侵袭性牙周炎患者牙周基础治疗的疗效观察

目的评价侵袭性牙周炎牙周基础治疗的效果。方法选择2006年9月-2008年12月于中国医科大学口腔医院牙周科就诊的48例侵袭性牙周炎患者为研究对象,其中局限型侵袭性牙周炎（LAgP）20例,广泛型侵袭性牙周炎（GAgP）28例。所有患者均进行牙周基础治疗,分别在治疗前和治疗结束后1、3、6个月检测全口牙的探诊深度（PD）、临床附着丧失（CAL）、出血指数（BI）和牙齿松动度。结果LAgP和GAgP患者在治疗后1、3、6个月的PD、CAL、BI和牙齿松动度较治疗前均有明显改善（P<0.05）。LAgP患者的PD、CAL在治疗后3个月与治疗后1个月比较,GAgP患者的PD、CAL在治疗后6个月与治疗后3个月比较,其差异均有统计学意义（P<0.05）。所有患者第一恒磨牙治疗后1、3、6个月的CAL较同期中切牙的改善情况更明显。结论牙周基础治疗对侵袭性牙周炎具有良好的治疗效果,GAgP和LAgP患者牙周基础治疗后的中期效果有差异。     

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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。     

Antimicrobials for the treatment of aggressive periodontitis

Aggressive periodontitis is characterized by a considerable attachment loss over a relatively short period of time. It may be the consequence of either the presence of highly aggressive pathogens or a highly susceptible host. In the first case, the use of antimicrobials should be beneficial in the treatment of those patients. However, due to the organization of the micro-organisms as a biofilm, the increasing incidence of allergies and resistance against antimicrobials and their side-effects, there is still controversy about their benefit in the treatment of periodontal disease. This paper discusses indications for the use of antimicrobials, the substances prescribed and the type of application under the conditions of aggressive periodontitis.     

比较局部或全身应用抗生素辅助治疗广泛性侵袭性牙周炎的临床疗效

目的：比较局部或全身应用抗生素加龈下刮治及根面平整的机械治疗对广泛性侵袭性牙周炎临床疗效的影响。方法：采用随机分组方法分为局部使用盐酸米诺环素组、口服阿莫西林＋甲硝唑组和单纯龈下刮治及根面平整的治疗组,通过观察各项临床牙周指数在治疗前后的变化,比较三组之间的疗效差异。结果：三组的各项临床牙周指数较治疗前均有显著性差异（P〈0.01）,治疗后局部用药组和全身用药组的龈沟出血指数（SBI）、探诊深度（PD）和附着水平丧失（CAL）均较单纯机械治疗组有显著性差异（P〈0.01）,但局部用药组和全身用药组之间SBI、PD、CAL的无显著性差异（P〉0.05）。结论：局部或全身应用抗生素均可有效提高广泛性侵袭性牙周炎的临床疗效,且两者疗效无显著性差异。     

Treatment of experimental periodontal disease by photodynamic therapy in immunosuppressed rats

Background and Objective: The aim of this study was to compare photodynamic therapy (PDT) as an adjunctive treatment of induced periodontitis with scaling and root planing (SRP) in dexamethasone‐inhibited rats. Material and Methods: The animals were divided into two groups: ND (n=90), saline solution treatment; D (n=90), dexamethasone treatment. In the ND and D Groups, periodontal disease was ligature‐induced at the first mandibular molar. After 7 days, the ligature was removed and all animals received SRP and were divided according to the following treatments: SRP, saline solution; Toluidine Blue‐O (TBO), phenothiazinium dye; and PDT, TBO and laser irradiation. Ten animals in each treatment were killed at 7, 15 and 30 days. The radiographic and histometric values were statistically analysed. Results: In the ND and D Groups, radiographic analysis showed less bone loss in animals treated by PDT in all the experimental periods than SRP and TBO at 15 days (p<0.05). After a histometric analysis was carried out in the ND and D groups, the animals treated by PDT showed less bone loss in all periods than SRP and TBO after 15 days (p<0.05). Conclusions: The PDT was an effective adjunctive treatment of induced periodontitis compared with SRP in dexamethasone‐inhibited rats.