盐酸米诺四环素软膏对慢性牙周炎龈沟液中硫化物的影响

目的：分析慢性牙周炎病人局部应用盐酸米诺四环素（minocycline HCl，MINO）后，不同牙周状态下龈沟液（GCF）中硫化物（suleus sulphide level，SUL）浓度变化及其与临床指标的关系。方法：采用金刚牙周探测仪对盐酸米诺四环素治疗前后龈沟液中硫化物浓度及其临床指标进行测定。随机单盲法选择慢性牙周炎病人21例，61个患牙。用药组（T）34个患牙，204个位点，基础治疗后将盐酸米诺四环素软膏置牙周袋内；对照组（C）卯个患牙，162个位点，以单纯基础治疗为主。于基线前两周完成全口龈上洁治、口腔卫生宣教。基线时测定相应位点龈沟液中硫化物浓度，龈沟出血指数（SBI），牙周袋探诊深度（PPD），牙周临床附着丧失水平（CAL）；然后行龈下刮治术，用药组龈沟内放药，对照侧不放药。第2周各项指标检查同上。结果：用药组（T）龈沟液中硫化物浓度与其基线时和对照组相比明显下降（P〈0．05），其临床指标用药组（T）与对照组（C）相比改善明显（P〈0．05），龈沟液中硫化物的浓度与临床指标间具有相关性。结论：盐酸米诺四环素软膏（MINO）辅助治疗牙周炎，能有效降低龈沟液中硫化物浓度，改善牙周组织状况；椅旁龈沟液硫化物浓度变化可间接反映对牙周袋内细菌的杀灭、抑制作用。     

盐酸二甲胺四环素辅助治疗慢性牙周炎的短期临床疗效观察

目的 观察盐酸二甲胺四环素(MINO)辅助治疗慢性牙周炎的临床效果.方法 将78例患者200颗患牙采用自身对照随机分为MINO试验组和对照组,观察用药结束后1周、 4周MINO组与对照组牙周袋深度(PD)、附着水平(AL)、探诊出血(BOP)的变化.结果 用药结束后1周、4周,两组PD、AL和BOP阳性率较基线时都有显著下降; 1周时试验组PD、AL和BOP阳性率虽然都低于对照组,但两组比较差异均无统计学意义(P＞0.05);而4周时两组PD、AL和BOP阳性率比较则差异有统计学意义(P＜0.05).结论 盐酸二甲胺四环素对慢性牙周炎有明显的辅助治疗效果,是临床上一种值得推广的局部治疗药物.     

二甲胺四环素软膏治疗牙周炎的研究

本文的目的是研究牙周袋内放置二甲胺四环素软膏治疗牙周炎的临床和微生物学疗效。将２１名中度牙周炎患者的７６颗患牙随机分组，每周局部给药，连续四周。用药前及用药后２、４、７周分别检测临床指数，并采取龈下菌斑，检测螺旋体的百分比以及其中的牙龈类杆菌。结果证实局部应用二甲胺四环素软膏是一种有效地治疗牙周炎的手段。     

盐酸米诺环素缓释剂对慢性牙周炎龈沟液弹性蛋白酶水平的影响

目的：观察慢性牙周炎应用盐酸米诺环素缓释软膏治疗前后龈沟液中细胞外弹性蛋白酶（elastase in su-pernatant,EA-s）和细胞内弹性蛋白酶（elastase in the pellet,EA-p）水平的变化。方法：35例慢性牙周炎患者,每例口腔左右两个象限随机分为实验组和对照组,基础治疗后实验组使用盐酸米诺环素缓释软膏,1周1次,共4周,对照组不使用盐酸米诺环素缓释软膏,测定两组治疗前后龈沟液中EA-s和EA-p水平。结果：实验组、对照组在治疗后龈沟液中EA-s和EA-p的总量和浓度均明显降低（p〈0.01）。治疗前后实验组与对照组龈沟液中EA-s和EA-p的总量和浓度变化有显著性差异,实验组优于对照组（p〈0.01）。结论：基础治疗和盐酸米诺环素缓释软膏联合应用对慢性牙周炎的治疗在降低龈沟液中EA方面优于单纯的基础治疗。     

盐酸米诺环素缓释剂对慢性牙周炎龈沟液碱性磷酸酶水平的影响

目的:观察成人慢性牙周炎应用盐酸米诺环素缓释软膏治疗前后龈沟液中碱性磷酸酶(alkalinephos phatase ,ALP)水平的变化。方法:2 8例慢性成人牙周炎患者,每例口腔左右两个象限随机分为实验组和对照组。基础治疗后实验组使用盐酸米诺环素缓释软膏,一周一次,共4周。对照组不使用盐酸米诺环素软膏。测定两组治疗前后龈沟液中ALP水平。结果:实验组、对照组在治疗后龈沟液中ALP均明显降低(P <0 .0 1)。治疗前后实验组与对照组龈沟液中ALP变化有显著性差异,实验组优于对照组(P <0 .0 1)。结论:基础治疗和盐酸米诺环素缓释软膏联合应用对成人慢性牙周炎的治疗在降低龈沟液中ALP方面优于单纯的基础治疗。     

胶原酶在牙周炎发病及四环素类药物在牙周炎治疗中的作用

胶原酶在牙周炎发病中起破坏作用;四环素类药物有抑制胶原酶活性的作用,还能促进牙周组织再生,小剂量应用四环素类药物,既安全又能有效地辅助牙周炎的机械治疗,在牙周炎治疗的临床应用上有发展前途。     

龈沟液中I型胶原自身抗体的检测

本研究用间接ＥＬＩＳＡ法检测成人牙周炎（ＡＰ）２７例为４４牙，快速进展性牙周炎（ＲＰＰ）１０例２６牙及吉健康对照（Ｈ）１２例牙龈沟液中的Ｉ型胶原自身抗体（ＩｇＧ）。结果ＡＰ，ＲＰＰ及Ｈ各组的Ｉ型胶原抗体检出率分别为２７．３％，２６．９％和２２．２％，各组间的检出率无统计学差异（Ｐ〉０．０５），且Ｉ型胶原抗体水平与临床参数也无显著相关。本研究结果不支持牙周炎时机体对Ｉ型胶原产生了自身体液免疫反应，牙     

替硝唑冲洗液对龈沟液中Ⅱ型胶原酶水平的影响

目的探讨龈下刮治同期使用药物冲洗对龈沟液中Ⅱ型胶原酶水平的影响。方法选取100例慢性牙周炎患者,随机分为2组,每组50例。试验组行超声龈下刮治同期0.2%替硝唑冲洗,对照组行单纯超声龈下刮治纯净水冲洗。分别于治疗前及治疗后2周收集患牙的龈沟液并记录相关的临床指标。采用双抗体夹心酶联免疫法检测龈沟液中Ⅱ型胶原酶水平。结果 2组患者治疗后患牙牙周临床指标均有明显的改善,治疗后龈沟液中Ⅱ型胶原酶的水平明显降低,差异有统计学意义（P〈0.01）,且试验组较对照组下降幅度更明显,差异有统计学意义（P〈0.05）。结论超声龈下刮治同期0.2%替硝唑冲洗较单纯超声龈下刮治使龈沟液中Ⅱ型胶原酶水平降低更显著。     

低量强力霉素对牙周炎患者龈沟液胶原酶等活性的影响

为探讨低剂量强力霉素对牙周炎患者龈沟液中多种酶活性的抑制作用，作者对５例慢性成人牙周炎患者，经分别口服空白剂，强力霉素４０ｍｇ／ｄ，强力霉素２０ｍｇ／ｄ及停药共４个阶段，测量各自龈沟液量及龈沟液胶原酶、弹性蛋白酶、β－葡萄糖醛酸酶活性。结果：在口服强力霉素４０ｍｇ／ｄ时，其龈沟液量及活性均较用药前明显下降（Ｐ〈０．０１），且连续服用２周无明显副作用，可间隔１个月后重新用药。     

The effect of tetracycline and/or scaling on human periodontal disease

The objective of this study was to test the efficacy of scaling and root planing with or without adjunctive tetracycline therapy in the treatment of periodonitis in humans. The presence of plaque, gingival inflammation, probing depths and attachment levels was assessed for all teeth in 12 patients with chronic, advanced periodontitis. After an initial examination all patients were given detailed oral hygiene instructions. The teeth in one-half of each arch were then scaled and root planed. The teeth in the contralateral half were not treated. Six patients were given tetracycline (1 gm/day) during the first and second weeks and the seventh and eighth weeks of the trial. The study thus included four different treatment groups: 1) no treatment, 2) scaling and root planing alone, 3) tetracycline administration alone, and 4) scaling and root planing combined with tetracycline administration. All patients were reexamined at 8 and 25 weeks subsequent to the initiation of therapy. Both PlI and GI scores decreased significantly in all groups. The GI scores were significantly lower in the scaled and root planed areas as compared to the contralateral sides at both the 8- and 25-week examinations. The PlI score was lower in the scaled and root planed areas only at the 25-week interval. The gingival probing depths were reduced in all groups. A significantly greater decrease in probing depth, however, was noted in scaled and root planed areas. There was a trend to gain of attachment in the treated areas but the magnitude of the gain was very small. The findings of the trail also revealed that the administration of tetracycline had only a minor effect on the parameters examined.     

The effect of non-surgical treatment on periodontal pockets in smokers and non-smokers

Abstract. Changes in probing pocket depth following non-surgical periodontal treatment were investigated in 75 patients, 40 of whom were heavy smokers. Pockets with an initial probing depth of 4–6 mm were studied. The treatment consisted of patient instruction and motivation and debridement of plaque and calculus by hand instrumentation. The treatment was completed within 5 months and probing depth was recorded prior to and 1 month following the completion of therapy. Plaque index was reduced to a minimum in both smokers (P1I = 0.2) and non-smokers (P1I = 0.1) following treatment. An average reduction in probing pocket depth of 1.1 mm in smokers and 1.2 mm in non-smokers was observed. The reduction attained was less in smokers than in non-smokers for all regions of the dentition investigated. The greatest difference between groups was observed for the maxillary anterior region.     

The effect of non-surgical periodontal therapy on peroxidase activity in diabetic patients: a case-control pilot study

Objective: To evaluate the effect of periodontal therapy on clinical parameters as well as on total salivary peroxidase (TSP) activity and myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus (DM2) and of systemically healthy individuals.
Material and Methods: Twenty DM2 subjects with inadequate metabolic control (test group) and 20 systemically healthy individuals (control group), both groups with chronic periodontitis, were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), clinical attachment level (CAL), visible plaque index (VPI), bleeding on probing (BOP), gingival bleeding index (GBI) and presence of suppuration (SUP), as well as TSP activity and GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy.
Results: At baseline and 3 months post-treatment, the test group presented a higher percentage of sites with VPI and BOP ( p <0.01). MPO activity in the GCF presented lower values ( p <0.05) for the test group at both baseline and the post-treatment period. The periodontal treatment resulted in a significant improvement of most clinical and enzymatic parameters for both groups ( p <0.05).
Conclusions: In both groups, the periodontal therapy was effective in improving most clinical parameters and in reducing salivary and GCF enzymatic activity. The diabetic individuals presented lower MPO activity in the GCF.     

Effect of non-surgical periodontal therapy combined with adjunctive antibiotics in subjects with "refractory" periodontal disease

The aim of the present study was to evaluate the clinical effect of non-surgical periodontal therapy with the adjunct of a selected antibiotic in subjects with refractory periodontitis. 10 subjects were selected for the study; all had a history of periodontal surgery, tetracycline therapy, and regular maintenance by a periodontist. Clinical registrations including gingival index, plaque index, presence of bleeding and suppuration, pocket depth, and duplicate measurements of attachment level were performed at baseline and at monthly intervals. When disease activity was detected based on the tolerance method, a bacterial sample was taken from the active site and its susceptibilities to a number of antibiotics were determined. For the selected 10 subjects, Augmentin was the antibiotic of choice. Each subject received 750 mg/day for 2 weeks, during which time a full-month scaling and root planing was performed under local anesthesia. Clinical re-evaluation was performed after 3, 6, 9 and 12 months. At the time disease activity was detected, the average loss of attachment at all active sites was 2.2 mm, and the increase in pocket depth 1.5 mm. At 3 months post-therapy, these sites had regained 2 mm of attachment which remained stable through the 12-month examination. Pocket depths decreased 2.5 mm over the first 6 months and then stabilized. The frequency of all sites that gained 1 mm or more of attachment increased by approximately 10% over the first 9 months following therapy. The frequency of all sites that decreased 1 mm or more in pocket depth increased approximately 15% over the same period.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effect of systemic antibiotics administered during the active phase of non-surgical periodontal therapy or after the healing phase: a systematic review

Objective

The aim of this systematic review was to compare the clinical effectiveness of systemic antibiotics administered in the active stage of periodontal treatment or after the healing phase.

Material and Methods

An electronic search was performed in the databases EMBASE, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL), in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. A manual search of the reference list of selected studies and of review articles was also performed up to November 2013. Randomized Clinical Trials (RCT) that evaluated the systemic administration of antibiotics as adjuvants to scaling and root planning (SRP) at different phases of periodontal treatment were included. Systematic reviews and studies that evaluated subjects with systemic diseases and those that used subantimicrobial doses of antibiotics were excluded.

Results

The initial search identified 1,039 articles, of which seven were selected, and only one met the inclusion criteria. This study showed that subjects taking metronidazole and amoxicillin at the initial phase of treatment exhibited statistically significantly greater reduction in pocket depth and gain in clinical attachment level in initially deep sites (PD≥7 mm) than subjects taking antibiotics after healing (p<0.05). This comparison was conducted 2 months after antibiotic intake, at the healing phase.

Conclusion

To date, only one short-term RCT has directly compared different moments of systemic antibiotics administration, as adjuncts to SRP, in the treatment of periodontitis. Although the results of this study suggested some benefits for antibiotics intake during the active phase of therapy, these findings need to be confirmed by larger placebo-controlled randomized clinical trials with longer follow-up periods.     

Effect of tetracyclines on collagenase activity in patients with recurrent aphthous ulcers

Human neutrophil-type (MMP-8) and fibroblast-type (MMP-1) interstitial collagenase, and their inhibition by tetracyclines in saliva from patients with recurrent aphthous ulcers (RAU) or aphthae, were studied by means of sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and enzymological analyses. In the salivary specimens obtained from patients with aphthae, collagenase was found in endogenously active form and was predominantly of MMP-8 type. Topical rinsing treatment with chlortetracycline (Aureomycin®) alleviated the discomfort caused by the lesions but did not reduce salivary collagenase amounts; however in vitro , doxycycline inhibited salivary collagenase totally.     

Hyaluronic acid as adjunctive to non-surgical and surgical periodontal therapy: a systematic review and meta-analysis

Clinical Oral Investigations - To evaluate the potential added benefit of the topical application of hyaluronic acid (HA) on the clinical outcomes following non-surgical or surgical periodontal...     

牙周非手术治疗药物性牙龈肥大伴牙周炎的疗效分析

目的 评价牙周非手术治疗药物性牙龈肥大的短期疗效.方法 因服用钙通道阻滞剂引起药物性牙龈肥大伴牙周炎的患者8例,在未停药的基础上经牙周非手术治疗,比较治疗前后牙周指数变化.结果 治疗后所有患者牙周炎症及牙龈肥大状况得到改善,牙周袋深度降低,出血指数降低,差异有统计学意义(P＜0.05).牙周探诊深度大于5 mm位点数由58.39％降至9.71％;牙龈出血指数大于2的位点数由96.86％降至42.54％.结论 牙周非手术治疗短期内可明显改善药物性牙龈肥大伴牙周炎患者的牙龈炎症状况,减轻牙龈肥大.     

四环素透明质酸凝胶辅助治疗慢性牙周炎的疗效观察

目的：观察四环素透明质酸凝胶辅助治疗牙周炎的临床疗效。方法：采用口内自身对照研究方法，选择68名牙周炎病人共200个牙周袋分为四环素透明质酸凝胶实验组和对照组。实验组患牙行洁治、刮治、根面平整后，龈下辅助给予四环素透明质酸凝胶，对照组仅作洁治、刮治、根面平整，观察两组患牙的临床指标（PLI、SBI、PD、AL、MD）和龈下菌斑螺旋体构成比的动态变化。结果：两组患牙各临床指标在治疗后均显著改善，治疗后4周，对照组PD、AL、MD及龈下菌斑螺旋体的构成比与治疗后1周相比无显著差异。结论：慢性牙周炎在基础治疗上，龈下局部应用四环素透明质酸凝胶辅助治疗牙周炎可取得较好的疗效。