阿莫西林联用甲硝唑辅助牙周机械治疗对牙周炎患者龈沟液中病原菌及RANKL/OPG水平的影响

Effect of amoxicillin and metronidazole combined with mechanical therapy in the treatment of periodontitis and the influence on pathogenic bacteria and RANKL/OPG level

目的:探讨阿莫西林联用甲硝唑辅助牙周机械治疗对牙周炎患者龈沟液中病原菌及RANKL/OPG水平的影响。方法:选取我院口腔科于2013年1月~2016年1月期间就诊的170例牙周炎患者为研究对象,随机分为2组,每组85例;对照组给牙周机械治疗和龈下清创术,观察组患者在机械治疗和清创术后口服阿莫西林与甲硝唑;比较两组患者的临床疗效疗、治疗前后的各牙周指标、龈沟液中病原菌和RANKL/OPG,观察不良反应。结果:观察组和对照组的总有效率分别为94.1%、74.1%,差异有统计学意义(P<0.05)。与治疗前相比,治疗后两组患者的牙龈菌斑指数、探诊出血指数、牙周袋深度和附着水平水平均显著降低(P<0.05),且观察组的各牙周指标均显著低于对照组(P<0.05);治疗后,两组患者的伴放线杆菌、牙龈卟啉单胞菌和福赛类杆菌检出率显著低于治疗前,观察组的各病原菌检出率显著低于对照组(P<0.05);与治疗前相比,治疗后两组患者龈沟液中RANKL水平显著下降、OPG水平显著升高、RANKL/OPG显著下降(P<0.05),但观察组的变化程度更为显著(P<0.05)。两组患者的不良反应率均为2.35%,无显著差异(P>0.05)。结论:阿莫西林联合甲硝唑辅助牙周机械治疗能够有效清除龈沟液中的病原菌,改善牙周炎患者牙周指标,效果良好,并能纠正纠正龈沟液中RANKL/OPG比例失调,抑制骨吸收,有效治疗牙周炎。

Objective： To analyze the effect of amoxieillin and metronidazole combined with mechanical therapy in the treatment of periodontitis and the influence on pathogenic bacteria and RANKL/OPG level. Methods ： One hundred and seventy periodontitis patients were selected as the research objects and divided into two equal groups randomly. The control group was treated with basic treatment and debridement, while observation group was treated amoxieillin and metronidazole additionally. The clinical effect, periodontal index, pathogenic bacteria in gingival erevicular fluid, RANKL/OPG level before and after treatment were compared. Results：The effective rates of two groups were 94. 1% ,74. 1% respectively,which indicated significantly difference （ P 〈 0. 05 ）. The indexes including Gingival plaque index, probing bleeding index, periodontal pocket depth, attachment level, and the pathogenic bacteria detection rate of both groups were significantly decreased after treatment （ P 〈 0. 05 ） , the observation group was significantly lower （ P 〈 0. 05 ）. Both groups＇ RANKL level were decreased （ P 〈 0. 05 ）, OPG level were increased （ P 〈 0. 05 ）, RANKL/OPG were decreased （ P 〈 0. 05 ） , and observation group varied more signifieantly（P 〈0. 05 ）. The adverse effects of both groups was 2. 35% ,which showed no significant difference（P 〉 0. 05 ）. Conclusion：Amoxicillin and metronidazole combined with mechanical therapy can effectively eliminate pathogens in gingival crevicular fluid, improve periodontal index, inhibit inflammation, adjust the ratio of RANKL/OPG, prevent bone resorption, can effectively cure periodontltis.