Systemic MMP inhibition for periodontal wound repair: results of a multi-centre randomized-controlled clinical trial
Systemic MMP inhibition for periodontal wound repair: results of a multi-centre randomized-controlled clinical trial
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DOI：
10.1111/j.1600-051x.2008.01351.x
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发表时间：
2009-02-01
影响因子：
6.7
通讯作者：
Giannobile, William V.
中科院分区：
文献类型：
--
作者：
Gapski, Ricardo;Hasturk, Hatice;Giannobile, William V.
Gapski R、Hasturk H、Van Dyke TE、Oringer RJ、Wang S、Braun TM、Giannobile WV。牙周伤口修复的全身 MMP 抑制：多中心随机对照临床试验的结果。临床牙周病学杂志2009； 36：149-156。 doi: 10.1111/j.1600-051X.2008.01351.x。这项多中心、前瞻性、对照试验旨在检查基质金属蛋白酶（MMP）抑制剂亚抗菌剂量多西环素（SDD）联合接入皮瓣手术对慢性重度牙周炎患者牙周伤口修复的生物反应。70名受试者被纳入一项为期12个月的研究，随机、安慰剂对照、双盲试验，评估 6 个月治疗以及安慰剂+手术或 SDD（20 mg b.i.d.）+手术“清除”后的疾病反应。主要结果指标包括临床附着水平（CAL），次要结果指标包括探诊深度（PD）、探诊出血（BOP）以及龈沟液骨标志物评估[胶原端肽（ICTP）]。这些测量是在手术和给药后 12 个月的基线时进行的。接受 SDD 和手术治疗的患者表现出手术治疗部位 >= 7 mm 的 PD 明显减少，并且 CAL 有所增加 (p < 0.004)。此外，与安慰剂相比，SDD+手术导致 ICTP 水平短期下降。当SDD撤回时，ICTP水平和临床参数出现反弹。这项多中心研究的结果表明，SDD与手术相结合，通过减少PD、增加CAL增益和抑制早期骨吸收来改善牙周治疗的短期反应。
Gapski R, Hasturk H, Van Dyke TE, Oringer RJ, Wang S, Braun TM, Giannobile WV. Systemic MMP inhibition for periodontal wound repair: results of a multi-centre randomized-controlled clinical trial. J Clin Periodontol 2009; 36: 149-156. doi: 10.1111/j.1600-051X.2008.01351.x.This multi-centre, prospective, controlled trial was designed to examine the biological response of the matrix metalloproteinase(MMP) inhibitor subantimicrobial dose doxycycline (SDD) combined with access flap surgery on periodontal wound repair in patients with chronic severe periodontitis.Seventy subjects were enrolled into a 12-month, randomized, placebo-controlled, double-masked trial to evaluate disease response to 6 months therapy and "wash-out" of either placebo+surgery or SDD (20 mg b.i.d.)+surgery. Primary outcome measure included clinical attachment levels (CAL) and secondary outcomes included probing depth (PD), bleeding on probing (BOP), as well as gingival crevicular fluid bone marker assessment [collagen telopeptides (ICTP)]. These measurements were taken at baseline through 12 months post-surgery and drug administration.Patients treated with SDD and surgery demonstrated stronger reductions in PD in surgically-treated sites of >= 7 mm as well as gains in CAL (p < 0.004). Furthermore, SDD+surgery resulted in short-term reductions in ICTP levels compared with placebo. Rebounds in ICTP levels and clinical parameters occurred when SDD was withdrawn.The results from this multi-centre study suggests that SDD in combination with surgery improves the short-term response of periodontal therapy by reducing PD, increasing CAL gain and inhibiting early stage bone resorption.