全身应用不同抗生素辅助牙周基础治疗侵袭性牙周炎的临床疗效对比研究

Comparative study of the clinical efficacy of systemic antibiotics assisted periodontal treatment of aggressive periodontitis

目的本研究通过临床干预实验,观察不同抗生素辅助牙周基础治疗对侵袭性牙周炎疗效的影响,为侵袭性牙周炎患者的临床治疗选择合适的药物。方法选取36例侵袭性牙周炎患者,随机分为三组,三组年龄,性别相匹配。其中第一组牙周基础治疗后服用阿莫西林联合甲硝唑,第二组治疗后服用阿奇霉素,另外一组为对照组,即牙周基础治疗后未服用任何抗生素。分别在治疗前和治疗结束后6周检测探诊深度(PD)≥5㎜位点的PD、临床附着丧失(CAL)、龈沟出血指数(BI),比较三组之间疗效的差异,对所得的数据进行统计分析。结果广泛型侵袭性牙周炎患者的治疗后6周的PD,CAL,BI均较治疗前有显著改善,且有统计学意义(P<0.05);口服阿莫西林联合甲硝唑组及口服阿奇霉素组的患者分别与未全身用药组的患者比较,PD和CAL差异有统计学意义(P<0.05);但BI差异无统计学意义(P>0.05);口服阿莫西林联合甲硝唑组的患者与口服阿奇霉素组的患者比较,PD,CAL,BI的差异均无统计学意义(P>0.05)。结论侵袭性牙周炎患者在牙周基础治疗后口服阿奇霉素与口服甲硝唑联合阿莫西林的效果无显著差异。

Objective To evaluate the curative effect with systemic adjunctive antibiotic therapy in aggressive periodontitis after scaling and root planning. For patients with aggressive periodontitis to choose the appropriate systemic adjunctive antibiotic. Methods Three groups received non-surgical periodontal therapy including oral hygiene instruction ,subgingival scaling and root planning within 2 weeks. After subgingival scaling and root planning, patients received further guidance on the control of dental plaque per week, The first group taken by amoxicillin and metronidazole,after periodontal treatment .The second group taking azithromycin after treatment, the other one was the control group, that is not taking any antibiotics after periodontal treatment. Probing depth （PD） which not less than 5ram, clinical attachment loss（CAL）, bleeding index（BI） was recorded at baseline and 1 month after initial treatment. Results 36 cases GAgP patients newly diagnosed checked 389 teeth, a total of 628 sites; All indices of 3 groups improved significant improvement （P〈0.05） after therapy; Indices of PD and CAL of systemic administration groups showed significant improvement （P〈0.05） compared with scaling and root planning group with no drugs; Indices of BI showed no difference （P〉0.05）; But indices of two kinds of systemic administration showed no difference （P〉0.05）. Conclusion There were no differences in therapeutic effect after Periodontal initial therapy between patients with amoxicillin （AMX） and metronidazole （MTZ） and patients with azithromycin （AZM）.