盐酸米诺环素缓释抗菌软膏修复牙周牙髓联合病变

Minocycline hydrochloride slow-release antibacterial ointment in the treatment of combined periodontal-endodontic lesions

背景:关于盐酸米诺环素对慢性牙周炎、牙周脓肿等的辅助治疗作用已有较多报道,但有关盐酸米诺环素在牙周牙髓联合病变中的详细研究,目前国内报道较少。目的:探讨缓释型盐酸米诺环素在牙周牙髓联合病变临床治疗中应用的效果。方法:选择68例(68颗)牙周牙髓联合病变患者进行牙周机械治疗联合根管治疗,按患者意愿分3组进行牙周治疗,实验组(n=24)牙周机械治疗后局部注入盐酸米诺环素,阳性对照组(n=24)牙周机械治疗后局部注入碘甘油,阴性对照组(n=20)牙周机械治疗后未注入药物,3组均于牙周机械治疗后1个月复诊,比较治疗前后牙周探诊深度、附着丧失和龈沟出血指数的差异。结果与结论:牙周机械治疗1个月后,3组牙周探诊深度、附着丧失和牙龈出血指数均较治疗前明显改善(P<0.05);实验组与阳性对照组牙周探诊深度和龈沟出血指数优于阴性对照组(P<0.05),实验组牙周探诊深度和龈沟出血指数优于阳性对照组(P<0.05)。表明在牙周牙髓联合病变的临床治疗中,除了采取牙周机械治疗和根管治疗,局部应用缓释型盐酸米诺环素能有效降低牙周袋深度,改善牙龈炎症状况,巩固临床治疗效果。

BACKGROUND：The role of minocycline hydrochloride in adjuvant therapy of chronic periodontitis and periodontal abscess has been widely reported, but detailed study of minocycline hydrochloride for combined periodontal-endodontic lesions is rare at present. OBJECTIVE：To investigate the effect of minocycline hydrochloride in the treatment of combined periodontal-endodontic lesions. METHODS：A total of 68 teeth with combined periodontal-endodontic lesions were treated with periodontal mechanical treatment and root canal therapy. According to the patient’s wiling, 68 patients were divided into experimental group （n=24; local injection of minocycline hydrochloride after periodontal mechanical treatment）, positive control group （n=24; local injection of iodine glycerol after periodontal mechanical treatment）, and negative control group （n=20; no injection after periodontal mechanical treatment）. These three groups were reviewed 1 month after periodontal mechanical treatment, and the differences before and after treatment were compared, including periodontal probing depth, attachment loss and gingival bleeding index. RESULTS AND CONCLUSION： Probing depth, attachment loss and gingival bleeding index in three groups were significantly improved after 1 month of periodontal mechanical treatment （P〈 0.05）; both probing depth and sulcus bleeding index in experimental group and positive control group were better than that of the negative control group （P 〈 0.05）, and probing depth and sulcus bleeding index in experimental group were better than that of positive control group （P 〈 0.05）. Experimental findings indicate that, in the clinical treatment of combined periodontal-endodontic lesions, in addition to periodontal mechanical treatment and root canal therapy, local application of minocycline hydrochloride can effectively reduce the depth of periodontal pocket, improve gingival inflammatory conditions and consolidate curative effect.