Periodontal debridement as a therapeutic approach for severe chronic periodontitis: a clinical, microbiological and immunological study.
Periodontal debridement as a therapeutic approach for severe chronic periodontitis: a clinical, microbiological and immunological study.
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牙周清创作为严重慢性牙周炎的治疗方法：临床、微生物学和免疫学研究。
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发表时间：
2008
影响因子：
6.7
通讯作者：
M. Casati
中科院分区：
文献类型：
--
作者：
Érica Del Peloso Ribeiro;S. Bittencourt;E. Sallum;F. Nociti;R. Gonçalves;M. Casati
目的
目的探讨牙周清创术治疗重度慢性牙周炎的临床、微生物学和免疫学特点。
材料和方法
选择25名患者，他们至少有8颗牙齿，探测袋深度（PPD）≥ 5 mm，探测时出血（BOP），并随机分配到象限刮治和根面平整术或一次全口牙周清创术。评价了以下临床结果：菌斑指数、BOP、龈缘位置、相对附着水平（RAL）和PPD。采用实时荧光定量PCR方法对伴放线菌聚集菌、牙龈卟啉单胞菌和嗜酸坦纳菌进行定量分析。采用酶联免疫吸附法检测龈沟液（GCF）中IL-1 β、前列腺素E2、INF-γ和IL-10。在基线、治疗后3个月和6个月评价所有参数。
结果
随着时间的推移，两组的PPD减少和附着增加的平均值相似。除了两组治疗后细菌水平显著降低外，微生物分析未能证明它们之间存在显著差异。最后，在GCF中的炎症介质水平方面没有观察到组间差异。
结论
牙周清创导致类似的临床，微生物和免疫学的结果相比，标准的规模和根面平整，因此可能是一个可行的方法来处理严重的慢性牙周炎。
AIM
To clinically, microbiologically and immunologically characterize periodontal debridement as a therapeutic approach for severe chronic periodontitis.
MATERIAL AND METHODS
Twenty-five patients presenting at least eight teeth with a probing pocket depth (PPD) of >or=5 mm and bleeding on probing (BOP) were selected and randomly assigned to quadrant-wise scaling and root planing or one session of full-mouth periodontal debridement. The following clinical outcomes were assessed: plaque index, BOP, position of gingival margin, relative attachment level (RAL) and PPD. Real-time PCR was used for quantitative analysis of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia. The enzyme-linked immunosorbent assay permitted the detection of IL-1beta, prostaglandin E(2), INF-gamma and IL-10 in gingival crevicular fluid (GCF). All the parameters were evaluated at baseline, and at 3 and 6 months after treatment.
RESULTS
Both the groups had similar means of PPD reduction and attachment gain over time. Besides a significant reduction in the bacterial level after treatment in both groups, microbiological analysis failed to demonstrate significant differences between them. Finally, no difference was observed between groups with respect to the levels of inflammatory mediators in GCF.
CONCLUSION
Periodontal debridement resulted in a similar clinical, microbiological and immunological outcome when compared with standard scaling and root planing and therefore may be a viable approach to deal with severe chronic periodontitis.
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