PERIODONTAL-DISEASE TREATMENT BY LOCAL-DRUG DELIVERY
PERIODONTAL-DISEASE TREATMENT BY LOCAL-DRUG DELIVERY
复制标题
DOI：
10.1902/jop.1985.56.5.265
复制
发表时间：
1985-01-01
影响因子：
4.3
通讯作者：
HOGAN, PE
中科院分区：
文献类型：
--
作者：
GOODSON, JM;OFFENBACHER, S;HOGAN, PE
采用暗视野显微镜观察洁治前后或四环素局部给药前后牙周组织龈下微生物的变化。一个标准化的采样和计数方法，使用裂隙冲洗技术，以确定使用暗视野显微镜的形态类型的数量和比例。装载四环素的中空纤维建立了200，000 μ g/ml的初始血管内浓度，其在24小时内指数下降至15 μ g/ml。这些纤维在牙周炎部位的重复的微血管内放置在10天的时间内产生了细菌计数的增量减少。在体外试验条件下，由乙烯醋酸乙烯酯制成的负载有25%盐酸四环素的整体纤维可持续释放10天。在一项研究中，10名患者接受了治疗，比较了这些纤维与刮除的效果。将纤维置于龈下以填充囊袋至其可能的深度，并用牙周敷料覆盖，保持10天。在10天结束时测得的平均血管内四环素浓度为643 μ g/ml。在这些部位，总计数、螺旋体、活动杆和非活动杆在治疗后立即显著减少。总计数降低至接近暗视野显微镜检测限的水平。相比之下，缩放产生的暗场计数的变化要小得多，没有统计学意义。
The subgingival microbiologic composition of periodontal sites was evaluated by darkfield microscopy before and after scaling or local delivery of tetracycline. A standarized sampling and counting method using a crevicular washing technique was developed to determine both numbers and proportions of morphotypes using darkfield microscopy. Tetracycline-loaded hollow fibers established an initial intrasulcular concentration of 200,000 .mu.g/ml, which decreased exponentially to 15 .mu.g/ml in 24 h. Repetitive intrasulcular placement of these fibers at periodontitis sites produced an incremental reduction in bacterial counts over a 10 day period. Monolithic fibers made of ethylene vinyl acetate loaded with 25% tetracycline hydrochloride provided sustained release for 10 days under in vitro test conditions. Ten patients were treated in a study comparing the effects of these fibers with scaling. Fibers were placed subgingivally to fill pockets to their probable depth and covered with a periodontal dressing which was maintained for 10 days. The average intrasulcular tetracycline concentration measured at the end of the 10 days period was 643 .mu.g/ml. At these sites, total counts, spirochetes, motile rods and nonmotile rods were significantly reduced immediately following treatment. Total counts were depressed to levels near the detection limit of darkfield microscopy. In comparison, scaling produced much smaller alterations of darkfield counts which were not statistically significant.