氯己定薄片辅助牙周治疗的疗效观察

目的评价控释药氯己定薄片(chip)辅助牙周刮治(scaling and root planing, SRP)治疗牙周炎的疗效和安全性.方法 65例成人牙周炎患者经全口SRP后,左右侧象限均至少有一个牙位探诊深度(probing depth, PD)≥5 mm且探诊出血(bleeding on probing, BOP),选此种牙为受试牙,检查和记录其临床指标,并随机选择一侧的受试牙刮治后放药,另一侧受试牙刮治后不做处理,临床观察6个月.结果用药组在第6个月时的PD减少(1.32 mm)以及附着增加(0.91 mm)均显著高于对照组(0.77 mm,0.40 mm),差异有非常显著性(P<0.001),第6个月用药组的BOP阳性率(79.4%)明显低于对照组(92.4%)(P<0.001);两组的牙面着色指数无统计学差别.44.6%的患者反映用药部位不适,主要为牙龈轻度胀痛.结论 SRP+氯己定薄片组在减少PD、增加牙周附着和减轻牙周组织炎症方面优于单纯SRP组,是一种适于牙周维护治疗的有效且安全的局部用药.

The efficacy of the Chlorhexidine chip following scaling and root planing (SRP) and compared to SRP alone

OBJECTIVE: To evaluate the clinical efficacy and safety of the adjunctive use of Chlorhexidine Chip (CHX; commercial name, Perio Chip) following scaling and root planing (SRP) in periodontitis. METHODS: One center, blinded, randomized, split-mouth and active control study was designed. Sixty-five adult periodontitis patients were enrolled into the baseline after SRP. Each subject had at least one tooth with pocket depth of 5 mm or more and bleeding on probing (BOP) in each side of the mouth. Then the tooth was selected as a target and its parameters of probing depth (PD), attachment loss (AL), BOP, gingival index (GI), plaque index (PI) and staining index (SI) were recorded. Each side of mouth was randomly assigned to one of two treatments--drug placement after SRP or SRP alone. All the adverse events and parameters were recorded at time of 3-month, 6-month and meanwhile the patients received oral hygiene instruction and scaling. The same was conducted at 6-week, 4.5-month except for recording of parameters and scaling of the target teeth. RESULTS: Reduction of PD and gain of attachment at 6-month in group of SRP plus CHX (1.32 mm, 0.94 mm) were significantly higher than those in group of SRP alone (0.77 mm, 0.40 mm) (P < 0.001). Forty-four point six percent (44.6%) of patients reflected adverse reactions related to drug placement. Toothaches, the main reactions, were mild to moderate in nature and spontaneously resolved within 2-4 days. CONCLUSIONS: The chlorhexidine chip is indeed a safe and effective control-delivered drug for topical use when patient in his supportive periodontal therapy.