侵袭性牙周炎基础治疗中不同时机口服抗生素的短期疗效观察  

Short term effect of combined use of amoxicillin and metronidazole at different time of non-surgicalperiodontal treatment for aggressive periodontitis

作　　者：路瑞芳[1] 徐莉[1] 冯向辉[1] 孟焕新[1] 

机构地区：[1]北京大学口腔医学院·口腔医院牙周科,100081

出　　处：《中华口腔医学杂志》2012年第11期666-670,共5页Chinese Journal of Stomatology

基　　金：基金项目：国家自然科学基金（30973319）;“十一五”国家科技支撑计划（2007BAll8802）;首都医学发展科研基金（2009-2033）

摘　　要：目的探讨侵袭性牙周炎（aggressive periodontitis，AgP）患者基础治疗过程中不同时机El服阿莫西林和甲硝唑的短期临床疗效，以期为AgP患者基础治疗中选择用药时机提供参考。方法将45例A扩患者按照随机对照数字表法分为非用药组、洁治后用药组和刮治后用药组，每组15例。所有患者均接受牙周基础治疗，其中洁治后、刮治后用药组分别在洁治后及完成刮治后即刻口服阿莫西林胶囊和甲硝唑片，3个组均在基础治疗前和治疗后8周进行牙周检查。结果洁治后、刮治后用药组患者探诊深度减少[M（Q25，Q75）][分别为2．5（1．8，3．3）mm、2．3（1．9，2．7）mm]和附着增加[M（Q25，Q75）][分别为0．9（0．5，1．4）mnl、0．8（0．4，1．3）mm]均显著高于非用药组[探诊深度减少和附着增加分别为1．8（1．3，2．1）mm、0．4（0．2，1．0）Mm]，差异均有统计学意义（P〈0．05）；其中在探诊深度≥7mm的位点，洁治后用药组的探诊深度减少[4．0（3．0，5．0）mm]显著高于刮治后用药组［4．0（3．0，4．0）mm，P〈0．05。结论AgP患者牙周基础治疗中辅助口服阿莫西林和甲硝唑较单纯牙周基础治疗可取得更好的疗效；有多个位点PD≥7mm的患者可以在洁治后服药，但仍需要远期疗效观察及微生学研究。Objective To evaluate the short term clinical resuhs of scaling and root planning（SRP） only, SRP combined with amoxicillin （AMX） and metronidazole （MTZ） after supragingival scaling or after SRP in the treatment of aggressive periodontitis （ AgP）. Methods A total of 45 patients with AgP were randomly divided into SRP group, SRP with AMX ＋ MTZ after supragingival scaling group and AMX ＋ MTZ after SRP group. Subgingival scaling and root planning were performed one week after supragingival scaling and finished within 1 month. AMX and MTZ were given for 7 days immediately after supragingival scaling or the last time of SPR. Clinical examinations including probing depth （ PD ）, attachment level （AL） and bleeding index（BI） were performed at baseline and 8 weeks after non-surgical periodontal treatment by the same examiner. Results There were more PD reduction and AL gain in both AMX ＋ MTZ after supragingival scaling group and AMX ＋ MTZ after SRP group compared with SRP group [ 2. 5 （ 1.8, 3.3） mm,2.3（1.9, 2.7） mmvs. 1.8（1.3, 2.1） mm,P〈O. 05];[0.9（0.5, 1.4） mm, 0.8（0.4, 1.3） mm vs. 0. 4（0. 2, 1.0） ram, P 〈0. 05]. In sites PD≥7 ram, PD reduction was more in AMX ＋ MTZ after supragingival scaling group than AMX ＋ MTZ after SRP group [ 4.0 （ 3.0,5.0 ） mm vs. 4. 0 （ 3.0, 4. 0） ram, P 〈 0. 05 ） ]. Conclusions The combined use of AMX and MTZ during non-surgical periodontal treatment for patients with AgP was effective in short term. In patients with most sites PD≥7 mm, AMX and MTZ could be taken after supragingival scaling, but the long-tern1 clinical effects needs further investigation.

关 键 词：侵袭性牙周炎 基础治疗 阿莫西林 甲硝唑 

分 类 号：R781.4[医药卫生—口腔医学]