THE ANTIMICROBIAL AND CLINICAL EFFECTS OF A SINGLE SUBGINGIVAL IRRIGATION OF CHLORHEXIDINE IN ADVANCED PERIODONTAL LESIONS
THE ANTIMICROBIAL AND CLINICAL EFFECTS OF A SINGLE SUBGINGIVAL IRRIGATION OF CHLORHEXIDINE IN ADVANCED PERIODONTAL LESIONS
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DOI：
10.1111/j.1600-051x.1986.tb01417.x
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发表时间：
1986-01-01
影响因子：
6.7
通讯作者：
POWELL, RN
中科院分区：
文献类型：
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作者：
LANDER, PE;NEWCOMB, GM;POWELL, RN
评价氯己定（CH）龈下冲洗对晚期牙周病变致病植物群的抗菌作用。在16例患者中，在10周的时间内，通过差分暗视野显微镜监测龈下部位内的定植模式的变化。此外，还监测了患病部位临床参数的变化。对临床和微生物学参数进行了初始基线评价。每例患者选择4个中晚期牙周病部位。随机用单剂量的0.2% CH凝胶、0.2% CH溶液或生理盐水冲洗这些部位，而留下1个部位作为对照。患者每周一次，直到第5周，然后在第7周和第10周。在每次预约时，从每个部位的龈下区域采集微生物样本，并评估临床指标。结果表明，用0.2%的CH溶液或0.2%的CH凝胶单次冲洗，对减少螺旋体的百分比有显著效果，并在一定程度上减少运动细菌。在冲洗的囊袋中，球菌、梭形和丝状微生物的定植随之发生变化;这与出血部位%的减少一致。观察到各种模式的定植已被描述，并可能有助于差异暗场（DDF）监测病变。钝性探针出血与螺旋体菌群为主的植物群有关。在10周期间，未发现其他参数之间存在其他相关性。单次应用CH凝胶和溶液的治疗效果不超过10周，在2至4周时达到峰值反应。得出的结论是，涉及CH灌溉的治疗制度可以每月进行。在使用CH凝胶和溶液之间未发现有效性差异。
The antimicrobial effects of subgingival chlorhexidine (CH) irrigations on the pathogenic flora in advanced periodontal lesions were assessed. Changes in the patterns of colonization within the subgingival sites were monitored by differential dark-field microscopy, in 16 patients, over a period of 10 weeks. In addition, changes in the clinical parameters of the diseased sites were also monitored. Initial base-line evaluations were made for both the clinical and microbiological parameters. 4 sites of moderate to advanced periodontal disease were selected in each patient. These were randomly irrigated with a single dose of either 0.2% CH gel, 0.2% CH solution, or physiological saline, while 1 site was left as a control. The patients were seen weekly, until the 5th week, then at the 7th and 10th weeks. At each appointment, a microbiological sample was taken from the subgingival region of each site, together with an assessment of the clinical indices. Results indicated that a single irrigation of an 0.2% solution of CH or 0.2% CH gel had a marked effect in decreasing the % of spirochaetes and, to some extent, motile bacteria. There was a concomitant shift in colonization to cocci, fusiform and filamentous organisms in pockets that were irrigated; this coincided with a reduction in the % of bleeding sites. Various patterns of colonization were observed which have been described and may assist in differential dark field (DDF) monitoring of lesions. Bleeding on blunt probing was found to be correlated with a flora dominated by spirochaetes. No other correlations were found over the 10-week period between the other parameters. The therapeutic effect of a single application of CH gel and solution did not exceed 10 weeks and a peak response was recognised at 2 to 4 weeks. It was concluded that treatment regimes involving CH irrigation could be undertaken on a monthly basis. No differences in efficacy could be found between the use of CH gel and solution.