米诺环素辅助龈下刮治联合根面平整术对侵袭性牙周炎龈下菌斑中牙周致病菌的影响

Effect of minocycline on periodontal pathogens in subgingival plaque of aggressive periodontitis treated with subgingival curettage and root planing

摘要:

目的 探讨米诺环素辅助龈下刮治联合根面平整术对侵袭性牙周炎（AgP）龈下菌斑中牙周致病菌的影响。方法 选取2019年3月—2021年3月南开大学口腔医院收治的AgP患者206例作为研究对象，按照随机分组方法分为研究组和对照组，每组103例。对照组行龈下刮治联合根面平整术常规治疗，研究组在对照组基础上给予米诺环素辅助治疗。记录两组临床疗效，比较两组治疗前后牙周指标、炎症因子及牙周致病菌检出情况及不良反应。结果 研究组总有效率高于对照组（P <0.05）。研究组治疗前后龈沟出血指数、附着水平、菌斑指数、牙周袋深度的差值大于对照组（P <0.05）。研究组治疗前后肿瘤坏死因子α、白细胞介素6、白细胞介素8的差值大于对照组（P <0.05）。研究组治疗前后牙龈卟啉单胞菌、福赛坦菌、齿垢密螺旋体检出率的差值大于对照组（P <0.05）。研究组与对照组总不良反应发生率比较，差异无统计学意义（P >0.05）。结论 米诺环素辅助龈下刮治联合根面平整术治疗AgP可提高疗效，改善牙周组织状况，减轻炎症反应，有效清除牙周致病菌，且安全性良好。

Abstract:

Objective To explore the effect of minocycline on periodontal pathogens in subgingival plaque of aggressive periodontitis (AgP) treated with subgingival curettage and root planing .Methods A total of 206 AgP patients admitted to our hospital from March 2019 to March 2021 were selected, and they were divided into study group (103 cases) and control group (103 cases) via random number table method. The control group was given conventional treatment with subgingival curettage and root planing, and the study group was additionally given minocycline on the basis of the control group. The clinical effects of the two groups were recorded, and alterations in periodontal parameters, inflammatory factors and periodontal pathogens before and after the treatment as well as the incidence of adverse reactions were compared between the two groups.Results The overall effective rate of the study group was higher than that of the control group (P < 0.05). The differences of sulcus bleeding index, gingival attachment level, plaque index, periodontal pocket depth before and after treatment in the study group were higher than those in the control group (P < 0.05). The differences of tumor necrosis factor-α, interleukin-6, and interleukin-8 levels before and after treatment in the study group were also higher than those in the control group (P < 0.05). In terms of the periodontal pathogens, the differences of the detection rate of Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola before and after treatment were greater in the study group relative to the control group (P < 0.05). There was no difference in the overall incidence of adverse reactions between the study group and the control group (P > 0.05).Conclusions Minocycline may enhance the clinical efficacy of subgingival curettage and root planing for AgP. It improves the periodontal condition, reduces the inflammation, eliminate periodontal pathogens, and exhibits a good safety profile.