FULL-VS PARTIAL-MOUTH DISINFECTION IN THE TREATMENT OF PERIODONTAL INFECTIONS - SHORT-TERM CLINICAL AND MICROBIOLOGICAL OBSERVATIONS
FULL-VS PARTIAL-MOUTH DISINFECTION IN THE TREATMENT OF PERIODONTAL INFECTIONS - SHORT-TERM CLINICAL AND MICROBIOLOGICAL OBSERVATIONS
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DOI：
10.1177/00220345950740080501
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发表时间：
1995-08-01
影响因子：
7.6
通讯作者：
EYSSEN, H
中科院分区：
文献类型：
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作者：
QUIRYNEN, M;BOLLEN, CML;EYSSEN, H
在标准的牙周治疗策略中，连续的牙根平整(每象限间隔一到两周)，在治疗完成之前可能会发生消毒区域的再次感染。这项研究从临床和微生物学两个方面研究了24小时内的全口消毒是否显著改善了牙周治疗的结果。将10例晚期慢性牙周炎患者随机分为试验组和对照组。对照组患者每两周每象限接受一次洁治和根面平整以及口腔卫生指导。试验组通过去除所有菌斑和结石(在24小时内两次就诊)进行全口消毒。此外，在每次检查中，用1%的洗必泰凝胶刷舌1分钟，用0.2%的洗必泰溶液冲洗口腔2分钟。此外，所有患者均接受1%洗必泰(1%)龈下冲洗。口腔卫生和0.2%洗必泰含漱液在两周内延缓了眼袋的再生。记录临床参数，并在基线、1个月和2个月后从右上象限采集斑块样本。在两次随访中，试验组患者对深口袋的探诊深度显著降低(p<；0.05)。在一个月的访问中，差示相差显微镜显示试验组螺旋体和运动杆的比例显著降低(p=0.01)。培养结果显示，试验组1个月的病原菌数量明显少于对照组(p=0.005)。两个月后，同一地点的细菌数量明显增加(p=0.02)。此外，试验组所有最初感染牙龈假单胞菌的部位(6/10)在治疗后均转为阴性。这些发现表明，通过一次全口消毒可以显著改善治疗结果(无论是在微生物方面还是在临床上)。
In a standard periodontal treatment strategy with consecutive root planings (per quadrant at a one- to two-week interval), re-infection of a disinfected area might occur before completion of the treatment. This study examines, both clinically and microbiologically, whether a full-mouth disinfection within 24 hours significantly improves the outcome of periodontal treatment. Ten patients with advanced chronic periodontitis were randomly allocated to a test and a control group. The patients from the control group received scalings and root planings as well as oral hygiene instructions per quadrant at two-week intervals. Full-mouth disinfection in the test group was sought by the removal of all plaque and calculus (in two visits within 24 hours). In addition, at each of these visits, the tongue was brushed with a 1% chlorhexidine gel for one min and the mouth rinsed with a 0.2% chlorhexidine solution for two min. Furthermore, subgingival chlorhexidine (1%) irrigation was performed in all pockets. The recolonization of the pockets was retarded by oral hygiene and 0.2% chlorhexidine rinses during two weeks. The clinical parameters were recorded, and plaque samples were taken from the right upper quadrant at baseline and after one and two months. The test group patients showed a significantly higher reduction in probing depth for deep pockets at both follow-up visits (p < 0.05). At the one-month visit, differential phase-contrast microscopy revealed significantly lower proportions of spirochetes and motile rods in the test group (p = 0.01). Culturing showed that the test group harbored significantly fewer pathogenic organisms at one month (p = 0.005). At two months, the same sites harbored significantly more ''beneficial'' bacteria (p = 0.02). Moreover, all sites of the test group initially harboring P. gingivalis (6/10) became negative after treatment. These findings suggest that it is possible to achieve a significant improvement of the treatment outcome (both microbiologically and clinically) with a one-stage full-mouth disinfection.