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

doi:10.3969/j.issn.2095-4344.2014.34.020

Abstract

Abstract:

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 willing, 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.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: periodontal diseases, dental pulp disease, periodontal attachment loss

CLC Number:

R318

Wang Miao-yan, Chen Guang-sheng, Zhuang Hai-yan. Minocycline hydrochloride slow-release antibacterial ointment in the treatment of combined periodontal-endodontic lesions[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(34): 5525-5529.

Figures/Tables 1

2.1 参与者数量分析按意向性处理分析，3组68例68颗患牙均进入结果分析。 2.2 各组研究对象性别和年龄的分析比较 3组患者的性别和年龄差异无显著性意义(P > 0.05)，具有可比性，见表1。 2.3 实验组治疗前后牙周指标的变化实验组牙周探诊深度和附着丧失治疗前后的差值均满足正态性，采用配对t 检验，治疗前牙周探诊深度和附着丧失的均数分别为 4.56 mm和3.24 mm，治疗后分别为2.76 mm和1.83 mm，经统计分析，治疗前后的牙周探诊深度和附着丧失比较差异有显著性意义(牙周探诊深度：t=12.267，P < 0.001；附着丧失：t=10.461，P < 0.001)；因龈沟出血指数治疗前后的差值不满足正态性，采用符号秩和检验，结果显示治疗前后的龈沟出血指数均数依次为3.38和1.16，其变化差异有显著性意义(V=299，P < 0.001)。说明实验组治疗后牙周指标均有明显改善，见表2。 2.4 阳性对照组治疗前后牙周指标的变化阳性对照组牙周探诊深度、附着丧失和龈沟出血指数治疗前后的差值均满足正态性，一致采用配对t 检验，治疗前牙周探诊深度、附着丧失和龈沟出血指数的均数分别为4.49 mm、 3.23 mm和3.37，治疗后分别为3.07 mm、1.99 mm和1.35。经统计分析，治疗前后的牙周探诊深度、附着丧失和龈沟出血指数比较差异有显著性意义(牙周探诊深度：t=12.499，P < 0.001；附着丧失：t=7.013，P < 0.001；龈沟出血指数：t=12.927，P < 0.001)。说明阳性对照组治疗后牙周指标同样发生明显改善，见表3。 2.5 阴性对照组治疗前后牙周指标的变化阴性对照组因牙周探诊深度治疗前后的差值不满足正态性，采用符号秩和检验，结果表明牙周探诊深度治疗前后的均数依次为 4.53 mm和3.34 mm，其变化差异有显著性意义(V=210，P < 0.001)；附着丧失和龈沟出血指数治疗前后的差值均满足正态性，采用配对t 检验，治疗前附着丧失和龈沟出血指数的均数分别为3.21 mm和3.44，治疗后则分别为2.06 mm和1.62，经统计分析，治疗前后的附着丧失和龈沟出血指数比较差异有显著性意义(附着丧失：t=5.294， P < 0.001；龈沟出血指数：t=11.355，P < 0.001)。说明单纯采用机械治疗牙周指标亦会出现明显改善，见表4。 2.6 各组患牙治疗前后牙周指标的分析比较治疗前3组间的比较：正态性和方差齐性检验显示，3组患牙治疗前仅牙周探诊深度满足正态性和方差齐性，故采用方差分析比较3组牙周探诊深度的差异，而附着丧失和龈沟出血指数不满足正态性和方差齐性，采用Wilcoxon秩和检验比较组间差异。结果显示为3组的牙周探诊深度、附着丧失和龈沟出血指数比较差异均无显著性意义(牙周探诊深度：F=0.027，P > 0.05；附着丧失：χ2=0.135，P > 0.05；龈沟出血指数：χ2=0.289，P > 0.05)，表明3组患牙治疗前的整体牙周状况差异无显著性意义。治疗后3组间的比较：正态性和方差齐性检验显示，3组治疗后的附着丧失满足正态性和方差齐性，故采用方差分析比较3组附着丧失的差异，而牙周探诊深度和龈沟出血指数不满足正态性和方差齐性，采用Wilcoxon秩和检验比较组间差异。结果显示为3组治疗后的牙周探诊深度和龈沟出血指数比较差异有显著性意义(探诊深度：χ2=10.296，P < 0.05；龈沟出血指数：χ2=6.079，P < 0.05)，而3组间治疗后附着丧失比较差异无显著性意义(F=1.112，P > 0.05)。说明3组治疗后的牙周探诊深度和龈沟出血指数存在组间差异，局部给药可有效改善牙周局部炎症状况；且实验组牙周指标中探诊深度和龈沟出血指数的改善程度优于阳性对照组，阳性对照组疗效则优于阴性对照组，而附着丧失则未表现统计学差异。 2.7 不良反应未发生与药物治疗相关的不良反应。"

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