Clinical response of azithromycin as an adjunct to non-surgical periodontal therapy in smokers
Clinical response of azithromycin as an adjunct to non-surgical periodontal therapy in smokers
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DOI：
10.1902/jop.2005.76.3.426
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发表时间：
2005-03-01
影响因子：
4.3
通讯作者：
Wang, HL
中科院分区：
文献类型：
--
作者：
Mascarenhas, P;Gapski, R;Wang, HL
背景：抗生素治疗可以用于非常特殊的牙周治疗情况，例如在吸烟者中发现更常见的牙周病难治性病例。本研究旨在评价阿奇霉素(Azm)联合洁治和根面平整(SRP)治疗吸烟者中重度慢性牙周炎的疗效。方法：31名受试者参加为期6个月的随机单掩蔽试验，评价SRP单独或SRP+Azm对临床、微生物(采用苯甲酰-DL-精氨酸萘胺[BANA]法)和牙龈沟液(GCF)I型胶原末端吡啶交联末端肽(ICTP)水平的影响。在基线时，每天抽1包香烟、至少有5个探诊深度(PD)为5毫米、探诊时出血(BOP)的患者被随机分为试验组或对照组。在基线、3个月和6个月时，进行临床测量(探诊深度[PD]、临床附着丧失[CAL]和探诊出血[BOP])。在基线、14天、3个月和6个月时进行GCF骨标志物评估(C-端肽[ICTP]和BANA试验分析)。结果：两组患者的PD和CAL均有临床改善，并持续6个月。采用以对象为基础的分析，接受SRP+Azm治疗的患者在中等(4-6 mm)和深层(>；6 mm)部位的PD减少和CAL增加得到增强(P<；0.05)。此外，在6个月的评估中，SRP+AZM导致BANA水平比单独SRP更大的降低(P<；0.05)，而对照组的BANA水平出现反弹。在研究过程中，两组之间的平均BOP和ICTP水平没有统计学意义上的差异。结论：在中重度附着丧失的吸烟者中，使用AZM和SRP联合使用可以提高非手术牙周治疗在减少探查深度和改善依恋水平方面的有效性。
Background: Antibiotic therapy can be used in very specific periodontal treatment situations such as in refractory cases of periodontal disease found to be more prevalent in smokers. This study was designed to determine the efficacy of azithromycin (AZM) when combined with scaling and root planing (SRP) for the treatment of moderate to severe chronic periodontitis in smokers.Methods: Thirty-one subjects were enrolled into a 6-month randomized, single-masked trial to evaluate clinical, microbial (using benzoyl-DL-arginine naphthylamine [BANA] assay), and gingival crevicular fluid (GCF) pyridinoline cross-linked carboxyterminal telopeptide of type I Collagen (ICTP) levels in response to SRP alone or SRP + AZM. At baseline, patients who smoked >= 1 pack per day of cigarettes who presented with at least five sites with probing depths (PD) of 5 mm with bleeding on probing (BOP) were randomized into the test or control groups. At baseline and 3 and 6 months, clinical measurements (probing depth [PD], clinical attachment loss [CAL], and bleeding on probing [BOP]) were performed. GCF bone marker assessment (C-telopeptide [ICTP] as well as BANA test analyses) were performed at baseline, 14 days, and 3 and 6 months.Results: The results demonstrated that both groups displayed clinical improvements in PD and CAL that were sustained for 6 months. Using a subject-based analysis, patients treated with SRP + AZM showed enhanced reductions in PD and gains in CAL at moderate (4 to 6 mm) and deep sites (> 6 mm) (P < 0.05). Furthermore, SRP + AZM resulted in greater reductions in BANA levels compared to SRP alone (P < 0.05) while rebounds in BANA levels were noted in control group at the 6-month evaluation. No statistically significant differences between groups on mean BOP and ICTP levels during the course of the study were noted.Conclusions: The utilization of AZM in combination with SRP improves the efficacy of non-surgical periodontal therapy in reducing probing depth and improving attachment levels in smokers with moderate to advanced attachment loss.