系统性抗生素的时间是否会影响牙周治疗的结果? 一个随机的临床试验
Daiane Fermiano1, Eduardo de Souza Oliveira2, Maria Josefa Mestnik1
1Dental Research Division, Guarulhos University, Guarulhos, Brazil.
Journal of periodontology
|February 7, 2026
概括
在牙周缩放和根平整 (SRP) 期间开始服用抗生素,口腔微生物组的改善速度比SRP后更快,尽管这两种方法在严重的牙疾病中产生了相似的临床结果.
科学领域:
- 牙周病药物 牙周病药物
- 微生物组研究的研究.
- 药理动力学是什么 药理动力学
背景情况:
- 牙周病的治疗通常结合了机械除菌与抗生素.
- 相对于规模化和根植计划 (SRP),针对抗生素的最佳时间尚不清楚.
- 了解时机影响牙周炎的临床和微生物学结果.
研究的目的:
- 评估一下,甲化 (MTZ) 和阿莫西西林 (AMX) 给药时间是否会影响牙周治疗的结果.
- 为了比较早期 (SRP期间) 与晚期 (SRP之后) 抗生素的效果.
- 评估对临床参数和下微生物群落结构的影响.
主要方法:
- 一个双盲,安慰剂控制,随机的临床试验,涉及68名患有III/IV期牙周炎的受试者.
- 两个组在14天内接受了SRP:早期抗生素组 (SRP期间的MTZ+AMX) 和晚期抗生素组 (SRP后的MTZ+AMX).
- 临床参数 (PD,CAL,斑块,出血,) 和下微生物群 (DNA-DNA杂交,网络分析) 在基线,3个月和1年被评估.
主要成果:
- 早期和晚期抗生素组在1年内显示出可比的临床改善,探测深度或临床附着水平降低没有显著差异.
- 早期的抗生素组表现出更快,更显著的生态重组 subgingival 微生物群.
- 早期使用促进了致病性细菌 (红色/色复合物) 的更快减少和有益细菌 (Actinomyces spp. ) 的情况.
结论:
- 与SRP相比,抗生素的时间没有影响牙周炎的整体临床治疗疗效.
- 早期的抗生素管理 (在SRP期间) 促进了下微生物社区结构的更快,更有益的转变.
- 在机械除菌开始时开始服用抗生素可能会促进更健康的口腔微生物群,可能会增强长期牙周稳定性.
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