米诺环素对慢性牙周炎的辅助治疗作用

目的 :探讨米诺环素对慢性牙周炎的辅助治疗作用。方法 :将 2 0个病例中患中度及重度慢性牙周炎的患牙 80个随机分成 4组 :①米诺环素 +刮治组 (SRP +M ) ;②单纯刮治组 (SRP) ;③单纯用米诺环素组 (M ) ;④未处理组 (U)。分别在基线、1周 ,4周时检测菌斑指数 (PI)、牙龈指数 (GI)、探诊出血指数 (BOP)、探诊深度 (PD)、附着丧失 (AL)等牙周病临床指标。结果 :SRP +M组在 1周和 4周时探诊深度和探诊出血率显著低于其它 3组 (P <0 .0 5 )。结论 :龈下局部应用米诺环素联合刮治术和根面平整术在降低探诊深度和探诊出血方面比单纯实施刮治术和根面平整术组效果明显。     

盐酸米诺环素治疗慢性牙周炎的疗效观察

目的：观察盐酸米诺环素(派丽奥软膏)治疗慢性牙周炎的疗效。方法 60例慢性牙周炎患者随机分为治疗组和对照组，每组各30例。全部病例均经全口洁治、刮治，治疗组局部用派丽奥软膏，对照组口服甲硝唑，局部涂布碘甘油。结果：治疗组显效ll例，有效19例，有效率占100％；对照组显效5例，有效20例，有效率占83．33％。结论：局部应用派丽奥软膏辅助治疗慢性牙周炎，可获得较理想的临床效果。     

2%盐酸米诺环素软膏辅助治疗慢性牙周炎

目的观察2%盐酸米诺环素软膏治疗慢性牙周炎的临床疗效.方法选取54例慢性牙周炎患者的216颗牙采用自身对照法,随机分为2组,实验组用2%盐酸米诺环素软膏,对照组用碘甘油.观察用药前后的临床症状及牙龈指数(GI)、牙周出血指数(SBI)、牙周袋深度(PD)、牙齿松动度(MD)的变化.结果实验组与对照组疗效相比两者有显著性差异(P＜0.01).结论2%盐酸米诺环素局部用于慢性牙周炎患者,药效持续时间长,能明显改善临床症状.     

盐酸米诺环素软膏治疗慢性牙周炎的临床观察

目的：探讨慢性牙周炎病人局部应用盐酸米诺环素软膏的临床疗效。方法：随机选择慢性牙周炎病人200例共800个患牙,分为两组,每组各100例400个患牙,记录牙龈指数（GI）、牙周袋深度、疼痛不适等临床症状,基础治疗后,实验组牙周袋内置放盐酸米诺环素软膏,每周1次,共3次,对照组放20 g/L碘甘油,隔2 d用药1次,共7次。在第3周末进行观察对比。结果：实验组GI、牙周袋深度的改善、临床疗效的综合评定与对照组相比均有非常显著性差异（P〈0.01）。结论：应用盐酸米诺环素软膏辅助治疗慢性牙周炎疗效显著。     

米诺环素局部用药治疗老年慢性牙周炎的疗效观察

目的：评价盐酸米诺环素软膏局部应用，治疗老年慢性牙周炎的疗效。0方法：选择60例老年慢性牙周炎的患者，共120颗牙。全口洁治和根面平整后，以患者一侧忠牙局部应用盐酸米诺环素软膏为实验组，对侧同名患牙局部应用双氧水、碘甘油作为对照组。于基线、基线后5、9周检测菌斑指数（PLI）、龈沟出血指数（SBI）、探诊深度（PD）。结果：两组临床指标均较基线有明显改善，PLI实验组优于对照组，差异有显著性（P〈0．01）。结论；牙周袋内应用米诺环素软膏配合牙周基础冶疗，能够有效改善牙周炎症状，且效果优于传统的碘氧疗法。     

盐酸米诺环素软膏治疗牙周炎的临床疗效分析

目的：观察盐酸米诺环素软膏局部治疗牙周炎的临床效果。方法：随机将52名牙周炎病人共156颗患牙分成试验组和对照组，观察用药前、后的临床症状和菌斑指数、探诊出血、牙周袋探诊深度、附着水平的变化。结果：两组基线时的牙周各项指数的平均值均无差异（P＞0．05);晦4周、7周均有显著性差异（P＜0．01）。结论：盐酸米诺环素软膏是治疗牙周炎有效、安全、简便的局部治疗药物。     

米诺环素对药物性牙龈增生辅助治疗的疗效观察

药物性牙龈增生影响菌斑控制,加重牙龈的炎症.米诺环素用于辅助治疗慢性牙周炎的易复发或顽固的牙周袋,改善由于牙龈增生而口腔卫生不易维护的牙龈环境.本文探讨应用米诺环素软膏联合刮治和根面平整治疗钙拮抗剂诱导牙龈增生的疗效.     

盐酸米诺环素联合翻瓣术辅助治疗慢性牙周炎疗效的Meta分析

目的 系统评价牙周翻瓣术中使用2%盐酸米诺环素处理根面的疗效,为其治疗慢性牙周炎提供循证医学证据。方法 检索中国期刊全文数据库、维普、万方、中国生物医学文献数据库、PubMed、ScienceDirect和Embase等数据库,检索时限为从建库到2017年7月。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3对数据进行Meta分析。结果 最终纳入7个随机对照实验,共217例受试者。Meta分析结果显示,与单纯翻瓣术（FO）组比较,盐酸米诺环素联合翻瓣术（FM）组患者随访3个月时的探诊深度减少[MD=-0.55,95%CI（-0.84,-0.26）,P=0.000 2],菌斑指数降低[MD=-0.08,95%CI（-0.15,-0.01）,P=0.03],随访6个月时探诊深度减少[MD=-0.62,95%CI（-1.04,-0.21）,P=0.003]方面更加明显,组间比较差异有统计学意义（P<0.05）。FM组患者随访3个月时在临床附着丧失获得[MD=-0.21,95%CI（-0.47,0.04）,P=0.10]方面改变的差异无统计学意义（P>0.05）。结论 在翻瓣下机械清创治疗慢性牙周炎中,使用2%盐酸米诺环素处理根面减少探诊深度和炎症控制方面有明显的效果。     

亚抗菌剂量的米诺环素对大鼠实验性牙周炎治疗作用的初步观察

目的:初步观察亚抗菌剂量的米诺环素在大鼠实验性牙周炎中的治疗作用。方法:由24只成年雄性SD大鼠组成3个实验组:1组是模型组:仅诱导牙周炎;2组是治疗组:诱导牙周炎且用亚抗菌剂量的米诺环素治疗;3组是阴性对照组:假手术(仅腹腔麻醉)。牙周炎的诱导采用丝线结扎法并辅以100g/L蔗糖水为饮料。动物于实验的28d和58d处死,观察指标为:(1)视觉指标:牙松动度(MT),牙龈指数(GI)和牙槽骨丧失(ABL);(2)组织学指标:牙周组织中单核细胞的渗出数、破骨细胞数和牙周组织胶原的含量。资料采用方差分析统计学处理。结果:与模型组相比,28d和56d指标均显示亚抗菌剂量的米诺环素能显著抑制GI,MT,ABL和破骨细胞的形成,56d指标表明亚抗菌剂量的米诺环素能显著抑制牙周组织中单核细胞的渗出和胶原组织的降解。结论:亚抗菌剂量的米诺环素能有效抑制牙槽骨的吸收和牙周胶原纤维的降解,减缓大鼠实验性牙周炎的发展进程。     

盐酸米诺环素软膏辅助一站式全口龈下刮治和根面平整术治疗中度慢性牙周炎的疗效评价

慢性牙周炎是由龈下菌斑中的微生物引发的牙周支持组织的感染性疾病,菌斑微生物及其产物长期作用于牙周组织引起机体的免疫应答反应并使牙龈、牙周膜及牙槽骨等出现进行性的破坏,龈下刮治术和根面平整术（scaling and root planning,SRP）作为牙周基础治疗的重要措施,能够有     

派丽奥与牙康治疗牙周炎的疗效比较

目的　比较派丽奥(2%盐酸米诺环素软膏)与牙康(甲硝唑棒)治疗牙周炎的临床疗效及对牙周可疑致病菌的清除作用。方法　选取11例慢性牙周炎患者的26颗牙周炎患牙为研究对象。患牙要求:①牙周袋探诊深度≥4 mm,且探诊后出血;②左右对称。26颗患牙随机分成实验组(派丽奥治疗组)13颗,对照组(牙康治疗组)13 颗。观察用药前及用药后7 d和14 d,患牙的牙周临床指标菌斑指数(PLI)、牙龈指数(GI)、探诊深度(PD)、探诊出血(BOP)的变化和龈下附着菌斑中螺旋体、球菌、杆菌的百分比,以及非附着菌斑中牙龈卟啉单胞菌、中间普氏菌、二氧化碳噬纤维菌等牙周可疑致病菌百分比的变化。结果　实验组和对照组患牙在用药前各项牙周临床指标和微生物学指标均无显著性差异(P>0.05)。用药后,两组患牙绝大部分牙周临床指标和微生物学指标均较用药前明显改善(P<0.05),但两组间无显著性差异(P>0.05)。结论　派丽奥与牙康均是治疗牙周炎有效、安全的局部治疗药物,两者的疗效无显著性差异。     

慢性根尖周炎一次性根管治疗的临床疗效观察

目的：评价慢性根尖周炎一次性根管治疗的临床效果和可靠性。方法：选择患有慢性根尖周炎的直根管患牙200例,采用改良双敞技术和平衡力法预备根管,0．5％次氯酸钠及17％EDTA冲洗,随机均分为两组：一次性根管治疗组在上述操作完成后立即行牙胶尖加树脂类封闭剂AHplus侧方加压术充填根管;多次性根管治疗组根管内封入氢氧化钙糊剂复诊,待无症状后再行根充。治疗结束后1d、7d、30d随访记录患者的疼痛反应。1年后进行临床及X线复查,计算每组根管治疗的成功及失败率,并进行统计学检验。结果：有94例患者回访,一次性根管治疗组43例,多次根管治疗51例。根管治疗术后1d疼痛发生率一次性治疗组高于多次性组,且有统计学差异,7d、30d的疼痛发生率两组间无明显差异。1年后复查两组的成功率无统计学差异。一次性根管治疗组的前牙与后牙治疗成功率间无统计学差异。结论：慢性根尖周炎一次性根管治疗术后疼痛发生率较多次法高,但远期疗效等同于多次法者。     

派丽奥软膏辅助治疗慢性牙周炎的临床疗效观察

目的：评价派丽奥软膏辅助治疗慢性牙周炎的疗效。方法：40例慢性牙周炎病例按就诊顺序随机分组,在牙周洁刮治疗基础上,以碘甘油辅助治疗为对照组,记录实验组和对照组在基线、用药后各时间点的临床指标PLI、SBI、PD、AL,并进行统计学处理。结果：实验组在用药后6个月内的PLI与对照组或基线比较均显著降低（P〈0.05）,但用药后9个月和12个月均无显著差异（P〉0.05）;实验组在用药后1～12个月的SBI、PD和AL与对照组或基线比较均显著降低（P〈0.05）,用药后12个月的SBI除外）。结论：在单疗程治疗后6个月内,派丽奥软膏辅助治疗慢性牙周炎的各项检测指标的改善均优于碘甘油。     

Azithromycin as an Adjunctive Treatment of Generalized Severe Chronic Periodontitis: Clinical,Microbiologic, and Biochemical Parameters

Background: This study examines the efficacy of azithromycin in combination with non‐surgical periodontal therapy on clinical and microbiologic parameters and gingival crevicular fluid (GCF) matrix metalloproteinases‐8 (MMP‐8) levels over 6 months in patients with severe generalized chronic periodontitis (CP). Methods: Twenty‐eight of 36 patients with severe generalized CP were included in this randomized, double‐masked, placebo‐controlled, parallel‐arm study. They were randomly assigned to azithromycin or placebo groups (500 mg, once daily for 3 days). Probing depth (PD), clinical attachment level, dichotomous presence or absence of supragingival plaque accumulation, and bleeding on probing were recorded. GCF samples were obtained from one single‐rooted tooth with PD ≥ 6 mm, whereas microbiologic samples were collected from two single‐rooted teeth with PD ≥ 6 mm. Microbiologic parameters were analyzed by quantitative real‐time polymerase chain reaction for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, and total bacteria. GCF MMP‐8 levels were determined by immunofluorescence assay. Results: Azithromycin and placebo groups demonstrated similar but significant improvements in all clinical parameters (P <0.05). A. actinomycetemcomitans, P. gingivalis, T. forsythia, P. intermedia, and total bacteria significantly decreased over the 6‐month period in both groups, whereas F. nucleatum was significantly reduced in all visits in the azithromycin group, with the levels also being lower compared with those of the placebo group (P <0.05). The azithromycin and placebo groups exhibited significant reduction in GCF MMP‐8 levels at the post‐treatment visit and at 2 weeks (P <0.05). Conclusion: On the basis of the present findings, it can be concluded that adjunctive azithromycin provides no additional benefit over non‐surgical periodontal treatment on parameters investigated in patients with severe generalized CP.     

Serum Anticardiolipin Concentrations in Patients With Chronic Periodontitis Following Scaling and Root Planing

Background: Anticardiolipin antibodies (antiCl), present in some patients with autoimmune disease, are associated with thrombosis, fetal loss, and other conditions. A significant proportion of patients with chronic periodontitis (CP) test positive for antiCl, likely because some periodontal pathogens contain antigens homologous to the target antigen of antiCl on the serum protein β‐2 glycoprotein‐I (β2GPI) and thus can induce antiCl by molecular mimicry. The authors hypothesized that treatment of periodontitis by scaling and root planing (SRP) could therefore decrease serum titers of antiCl in patients with CP. Methods: Thirty patients with CP received complete periodontal examinations at baseline including assessment of probing depth, attachment loss, gingival index, and plaque index. SRP was performed in two sessions at 2‐week intervals. Eight weeks later, patients were reexamined. Blood samples were taken at baseline, 2 weeks after the initial therapy appointment, and 8 weeks after the completion of treatment for assessment of immunoglobulin (Ig)G and IgM antiCl levels. Results: All periodontal parameters improved significantly. Consistent with previous observations, five (16.7%) of the 30 patients exhibited elevated levels of IgG or IgM antiCl at baseline. Following treatment, the concentrations of IgG and IgM antiCl remained unchanged for the entire cohort of 30 patients. However, in the five patients with elevated antiCl at baseline, IgM antiCl concentrations decreased significantly (P = 0.0008) owing to therapy, while IgG antiCl did not. Conclusion: The oral microflora is a likely source of antigen inducing antiCl in CP, since IgM antiCl levels can be reduced in the short term with conservative therapy.     

Effects of Scaling and Root Planing on Clinical Response and Serum Levels of Adipocytokines in Patients With Obesity and Chronic Periodontitis

Background: Despite several investigations suggesting that obesity is a risk indicator for periodontitis, little is known about the effect of obesity on periodontal treatment response. The aim of this study is to evaluate the effects of scaling and root planing (SRP) on clinical parameters and circulating levels of leptin and adiponectin in patients with obesity with chronic periodontitis (CP). Methods: Twenty‐four patients with obesity and CP and 24 patients without obesity with CP were submitted to SRP. Clinical parameters were assessed at baseline and 3 and 6 months after therapy. Serum levels of leptin and adiponectin were evaluated at all time points, using enzyme‐linked immunosorbent assay. Results: SRP improved the clinical parameters of both groups at 3 and 6 months (P <0.05). Nonetheless, the patients without obesity presented a lower mean probing depth (PD) at 6 months after therapy and a greater reduction in PD from baseline to 6 months in the full‐mouth analysis (primary outcome variable) and in initially deep sites (P <0.05). Leptin serum levels were higher in patients with obesity than in patients without obesity at all time points (P <0.05). No changes in the serum levels of leptin and adiponectin were observed in groups with and without obesity after therapy (P >0.05). Conclusions: Patients with obesity and CP presented lower reductions in PD than patients without obesity with CP at 6 months after SRP. Furthermore, the treatment did not affect the circulating levels of leptin and adiponectin in any group.     

二次牙周龈下刮治与牙周翻瓣术短期临床疗效比较

目的比较二次牙周龈下刮治和根面平整（scaling and root planning,SRP）与牙周翻瓣术治疗慢性牙周炎的短期临床疗效。方法选取牙周基础治疗3个月后牙周探诊深度为5～7mm的前牙或前磨牙共52颗作为研究对象,随机分为2组,二次SRP组行龈下刮治和根面平整术,翻瓣组进行改良Widman翻瓣术。分别在治疗前、治疗后3个月和6个月,检查记录探诊出血（bleeding on probing,BOP）、探诊深度（probing depth,PD）、牙龈退缩（gingival recession,GR）及临床附着水平（clinical attachment level,CAL）,并比较分析。结果二次SRP组和翻瓣组患牙的BOP阳性率、PD、GR、CAL治疗前分别为91.30%、（5.60±0.99）mm、（0.37±0.49）mm、（5.98±1.17）mm和92.13%、（5.87±1.02）mm、（0.30±0.47）mm、（6.03±1.30）mm,治疗后6个月分别为17.39%、（2.87±0.78）mm、（2.00±0.62）mm、（5.07±1.01）mm和11.23%、（2.53±0.51）mm、（2.36±0.68）mm、（4.89±0.84）mm,2组治疗后6个月各项指标与治疗前比较差异均有统计学意义（P〈0.01）。治疗后6个月2组间BOP阳性率、PD及CAL比较差异无统计学意义（P〉0.05）,但翻瓣组GR明显高于二次SRP组（P〈0.05）。结论对于前牙或前磨牙,二次SRP与牙周翻瓣术可达到相同的治疗效果,翻瓣术后牙龈退缩较二次牙周龈下刮治和根面平整后明显。     

脉冲Nd:YAG激光与超声洁刮治联合治疗牙周炎的效果观察

目的　观察Nd:YAG激光与超声洁刮治联合治疗牙周炎的临床效果。方法　选择牙周袋4~7 mm的 26颗同颌对称同名的慢性牙周炎患牙,随机分为实验组(激光加洁刮治)和对照组(洁刮治)。比较两组患牙治疗前后牙周袋内细菌检出总数和主要细菌组成比。结果　实验组患牙激光照射后即刻,细菌检出总数较治疗前显著降低(P<0·05)。完成治疗后两组患牙牙周袋内细菌检出总数较治疗前显著降低(P<0·05);但两组间差异无显著性。两组患牙治疗后牙周袋内G+球菌升高、G-杆菌下降,与治疗前有显著性差异;治疗后1周实验组牙周袋内球杆菌比例与对照组比较差异有显著性。结论　参数为2 W、20 Hz、100 mJ的脉冲Nd:YAG激光牙周袋内照射可明显减少牙周袋内细菌总量;激光与超声洁刮治联合治疗能短期内显著改善龈下微生态环境。     

A 2-Year Study of Adjunctive Minocycline-HCl in Actinobacillus actinomycetemcomitans-Associated Periodontitis

To study the effects of a step-wise treatment regimen on Actinobacillus actinomycetemcomitans-(Aa) associated periodontitis, 4 clusters among 33 patients harboring the organism were followed during successive periods of systemic minocycline plus mechanical debridement and minocycline plus modified Widman flap treatment. Localized Periodontitis was found in 2 clusters, one with 7 localized juvenile periodontitis patients and a 24-year old male with localized destruction and extremely low plaque levels (UP), and the other consisting of 10 patients with plaque and gingivitis and a wider age range (16 to 54 years, LP). Generalized severe and moderate periodontitis was found in 2 clusters which were further discriminated by severe gingivitis and high levels of supragingival plaque (9 patients, GSP), and mild inflammation and low plaque levels (6 patients, GMP). Mean percentages of Aa, as determined by selective cultivation of microbiota from at least 2 periodontal pockets of 6 mm or more were 63, 16, 33, and 7.8% in the clusters (P <0.01). Six months after active treatment, Aa was present in 6/9 patients and 50% of sites in GSP, and 3/6 patients and 46% of sites in GMP patients. In contrast, the organism was virtually eliminated by scaling and flap procedures in the localized periodontitis clusters, and did not reappear after 6 months (P <0.05). Combined antibiotic, mechanical, and surgical therapy resulted in a persistence of 20% of sites with residual probing depth of ≥ 4 mm in GMP patients after active therapy. At this point, 3 of the GMP patients and 1 GSP patient left the study. Multiple regression analysis showed a significant influence of log-transformed numbers in Aa in cheek and saliva samples at the end of the study, and cluster on the percent residual number of sites with periodontal probing depth of ≥ 7 mm (P <0.001). The present results suggest that the applied therapy would be appropriate in localized forms of Aa Periodontitis, but inappropriate in more severe and generalized forms to predictably eliminate Aa. Controlled long-term studies with larger groups of patients will be needed to establish the difference in treatment response suggested by these studies. J Periodontol 1993; 64:509–519.     

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.