不同时机口服抗菌药物辅助机械治疗重度慢性牙周炎的临床疗效

发布时间：2018-06-20 07:42

本文选题：牙周炎 + 牙科刮治术　；参考：《北京大学学报(医学版)》2015年01期

【摘要】：目的:评价重度慢性牙周炎(chronic periodontitis,CP)患者1周内完成全口龈下刮治及根面平整的可行性及治疗过程中不同时机口服阿莫西林和甲硝唑的临床疗效。方法:选取30例重度慢性牙周炎患者,男性14例,女性16例,平均年龄40.5±8.4岁(35~60岁),按照随机数字表分为A组(刮治同期用药),B组(刮治后用药)和C组(单纯刮治),每组10例。所有患者均于1周内分2次完成全口牙周机械治疗(刮治和根面平整)。A组在龈下刮治开始前0.5~1 h服用阿莫西林胶囊(0.5 g,3次/d)+甲硝唑片(0.2 g,3次/d),连服7 d;B组在全口龈下刮治完成次日开始服用阿莫西林胶囊(0.5 g,3次/d)+甲硝唑片(0.2 g,3次/d),连服7 d;C组服用安慰剂。3组均在牙周治疗前及治疗完成后2个月进行全口牙周临床检查,观察指标包括菌斑指数、探诊深度(probing depth,PD)、出血指数(bleeding index,BI)和牙齿松动度等。计算全口牙位点的平均探诊深度、平均邻面探诊深度(proximal probing depth,p PD),PD5 mm位点的百分比(PD5 mm%)、邻面PD5 mm位点的百分比(p PD5 mm%)、平均BI及探诊出血比率(percentage of sites with bleeding on probing,BOP%)。结果:(1)治疗前后PD、p PD、PD5mm%和p PD5 mm%有显著降低(P0.001);BOP%也有显著降低(P0.05)。(2)A组平均PD减少值[(2.15±0.42)mm]显著优于B组[(1.76±0.29)mm]和C组[(1.57±0.33)mm],P0.05。B组[(1.76±0.29)mm]与C组[(1.57±0.33)mm]平均PD减少值差异无统计学意义,P=0.354。A组p PD减少值[(2.45±0.43)mm]显著优于单纯刮治组[(1.90±0.48)mm],P0.05。A组、B组与C组组间BI及BOP%的改善程度差异无统计学意义。结论:重度慢性牙周炎患者1周内分两次完成全口龈下刮治是安全可行的,龈下刮治同时口服阿莫西林胶囊+甲硝唑较龈下刮治后用药和单纯刮治探诊深度减少更显著。
[Abstract]:Objective: to evaluate the feasibility of complete subgingival curettage and root surface leveling in patients with severe chronic periodontitis (CPD) in one week and the clinical efficacy of oral amoxicillin and metronidazole at different times during the treatment. Methods: 30 patients with severe chronic periodontitis, 14 males and 16 females, with an average age of 40.5 卤8.4 years old or 3560 years old, were divided into two groups: group A (group B) and group C (group C). All patients were divided into 2 complete periodontal mechanical therapy within one week (group A was given amoxicillin capsule 0.5 g / d 3 times / d at 0.5 h before subgingival curettage), metronidazole tablet 0.2 g / 3 / d of metronidazole, and group B was given 7 d / 3 / 3 / d of metronidazole tablets. Group A received oral administration of Amoxicillin capsule 0.5 g / d 1 h before the onset of subgingival curettage. The next day after subgingival curettage was completed, Amoxicillin capsule 0.5 g / d) metronidazole tablet 0.2 g / d was taken. Placebo 3 group was given placebo for 7 days. All patients were given full oral periodontal clinical examination before periodontal treatment and 2 months after treatment. The observed indexes included plaque index, probing depth, bleeding index (BI) and tooth mobility. The average probing depth of the whole tooth site was calculated, and the percentage of proximal probing depth to PD5 mm site was calculated. The percentage of PD5 mm site on the adjacent surface, the percentage of PD5 mm site on the adjacent surface, and the mean BI and bleeding ratio of probing and detecting of sites with bleeding on were calculated. Results: before and after treatment, PDP PD5mm% and pPD5mm% significantly decreased P0.001BPO%, and the average PD reduction value of group A [2.15 卤0.42)mm] was significantly higher than that of group B [1.76 卤0.29)mm] and group C [1.57 卤0.33)mm] P0.05.B [1.76 卤0.29)mm] and group C [1.57 卤0.33)mm]. There was no significant difference between group A and group C [1.57 卤0.33)mm]. There was no significant difference in the improvement of BI and BOP% between group B and group C in low value [2.45 卤0.43)mm] compared with simple curettage group [1.90 卤0.48)mm] P0.05.A group. Conclusion: it is safe and feasible for patients with severe chronic periodontitis to complete subgingival curettage twice in one week, and oral amoxicillin capsule metronidazole is more effective than that after subgingival curettage and simple curettage.
【作者单位】：北京大学口腔医学院·口腔医院牙周科;
【基金】：国家自然科学基金(81300879)资助~~
【分类号】：R781.42

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