甲硝唑四环素膜局部应用治疗牙周炎疗效观察

目的：评价甲硝唑四环素薄膜作为牙周炎基础治疗辅助手段的临床疗效。方法：选择成人牙周炎患者11例,每例患者口内至少有两个部位真性牙周炎≥4mm,共统计33颗牙,198个牙位点。对其基础治疗后,随机分为两组,试验组用甲硝唑四环素薄膜,对照组用空白薄膜。采用牙周袋局部上药治疗,每周1次,共治疗12周。临床观察PD、PAL、GI、BOP等指标。结果：甲硝唑四环素组各临床指标改善均优于对照组。结论：甲硝唑四环素薄膜局部应用治疗牙周炎是有效的。     

米诺环素凝胶治疗牙周炎临床观察

目的：探讨米诺环素凝胶治疗牙周炎的临床效果。方法：分析我院口腔科收治的60例牙周炎患者的临床资料,依据治疗措施不同进行临床分组,甲硝唑棒治疗组30例和米诺环素治疗组30例。结果：米诺环素治疗组牙周炎患者治疗后GI、SBI、PD、AL均明显优于甲硝唑棒治疗组,P＆lt;0.05,差异均有统计学意义。结论：米诺环素凝胶治疗牙周炎可以明显改善临床症状,值得临床推广应用。     

甲硝唑-多西环素复合凝胶治疗牙周炎的临床疗效

目的 :评价甲硝唑 多西环素 (甲多 )复合凝胶治疗牙周炎的临床疗效。方法 :选择成人牙周炎患者 18例 ,采用其左右侧对应牙 ,牙周袋探诊深度≥ 4mm ,进行随机、单盲、对照试验。试验组用甲多复合凝胶 ,对照组用甲硝唑棒。采用牙周袋局部上药治疗 ,qd× 7d ,临床观察牙周袋深度、菌斑指数、牙龈指数、出血指数等指标。结果 :试验组各临床指标改善均优于对照组。结论 :甲多复合凝胶治疗牙周炎是有效的。     

复方多西环素缓释药膜的制备与临床应用

目的 制备复方多西环素缓释药膜并进行临床应用观察.方法 以多西环素和替硝唑为主药,以聚乙烯醇为成膜材料制备药膜,用高效液相色谱法测定药膜中多西环素和替硝唑的含量;并将药膜用于牙周袋或冠周的牙龈盲袋中.用口服多西环素片剂作对照进行临床观察,考察该药膜的疗效.结果 高效液相色谱法能有效控制该制刺的质量;药膜用于牙周炎或冠周炎的治疗与对照组比较.疗效更显著.结论 该药膜工艺稳定、质量可控,对牙周炎、冠周炎有较好治疗作用.     

侵袭性牙周炎患者的心理护理

目的：研究总结侵袭性牙周炎患者的临床心理护理措施。方法：将2009年3月～2010年3月来本院就诊的18例侵袭性牙周炎患者随机分为心理护理组和对照组各9例,心理护理组患者使用心理护理联合临床治疗的方法,对照组患者使用单一的常规临床治疗,总结两组患者的临床结果进行对比。结果：心理护理组患者好转率100%（9例）,对照组患者好转率仅为22%（2例）。结论：临床研究结果显示,侵袭性牙周炎患者在治疗时配合对其进行心理护理,患者在配合度、复诊率、坚持维护治疗方面疗效显著,单一的常规治疗法临床疗效差。提示在治疗侵袭性牙周炎患者时,临床运用心理护理方法配合常规治疗,对提高治愈率有极其显著意义,值得临床推广。     

替硝唑牙周封闭治疗牙周炎80例观察

目的探讨使用替硝唑治疗牙周炎的临床疗效。方法收集整理2011年9月至2012年9月在本院进行替硝唑牙周封闭治疗牙周炎的80例患者的临床治疗情况,统计患者的临床疗效。结果本组80例患者中,经过替硝唑牙周封闭治疗后,66例患者的牙周炎痊愈,有12例患者的临床症状明显好转,此组患者的临床治疗总体有效率高达：97.5%。结论采用替硝唑进行牙周封闭治疗牙周炎临床疗效较好,该方法值得推广使用。     

口腔正畸治疗联合牙周组织再生术治疗牙周炎

目的：观察口腔正畸联合牙周组织再生治疗牙周炎临床疗效。方法：将近两年我院治疗的牙周炎患者120例,按照就诊时间顺序均分为对照组及观察组。对照组给予牙周组织再生治疗,观察组联合正畸治疗,比较两组患者牙周炎临床治疗效果。结果：对照组PLI、SBI、PPD及探诊出血率均显著高于观察组,差异均具有统计学意义（P〈0.05）。结论：组织再生术与正畸治疗联合治疗牙周炎,能促进消除患者咬合创伤,使出血指数大大降低,疗效显著,值得推广。     

盐酸米诺环素软膏治疗慢性牙周炎疗效观察

目的：观察盐酸米诺环素软膏治疗慢性牙周炎的临床疗效。方法：将60例于2011年1月～2014年11月在本院口腔科就诊的中、重度慢性牙周炎患者,随机分为治疗组和对照组,每组30例。根据出血指数和牙周袋深度测量观察疗效,最终以总有效率进行临床疗效对比分析。结果：治疗前两组出血指数和牙周袋深度比较均无显著差异（P>0.05）,治疗后出血指数无显著差异（P>0.05）,牙周袋深度显著减少（P<0.05）,而停药两周后出血指数和牙周袋深度均显著降低（P<0.05）。治疗组总有效率（91.1%）高于对照组（P<0.05）。结论：盐酸米诺环素软膏能有效治疗慢性牙周炎,具有一定的临床运用价值。     

盐酸米诺环素凝胶辅助治疗慢性牙周炎的临床研究

目的：探讨使用盐酸米诺环素凝胶辅助治疗慢性牙周炎的临床疗效。方法：将慢性牙周炎患者分为实验组和对照组,实验组采用盐酸米诺环素凝胶辅助机械疗法治疗,对照组仅采用机械疗法治疗,对比分析治疗效果。结果：实验组的治愈情况,龈沟出血指数（SBI）、菌斑指数（PLI）、牙周袋深度（PD）等指标均优于对照组。结论：采用盐酸米诺环素凝胶辅助机械疗法治疗慢性牙周炎效果显著,可临床推广。     

派丽奥治疗慢性牙周炎的临床疗效观察

目的：观察派丽奥抗生素软膏治疗慢性牙周炎的临床疗效。方法：选择临床诊断为慢性牙周炎的患者30例76颗患牙随机分为局部机械治疗对照组和加用派丽奥的实验组。记录基线、用药后1周、4周及8周的牙龈指数（GI）、牙周探诊深度（PD）和探诊出血（BOP）的变化并进行统计学分析。结果：实验组和对照组在基线时各临床指标差异无显著性意义（P〉0．05），治疗后两组患牙各临床指标较用药前有明显改善（P〈0．05），而且两组间各时段差异也有统计学意义。结论：派丽奥是治疗牙周炎有效、安全的局部治疗药物。     

Efficacy of subantimicrobial-dose doxycycline against nitrosative stress in chronic periodontitis

Aim:

To evaluate the effectiveness of subantimicrobial-dose doxycycline (SDD) as an adjunct to scaling and root planing (SRP) treatment against the nitrosative stress of moderate to advanced chronic periodontitis.

Methods:

Adults with untreated chronic periodontitis (n=174) were randomly administered SRP+SDD (n=87) (20 mg of doxycycline twice daily) or SRP+placebo (n=87) treatment for 3 months. At baseline and after 3 months, the probing depths (PD), bleeding on probing (BOP) and clinical attachment level (CAL) were measured, and a gingivomucosal biopsy was collected to assay the induction of nitric oxide synthase (iNOS) and 3-nitrotyrosine (3NT), and blood was collected to assay for total nitrites and nitrates (NO_x) and 3NT.

Results:

Compared to baseline, at the completion of treatment, significant decreases in the levels of tissue iNOS and 3NT and serum NO_x and 3NT were observed in both groups. SRP+SDD yielded a greater reduction in the gingivomucosal and serum nitrosative stress markers than did SRP+placebo. PD, BOP, and CAL reduction were correlated with the nitrosative stress parameters.

Conclusion:

On a short-term basis, SDD therapy may be used as an adjunct to SRP treatment against nitrosative stress in moderate to advanced chronic periodontitis.     

Sub-antimicrobial doxycycline for periodontitis reduces hemoglobin A1c in subjects with type 2 diabetes: A pilot study

In vitro and animal studies suggest a possible role for the tetracycline class of drugs in the inhibition of non-enzymatic protein glycation. We conducted a 3-month, randomized placebo-controlled pilot clinical trial of conventional sub-gingival debridement (periodontal therapy), combined with either a three month regimen of sub-antimicrobial-dose doxycycline (SDD), a two week regimen of antimicrobial-dose doxycycline (ADD), or placebo in 45 patients with long-standing type 2 diabetes (mean duration 9 years) and untreated chronic periodontitis. Subjects were taking stable doses of oral hypoglycemic medications and/or insulin. Treatment response was assessed by measuring hemoglobin A1c (HbA1c), plasma glucose, and clinical periodontal disease measures. At one-month and three-month follow-up, clinical measures of periodontitis were decreased in all groups (data to be presented elsewhere). At three months, mean HbA1c levels in the SDD group were reduced 0.9% units from 7.2% units ± 2.2 (±SD), to 6.3% units ± 1.1, which represents a 12.5% improvement. In contrast, there was no significant change in HbA1c in the ADD (7.5% ± 2.0 to 7.8% ± 2.1) or placebo (8.5% ± 2.0 to 8.5% ± 2.6) groups. Mean HbA1c change from baseline was significantly greater in the SDD group compared with the ADD group (p = 0.04) but not placebo (p = 0.22). Moreover, a larger proportion of subjects in the SDD group experienced improvement (p < 0.05) compared to the ADD or placebo groups. Mean plasma glucose levels were not significantly different between or within the groups. The results of this pilot study suggest that the treatment of periodontitis with sub-gingival debridement and 3-months of daily sub-antimicrobial-dose doxycycline may decrease HbA1c in patients with type 2 diabetes taking normally prescribed hypoglycemic agents.     

Using tetracyclines to treat osteoporotic/osteopenic bone loss: From the basic science laboratory to the clinic

Periodontitis (progressive inflammatory disease characterized by alveolar bone loss, a major cause of tooth loss worldwide) is associated with both systemic osteoporosis and its milder form, osteopenia. Tetracyclines, by virtue of their non-antimicrobial pro-anabolic and anti-catabolic properties, are excellent candidate pharmaceuticals to simultaneously treat these local and systemic disorders. This paper reviews the foundational basic science and translational research which lead to a pivotal multicenter randomized clinical trial in postmenopausal women with both periodontitis and systemic (skeletal) osteopenia. This trial was designed primarily to examine whether subantimicrobial dose doxycycline (SDD) could reduce progressive alveolar (oral) bone loss associated with periodontitis and, secondarily, whether SDD could reduce systemic bone loss in the same subjects. This paper describes the efficacy and safety findings from this clinical trial and also outlines future directions using this promising and novel approach to manage both oral and systemic bone loss.     

Non-antibacterial tetracyclines modulate mediators of periodontitis and atherosclerotic cardiovascular disease: A mechanistic link between local and systemic inflammation

Periodontitis, one of the most common chronic inflammatory diseases afflicting man, is increasingly being recognized as a risk factor for atherosclerotic cardiovascular disease (ASCVD). Non-antimicrobial tetracyclines are known to have inhibitory effects on inflammatory mediators and effector molecules, including cytokines and matrix metalloproteinases (MMPs), associated with both diseases. In this paper, we discuss the evidence that doxycycline and related non-antibiotic chemically modified tetracyclines (e.g., CMT-3) can effectively reduce cytokine (TNF-α, IL-6, and MCP-1) production by human mononuclear inflammatory cells when stimulated either by endotoxin (LPS) or by a complex of C-reactive protein/oxidized LDL cholesterol relevant to the pathogenesis of periodontal disease and ASCVD, respectively. This inhibition by tetracycline compounds appears to be mediated at least in part by a suppression of the phosphorylation/activation of the NFκB cell signaling pathway. We are currently conducting clinical trials on patients who exhibit both diseases, and our preliminary data suggest that virtually all acute coronary syndrome (ACS) patients exhibit moderate-to-severe periodontitis, a higher incidence of this oral inflammatory disease than that seen in the population at large. In other studies, a non-antimicrobial formulation of doxycycline (SDD) has been found to dramatically reduce hsCRP, IL-6 and MMP-9 levels in plasma of ACS patients, and SDD has also been found to significantly increase serum levels of both cardio-protective HDL cholesterol and its core molecule apolipoprotein A-I in ASCVD-vulnerable patients with periodontitis. Our current research suggests that one mechanism involved may be the ability of SDD to inhibit MMP-mediated HDL loss by protecting apolipoprotein A-I from proteinase attack. These pleiotropic mechanisms of non-antimicrobial tetracyclines provide significant therapeutic potential to treat chronic inflammatory diseases including both periodontitis and ASCVD.     

小剂量多西环素治疗慢性牙周炎的疗效和对基质金属蛋白酶8的影响

目的 探讨小剂量多西环素(LDD)对慢性牙周炎的临床疗效.方法 20例慢性牙周炎患者,均予洁刮治和根面平整术(SRP)治疗,并按随机数字表随机分为LDD和安慰剂2组,各10例.LDD组口服盐酸多西环素片,安慰剂组口服安慰剂,3个月为1个疗程.分别在治疗前和治疗后3、6、9、12个月时检测2组患者的菌斑指数、牙龈指数、探诊深度、附着丧失、龈沟液量及龈沟液中基质金属蛋白酶8(MMP-8)水平,并对2组结果 进行统计学分析.结果 与治疗前比较,治疗后2组菌斑指数、牙龈指数、探诊深度、附着丧失均明显改善,龈沟液量明显减少,MMP-8水平均下降(P＜0.05).与安慰剂组比较,LDD组的龈沟液量和MMP-8治疗后6个月下降明显[(0.13±0.02)μl比(0.29±0.02)μl;(3.7±3.2)ng/30 s比(12.3±4.1)ng/30 s,P＜0.05],牙龈指数、探诊深度在治疗后9、12个月改善更为明显[(0.65±0.25)比(1.25±0.13);(0.70±0.24)比(1.20±0.18);(2.54±0.18)mm比(3.22±0.12)mm;(2.25±0.17)m比(3.18±0.13)mm],差异均有统计学意义(均P＜0.05).结论 牙周基础治疗联合小剂量多西环素,能明显改善慢性牙周炎患者的临床症状,而这与其能降低龈沟液中MMP-8水平有关.

Abstract：

Objective To investigate the effect of low-dose doxycycline(LDD)on the level of gingival crev icular fluid(GCF) matrix metalloproteinases-8 ( MMP-8 ) in chronic periodontitis. Methods Twenty patients with chronic periodontitis were selected and randomly divided into two groups( n = 10 in each group). After scaling and root planning( SRP), the SRP + LDD group received LDD for 3 months, whereas the SRP + P group received placebo 3 months. The patients were evaluated every 3 months during the 12-month study period. The plaque index( PLI), gingival index( GI), probing depth( PD), attachment loss(AL) and GCF samples were collected at each visit. The level of MMP-8 were detected and analyzed. Results Compared to baseline, the scores of PLI, GI, PD, AL and MM P-8 of the two groups showed statistically improvement during the 12-month study period (P ＜ 0.05 ). Compared to the SRP + P group, the SRP + LDD group showed statistically differences of GI, PD at 9,12-month visit. Conclu sion Adjunctive SDD therapy can improve the clinical parameters and this clinical improvement is reflected by level of MMP-8 in chronic periodontitis after the therapy.     

心理暗示治疗对慢性牙周炎患者负性情绪及疼痛的效果分析

目的:探析在慢牙周炎患者中选取心理暗示治疗对疼痛和负性情绪的临床影响作用。方法:项目资料为2017年11月~2018年11月期间收治的66例慢性牙周炎患者,参考随机法实施研究。参照组(n=33)行常规超声洁治处理,实验组(n=33)行心理暗示治疗,观察两组治疗情况。结果:参照组慢性牙周炎患者疼痛评分、SAS评分、SDS评分与实验组数值比对,P<0.05,表明数据指标之间的统计学意义。结论:使用心理暗示治疗在慢性牙周炎患者中可显著缓解不良情绪,降低疼痛程度,提升治疗效果。     

派丽奥-布洛芬缓释凝胶应用于牙周炎治疗的临床分析

目的探讨派丽奥-布洛芬缓释凝胶治疗牙周炎的临床应用价值。方法将2010年4月-2012年8月我科诊治的80例牙周炎患者随机分成2组,对照组40例,采用派丽奥牙科用软膏治疗;实验组40例,采用派丽奥-布洛芬缓释凝胶治疗。观察和比较两组的近期疗效、牙龈红肿情况以及炎症因子指标水平的变化情况。结果实验组的总有效率显著高于对照组(P<0.05);实验组患者治疗后的菌斑指数、牙龈指数、龈沟出血指数、牙周袋深度、牙齿松动度、牙周附着丧失指标水平均显著小于对照组(P<0.05);实验组患者治疗后的白介素-6、白介素-8、肿瘤坏死因子-α指标水平均显著低于对照组(P<0.05)。结论派丽奥-布洛芬缓释凝胶治疗牙周炎能更好地控制牙龈炎症血肿,降低牙周袋深度,提高临床疗效。     

奥硝唑碘仿糊剂治疗乳牙慢性根尖周炎的疗效观察

目的 :比较奥硝唑碘仿糊剂和碘仿糊剂治疗乳牙慢性根尖周炎疗效的差异。方法:选择乳牙慢性根尖周炎患者107例 ,随机分为奥硝唑碘仿糊剂组59例 (实验组 ) ,碘仿糊剂组48例 (对照组) ,半年临床追踪观察 ,记录患牙的症状和体征。结果:实验组和对照组之间疗效有显著性差异 (P<0.05)。结论 :奥硝唑碘仿糊剂治疗乳牙慢性根尖周炎的疗效优于碘仿糊剂。