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。

Study on the effect of minocycline hydrochloride ointment on the sulfides in gingival crevicular fluid of chronic periodontitis

AIM:To analyze the changes of sulfides levels and their relationships with clinical parameters after administration subgingivally of 2%minocycline-HCl ointment to periodontal pocket of chronic periodontitis.METHODS: 61 teeth of 21 subjects were collected and divided into two groups witi a randomized single blind method.2%minocycline-HCI ointment was administered into periodontal pockets as drug group(T) including about 204 sites of 34 teeth.The control group(C) have only single initial therapy including 162 sites of 27 teeth.Supragingival scaling and oral hygiene instruction were finished 2 weeks before baseline.In baseline sulfides level and periodontal clinic parameters were measured with Diamond Probe/Perio2000 System. Following that the subgingival scaling was made.2%minocycline-HCI ointment was administrated into the periodontal pocket of drug group but not the controll sites.The same examinations were done again two weeks later.RESULTS: The sulfides levels were reduced((P<0.05)) in drug group than that of baseline and controlled group.Parameters in drug groups were significantly improved than that of the control group((P<0.05)).There was correlation between sulfides levels and clinical parameters.CONCLUSION: Local Administration of 2%minocycline-HCl ointment as the auxiliary treatment of chronic periodontitis can reduce the levels of sulfides levels and improve the periodontal tissue conditions.The changes of sulfides levels of chairside inspection may indirectly reflect the bactericidal and inhibition action in the periodontal pocket.