Enamel matrix proteins and systemic antibiotics as adjuncts to non-surgical periodontal treatment: clinical effects
Enamel matrix proteins and systemic antibiotics as adjuncts to non-surgical periodontal treatment: clinical effects
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DOI：
10.1111/j.1600-051x.2005.00664.x
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发表时间：
2005-03-01
影响因子：
6.7
通讯作者：
Giannopoulou, C
中科院分区：
文献类型：
--
作者：
Mombelli, A;Brochut, P;Giannopoulou, C
目的：评价牙周非手术治疗联合釉质基质衍生物(EMD)和/或全身抗生素治疗慢性牙周炎患者牙周深袋的临床疗效。采用开口设计，16名受试者被随机分配到对侧牙列区域，使用EMD或安慰剂进行洁治和牙根平整(SRP)。其中一半的受试者接受250毫克的甲硝唑和375毫克的阿莫西林，每天三次，持续7天，另一半接受安慰剂治疗。在每个对侧象限中选择一个牙周间病变作为研究地点。结果：接受全身抗生素治疗的受试者的临床效果明显好于安慰剂受试者。在这些病例中，探诊袋深度在6个月后显著减少(3.0+/-2.1 mm对1.6+/-1.4 mm，p=0.05)，平均临床附着增加在6个月(2.3+/-1.9 mm对0.7+/-1.6 mm，p=0.02)和12个月(2.3+/-3.5 mm对0.4+/-3.8 mm，p=0.02)后显著增加。用抗生素加EMD处理的部位获得了最多的临床依从性。结论：本研究支持牙周组织的最佳修复和再生需要抑制引起牙周病的微生物区系的观点。
Objectives: The purpose of the present study was to evaluate the clinical effects of non-surgical periodontal treatment, supplemented with enamel matrix derivative (EMD) and/or systemic antibiotics, in deep periodontal pockets of patients with chronic periodontitis.Methods: This was a randomized, placebo-controlled longitudinal clinical trial of 12 months duration. Using a split-mouth design, 16 subjects were randomly assigned to scaling and root planing (SRP) with EMD or placebo in contra-lateral dentition areas. One half of the subjects received 250 mg metronidazole and 375 mg amoxicillin three times a day for 7 days and the other half received a placebo. One inter-proximal periodontal lesion was chosen as study site in each of the contra-lateral quadrants.Results: Subjects treated with systemic antibiotics yielded significantly better clinical results than those treated with placebo. In these cases, probing pocket depth was reduced significantly more after 6 months (3.0 +/- 2.1 mm versus 1.6 +/- 1.4 mm, p=0.05), and the mean clinical attachment gain was significantly greater after 6 months (2.3 +/- 1.9 mm versus 0.7 +/- 1.6 mm, p=0.02) and 12 months (2.3 +/- 3.5 mm versus 0.4 +/- 3.8 mm, p=0.02). Sites treated with the antibiotics plus EMD gained the largest amount of clinical attachment. There was no significant benefit of EMD adjunctive to SRP in subjects not treated with antibiotics.Conclusions: The present study supports the notion that optimal repair and regeneration of the periodontium requires suppression of the microbiota causing periodontal disease.