Multilevel analysis of bacterial counts from chronic periodontitis after root planing/scaling, surgery, and systemic and local antibiotics: 2-year results.
Multilevel analysis of bacterial counts from chronic periodontitis after root planing/scaling, surgery, and systemic and local antibiotics: 2-year results.
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DOI：
10.3402/jom.v5i0.20939
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发表时间：
2013
影响因子：
4.5
通讯作者：
Thoresen M
中科院分区：
文献类型：
--
作者：
Mdala I;Olsen I;Haffajee AD;Socransky SS;de Blasio BF;Thoresen M
随访5种微生物复合体（包括健康相关放线菌属）龈下细菌计数的变化（2年以上）。牙周治疗后较深的牙周袋（≥5 mm）。研究了8种不同的治疗方法：（1）洁治+根面平整术（SRP）;（2）牙周手术（SURG）+全身阿莫西林（AMOX）+全身甲硝唑（MET）;（3）SURG+局部给药四环素（泰特）;（4）SURG;（5）AMOX +MET+泰特;（6）AMOX+MET;（7）泰特;和（8）SURG+AMOX+MET+泰特。SRP后立即给予抗生素。在基线、治疗后3、6、12、18和24个月，从176名受试者的每颗牙齿（第三磨牙除外）近颊侧收集龈下菌斑，并使用棋盘杂交法分析40种不同的细菌。采用负二项（NB）广义估计方程（NB GEE）模型分析计数数据，采用logistic GEE分析比例。我们通过用AMOX+MET+泰特治疗受试者，观察到红色复合物组成的短期有益变化长达3个月。对于红色复合体的Tannerella denticola和Treponema denticola，观察到相同治疗的类似短期改善。SURG对牙龈卟啉单胞菌也有短期的有益作用。没有牙周治疗应用于严重影响的网站促进放线菌的生长。吸烟增加了红色和橙子复合体的计数，而探诊出血（BOP）和牙龈发红也是更多红色复合体计数的预测因子。通过分析计数和分析比例获得了比较相似的结果。尽管在用AMOX+MET+泰特治疗的部位中观察到红色复合物计数的短期减少，但在八种治疗中的任何一种中都没有观察到长期显著效果。严重慢性牙周炎患者的口腔卫生不良会降低治疗的有益效果。
To follow changes (over 2 years) in subgingival bacterial counts of five microbial complexes including health-related Actinomyces spp. in deeper pockets (≥5 mm) after periodontal treatments. Eight different treatments were studied: (1) scaling+root planing (SRP); (2) periodontal surgery (SURG)+systemic amoxicillin (AMOX)+systemic metronidazole (MET); (3) SURG+locally delivered tetracycline (TET); (4) SURG; (5) AMOX+MET+TET; (6) AMOX+MET; (7) TET; and (8) SURG+AMOX+MET+TET. Antibiotics were given immediately following SRP. Subgingival plaque was collected mesiobuccally from each tooth, except third molars, from 176 subjects, completing the study, at baseline, 3, 6, 12, 18, and 24 months post-treatment and analysed for 40 different bacteria using checkerboard hybridization. A negative binomial (NB) generalized estimating equation (NB GEE) model was used to analyze count data and a logistic GEE was used for proportions. We observed short-term beneficial changes in the composition of the red complex of up to 3 months by treating subjects with AMOX+MET+TET. Similar short-term improvements with the same treatment were observed for Tannerella forsythia and Treponema denticola of the red complex. SURG had also short-term beneficial effect on Porphyromonas gingivalis. No periodontal treatments applied to severely affected sites promoted the growth of Actinomyces. Smoking elevated counts of both the red and orange complex while bleeding on probing (BOP) and gingival redness were also predictors of more red complex counts. Comparatively similar findings were obtained by analyzing counts and by analyzing proportions. Although short-term reductions in the counts of the red complex were observed in sites that were treated with AMOX+MET+TET, long-term significant effects were not observed with any of the eight treatments. Poor oral hygiene in patients with severe chronic periodontitis diminished the beneficial effects of treatment.