients with chronic periodontitis: effects on GCF MMP-13 levels and outcome of periodontal therapy

Aim: The aims of this study were to investigate (a) the matrix metalloproteinase-13 (MMP-13) promoter polymorphisms in severe, generalized chronic periodontitis (CP), (b) the relationship of periodontal therapy outcome with these genotypes and (c) gingival crevicular fluid (GCF) MMP-13 level–MMP-13 genotype correlation.
Materials and Methods: Genomic DNA was obtained from peripheral blood of 102 patients with severe, generalized CP, and 98 periodontally healthy subjects. MMP-13 −77A/G and 11A/12A polymorphisms were determined by the polymerase chain reaction-restriction fragment length polymorphism and DNA sequencing methods, respectively. Fifty-eight CP patients received non-surgical periodontal therapy and were followed for 6 months. Clinical periodontal parameters and GCF samples were collected at baseline and at 6 months. GCF MMP-13 levels were analysed by an enzyme-linked immunosorbent assay.
Results: The distribution of MMP-13 −77AG genotypes and allele frequencies did not differ significantly between study groups ( p >0.05). Study subjects, except 3, had the 11A/11A genotype. MMP-13 −77G allele carriers had similar GCF MMP-13 levels and clinical periodontal parameters compared with AA genotypes after non-surgical periodontal therapy ( p <0.05).
Conclusions: These data suggest that the −77A/G and 11A/12A polymorphisms of MMP-13 gene are not associated with susceptibility to severe, generalized CP in a Turkish population. It seems that −77G allele carriage may not influence the outcome of periodontal therapy.     

Re-treatment profiles during long-term maintenance therapy in a periodontal practice in Norway

BACKGROUND: Periodontal therapy coupled with active maintenance has been shown to be effective in maintaining periodontal health, however, the question of re-treatment is rarely alluded to in the literature. AIM: To quantify the type and extent of re-treatment in a group of patients who had completed a definitive course of periodontal treatment in a Norwegian specialist periodontal practice. The study also investigated factors associated with the provision of periodontal surgery as a re-treatment modality. METHODS: A consecutive group of patients who had comprehensive periodontal treatment, which included periodontal surgery, and were subsequently maintained for between 10 and 17 years were studied. RESULTS: One hundred and one patients with an average age at reassessment of 59.4 (standard deviation (SD) 9.0) years were studied. The average length of the review period was 13.1 (SD 1.9) years. In addition to routine maintenance, 50 patients had further re-treatment and 40 of those who were re-treated had periodontal surgery in the study period. Logistic regression showed that independent predictors of surgical re-treatment, with the effects adjusted for other variables in the model, were uncertain or poor prognosis at baseline, erratic or poor post baseline compliance and a family history of periodontal disease. CONCLUSION: Considerable amounts of re-treatment, including in many cases extensive non-surgical treatment or periodontal surgery, were provided for patients who had surgical periodontal treatment and were subsequently maintained for least 10 years in a specialist periodontal practice.     

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??Objective    To evaluate the prognosis of non-surgical treatment for severe periodontitis in anterior teeth??clarify the factors influencing the prognosis??and provide a reliable judgement for the prognosis of severe periodontitis in anterior teeth. Methods    A total of 290 teeth with probing depth??PD?? ≥ 6 mm were included in this study. General information of the patients??their periodontal clinical indexes??dental pulp state??periodontal bone defect types??periodontitis types??occlusal trauma??crown-to-root ratio??and prosthetic restorations at baseline and 3 months after treatment were recorded. According to the PD 3 months after non-surgical treatment??anterior teeth were divided into two groups??PD < 5 mm group and PD ≥ 5 mm group. Univariate analyses were used to compare the data between the two groups and Logistic regression analysis was performed for binary analysis using SPSS20.0 software package. Results    The results of univariate analyses showed that there were statistically significant difference between the two groups in gender??smoking??mean PD??the deepest PD??SBI??PLI??periodontal bone defect types and crown-to-root ratio at baseline??P < 0.05??. Logistic regression analysis showed that the gender??mean PD??SBI??PLI and crown-to-root ratios at baseline were statistically different between the two groups??P < 0.05??. Conclusion    The patient's gender??the mean PD??SBI??PLI and crown-to-root ratios at baseline are independent influencing factors of periodontal non-surgical treatment for severe periodontitis in the anterior teeth.     

牙周非手术治疗对2型糖尿病伴牙周炎患者糖化血红蛋白A1c和血清可溶性细胞间黏附分子-1的影响

目的 探讨牙周非手术治疗对2型糖尿病伴慢性牙周炎（DMCP）患者牙周状况、糖代谢及血清可溶性细胞间黏附分子-1（sICAM-1）的影响。方法 选择诊断为2型糖尿病伴慢性牙周炎的患者,按糖化血红蛋白A1c （ GHbA1c ）控制水平分为血糖控制良好组（GHbA1c＜7.00％,DMCP1组,30例）和血糖控制较差组（GHbA1c≥7.00％,DMCP2组,30例）;选择不伴有系统性疾病的慢性牙周炎患者（CP组,30例）为对照组。所有患者均进行牙周非手术治疗,分析治疗前（基线）及治疗后1、3个月时探诊深度（PD）、临床附着丧失（CAL）、菌斑指数（PLI）、龈沟出血指数（SBI）、探诊出血（BOP）、空腹血糖（FPG）、GHbA1c及血清sICAM-1水平的变化。结果 治疗后1、3个月时,3组PD、SBI、PLI、BOP阳性率、血清sICAM-1水平比基线时均明显降低（P＜0.05）,CP组和DMCP1组CAL比基线时亦均明显降低（P＜0.05）,但DMCP2组CAL无明显变化（P＞0.05）。治疗后3个月时,DMCP2组GHbA1c水平与基线时比较平均降低1.12%,差异有统计学意义（P＜0.05）,但CP组和DMCP1组在整个观察期间GHbA1c水平与基线时比较差异均无统计学意义（P＞0.05）。结论 牙周非手术治疗可降低2型糖尿病伴牙周炎患者的牙周炎症程度及血清sICAM-1的水平,并可改善血糖控制良好者的牙周附着水平;该治疗还可以降低血糖控制较差者的GHbA1c水平。     

牙周基础治疗对2型糖尿病患者血清瘦素含量影响研究

目的:观察牙周基础治疗对2型糖尿病伴牙周炎(DMCP)患者血清中瘦素(leptin)的浓度、临床牙周状态、血糖控制的影响。方法:选取DMCP患者和不伴有全身系统性疾病的慢性牙周炎(CP)患者各30例进行牙周基础治疗。分别在治疗前、治疗后1个月和3个月记录所有患者牙周临床指数:探诊深度(PD),附着丧失(AL)及菌斑指数(PLI),并检测血清中糖化血红蛋白(HbA1c)及leptin的含量。结果:DMCP组中PD、PLI和血清leptin含量在治疗后1个月和3个月时均显著降低(P<0.05),AL和血清HbAlc含量仅在治疗后3个月显著降低(P<0.05)。CP组中PD和PLI在治疗后1个月和3个月时均显著降低(P<0.05),AL和血清leptin含量仅在治疗后3个月显著降低(P<0.05)。2组治疗前血清leptin含量与牙周临床指数呈正相关。结论:牙周基础治疗有助于DMCP患者的血糖控制、牙周状态改善和血清中leptin含量下降。     

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??Objective    To investigate the biological effects of calcined natural bovine bone??CBB??and the effect of combination therapy for periodontal intrabony defects with CBB and basic fibroblast growth factor??bFGF??. Methods    Totally 10 cases of  severe periodontitis??8 cases of chronic periodontitis and 2 cases of aggressive periodontitis??were selected from February to June 2016 in Stomatological Center of CPLA??the First Affiliated Hospital of Naval Military Medical University. After 1 month of initial periodontal therapy??20 periodontal intrabony bone defects of 10 cases were treated with CBB bone grafting??group CBB??10 defects??or CBB combined with bFGF??group CBBbF??10 defects??. The patients were evaluated for plaque index??PI????bleeding index??BI????probing depths??PD??and clinical attachment loss??CAL??before the treatment and at 6 months and 12 months after surgery. The difference in bone filling was also determined. Results        The percentage of gingival tissue healing well at 1 month after operation in group CBBbF??90%??was better than that in group CBB??40%??. At 12 months??the percentage of good bone filling in bone defect area in group CBBbF??90%??was larger than that in group CBB??60%??. Both in group CBB and group CBBbF??BI??PD and CAL were significantly decreased at 6 and 12 months after operation compared with before operation??P < 0.05??. At 6 or 12 months after operation??the improvement of BI??PD??CAL in CBBbF group was significantly better than that in CBB group??P < 0.05??. In group CBB and group CBBbF??the degree of bone filling increased significantly at 6 and 12 months after operation than before operation. The degree of bone filling in group CBBbF was better than that in group CBB at 6 or 12 months. Conclusion    CBB bone graft and CBB combined with bFGF for repair of periodontal bone defect have good clinical effects??and the latter is better than the former.     

Longitudinal periodontal tissue alterations during supportive therapy. Findings from subjects with normal and high susceptibility to periodontal disease

AIM: The aim of the study was to evaluate disease progression during supportive periodontal therapy in (i) a group of 225 subjects with "normal" (NG) and (ii) a group with high susceptibility (HSG; n= 109) to periodontal disease (based on their baseline disease status). MATERIAL AND METHODS: The following variables were recorded at the baseline examination (1 year after they received non-surgical periodontal therapy) and at the re-examination after 12 years of maintenance: number of teeth, plaque, probing pocket depth, probing attachment level, bone level in full mouth radiographs. All assessments were performed in a standardized manner and by well-trained and calibrated examiners. Supportive periodontal therapy was delivered 3-4 x per year and included repeated oral hygiene instruction and debridement. In addition, sites that bled on probing and had a PPD value of > or = 5 mm received subgingival instrumentation. RESULTS: A comparison between the findings at baseline and after 12 years revealed that in the NG, most subjects maintained their periodontal condition unchanged during the maintenance period; only a few subjects experienced tooth loss and the figures describing the mean amount of bone and attachment loss were small (0.5 mm and 0.3 mm respectively). The HSG patients experienced some tooth loss and also lost significant amounts of bone and attachment during the 12 years of SPT. Thus, in this group of subjects, the mean overall PAL loss amounted to 0.8 mm, i.e., 0.06 mm/tooth surface/year. In the NG, the overall attachment loss was significantly smaller: 0.5 mm, i.e. 0.04 mm/tooth surface/year. CONCLUSION: In subjects with a high susceptibility for periodontal disease who had been treated for this condition by non-surgical means, an SPT program including regularly repeated oral hygiene instruction and subgingival debridement, made it possible to maintain bone and attachment levels at a reasonably stable level over a 12-year period. A similar SPT provided to a group of subjects with normal susceptibility to periodontal disease, on the other hand, prevented almost entirely major tooth, bone and attachment loss.     

利用Florida探针评价牙周炎非手术治疗的疗效

目的利用Florida探针评价牙周炎的非手术治疗的疗效。方法选择100例牙周炎患者为研究对象,进行牙周非手术治疗,采用Florida探针检测患者在治疗前和治疗结束后1个月时的探诊深度（PD）和附着丧失（AL）。检测位点为患者所有天然牙的近中颊、颊正中、远中颊和舌正中4个位点。将全口牙分成前牙组、前磨牙组、后牙组和所有牙组4组,比较4组间、4个位点间以及PD<5 mm和PD≥5 mm的位点间治疗前后PD和AL的变化。结果前牙组、前磨牙组、后牙组和所有牙组治疗后PD和AL与治疗前相比均有明显改善（P<0.05）,PD明显下降,且有牙周附着再获得;其中前牙的改善较磨牙和前磨牙更明显。PD<5mm和PD≥5mm的牙周位点间PD的恢复有统计学差异（P<0.05）,治疗后明显好转;而AL在治疗前后无统计学差异（P>0.05）。4个位点间改善程度的比较无统计学差异（P>0.05）。结论Florida探针能够较准确、客观地评价牙周状况。牙周非手术治疗对牙周炎具有良好的治疗效果,前牙疗效更为明显,同一牙齿不同位点的疗效基本一致。     

牙周非手术治疗对慢性肾病伴牙周炎患者牙周状况及血清C反应蛋白的影响

目的：探讨牙周非手术治疗对慢性肾病（CKD）伴牙周炎患者牙周状况及血清C反应蛋白（CRP）的影响。方法：分两组,A组为无全身严重疾病的牙周炎中老年患者38例,B组为伴慢性肾病的牙周炎中老年患者46例,两组均进行牙周非手术治疗,于牙周治疗前、后3个月分别检测其血清CRP及牙周指标。结果：A组治疗前牙周状况与B组相比,差异非常显著（P〈0.01）。两组患者治疗后牙周状况与治疗前均有改善,差异非常显著（P〈0.01）,A组的治疗效果好于B组,差异有显著性（P〈0.01）。治疗后A组患者血清CRP与治疗前有明显降低,差异非常显著（P〈0.01）,B组患者CRP与治疗前也有降低,差异有显著性（P〈0.05）。患者血清CRP与BOP、PD、AL等指标均呈正相关（P〈0.05）。结论：牙周非手术治疗可能通过改善牙周状况而降低慢性肾病伴牙周炎患者的血清CRP水平。     

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目的评价牙周基础治疗对侵袭性牙周炎（AgP）患者的疗效。方法选择2011年2月至2012年7月南京大学医学院附属口腔医院牙周科就诊的AgP患者58例,进行全口牙周基础治疗。于治疗后1、3、6个月复查,检查患者口中所有天然牙的牙周探诊深度（PD）、附着丧失（CAL）、探诊出血（BOP）、牙龈退缩（GR）,记录松动度。结果治疗后1个月大体观察牙龈组织炎症明显好转,牙龈色泽、形态在多数牙位恢复正常。治疗后3个月PD、CAL与治疗前相比降低,差异有统计学意义（均P〈0．05）;GR增加、松动度好转,但差异无统计学意义（均P〉0．05）。治疗后6个月PD、CAL与治疗前相比降低,GR较治疗前增加,差异均有统计学意义（均P〈0．05）;松动度好转,但差异无统计学意义（P〉0．05）。治疗后6个月与治疗后3个月相比,各项临床指标差异均无统计学意义（均P〉0．05）。治疗后3、6个月,≥3．5mm牙周袋和BOP所占比例与治疗前相比明显下降,差异均有统计学意义（均P〈0．05）。结论基础治疗是治疗AgP的有效手段,中短期疗效可靠。     

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.     

可摘式牙周夹板修复治疗牙周炎的临床效果分析

目的：评价可摘式牙周夹板对牙周炎伴牙列缺损患者的修复效果。方法：选取40例,随机分为2组,每组20例。两组患者行牙周基础治疗后,分别采用可摘式牙周夹板修复和可摘局部义齿修复,观察并记录不同时段各相关牙周指数。结果：可摘式牙周夹板组修复后24个月时菌斑指数（ plaque index,PLI）和出血指数（ bleeding in-dex,BI）较修复前增加（P＜0.05）;但修复后12个月和24个月时牙周探诊深度（periodontal probing depth,PD）较修复前下降,差异均有统计学意义（P＜0.05）。可摘局部义齿修复组修复后12个月和24个月时均出现PLI、BI和PD较修复前明显增加（P＜0.05）。结论：可摘式牙周夹板可改善牙周炎伴有牙列缺损患者的牙周状况,其修复疗效优于可摘局部义齿。     

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.     

非手术方法治疗侵袭性牙周炎临床疗效观察

目的探讨非手术方法治疗侵袭性牙周炎的临床效果。方法选择广泛型侵袭性牙周炎患者15例,进行口腔卫生宣教、龈上洁治、龈下刮治和根面平整,并蹲服罗红霉素和甲硝唑1周。分别于治疗前和治疗后3、6、12、18个月检查及记录出血指数、探诊深度和附着水平,并进行分析比较。结果出血指数、探诊深度和附着水平在治疗前分别为3．37±0．56、（5.83±1．68）mm．（6．78±1．50）mm,治疗后18个月下降为（0．69±0．48）mm、（2．15±0．45）mm、（4．60±0．78）mm,差异均有统计学意义（P=0.000）。结论广泛型侵袭性牙周炎患者经过牙周非手术治疗后可以取得良好的治疗效果,并且疗效较为稳定。