Gaetano Isola, Alessandro Polizzi, Simona Santonocito, Angela Alibrandi, Paolo Pesce, Thomas Kocher
{"title":"四面龈下器械治疗与全口龈下器械治疗对牙周炎患者临床和微生物参数的影响：随机临床试验。","authors":"Gaetano Isola, Alessandro Polizzi, Simona Santonocito, Angela Alibrandi, Paolo Pesce, Thomas Kocher","doi":"10.1111/jre.13279","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>This study evaluated the efficacy of quadrantwise subgingival instrumentation (Q-SI) versus one-stage full-mouth subgingival instrumentation (FM-SI) on probing depth and periodontal pathogen reduction over a 6-month follow-up period, as well as whether baseline periodontal pathogens influenced the impact of periodontal treatment protocols on outcomes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Patients with periodontitis were randomized to receive Q-SI (<i>n</i> = 43) or FM-SI (<i>n</i> = 45). Patients were instructed and motivated to maintain optimal oral hygiene during the treatment sessions. Clinical (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) and periodontal pathogens were assessed at baseline and after 30, 90, and 180 days. Total bacterial load and periodontal pathogens were analysed via real-time PCR.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>At the 6-month follow-up, the median PPD decreased from 4.8 mm (interquartile range [IQR]: 4.3–5.2) to 2.6 mm (IQR: 2.3–2.9) in FM-SI patients and from 4.7 mm (IQR: 4.1–5.2) to 3.2 mm (IQR: 2.4–3.5) in Q-SI patients (<i>p</i> < .001). At 6 months, FM-SI was more effective at reducing the median proportions of <i>Porphyromonas gingivalis</i> (<i>Pg</i>), <i>Aggregatibacter actinocomyctemcomitans</i>, and <i>Tannerella forsythia</i> (<i>Tf</i>) (<i>p</i> < .001 for each value). Multilevel linear regression analysis demonstrated that high baseline PPD (<i>p</i> = .029), <i>Pg</i> (<i>p</i> = .014), and <i>Tf</i> (<i>p</i> < .001) levels and the FM-SI protocol (<i>p</i> < .001) were statistically significant predictors of PPD reduction at 6 months. Furthermore, PPD reduction was significantly greater in the FM-SI group when lower baseline <i>Pg</i> levels were detected.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The FM-SI was more effective than the Q-SI in reducing the mean PPD and number of periodontal pathogens in periodontitis patients over a 6-month follow-up period. Higher baseline PPD and <i>Pg</i> levels had a negative impact on PPD reduction at 6 months after FM-SI.</p>\n </section>\n </div>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":"59 4","pages":"647-656"},"PeriodicalIF":3.4000,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of quadrantwise versus full-mouth subgingival instrumentation on clinical and microbiological parameters in periodontitis patients: A randomized clinical trial\",\"authors\":\"Gaetano Isola, Alessandro Polizzi, Simona Santonocito, Angela Alibrandi, Paolo Pesce, Thomas Kocher\",\"doi\":\"10.1111/jre.13279\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>This study evaluated the efficacy of quadrantwise subgingival instrumentation (Q-SI) versus one-stage full-mouth subgingival instrumentation (FM-SI) on probing depth and periodontal pathogen reduction over a 6-month follow-up period, as well as whether baseline periodontal pathogens influenced the impact of periodontal treatment protocols on outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Patients with periodontitis were randomized to receive Q-SI (<i>n</i> = 43) or FM-SI (<i>n</i> = 45). Patients were instructed and motivated to maintain optimal oral hygiene during the treatment sessions. Clinical (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) and periodontal pathogens were assessed at baseline and after 30, 90, and 180 days. Total bacterial load and periodontal pathogens were analysed via real-time PCR.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>At the 6-month follow-up, the median PPD decreased from 4.8 mm (interquartile range [IQR]: 4.3–5.2) to 2.6 mm (IQR: 2.3–2.9) in FM-SI patients and from 4.7 mm (IQR: 4.1–5.2) to 3.2 mm (IQR: 2.4–3.5) in Q-SI patients (<i>p</i> < .001). At 6 months, FM-SI was more effective at reducing the median proportions of <i>Porphyromonas gingivalis</i> (<i>Pg</i>), <i>Aggregatibacter actinocomyctemcomitans</i>, and <i>Tannerella forsythia</i> (<i>Tf</i>) (<i>p</i> < .001 for each value). Multilevel linear regression analysis demonstrated that high baseline PPD (<i>p</i> = .029), <i>Pg</i> (<i>p</i> = .014), and <i>Tf</i> (<i>p</i> < .001) levels and the FM-SI protocol (<i>p</i> < .001) were statistically significant predictors of PPD reduction at 6 months. Furthermore, PPD reduction was significantly greater in the FM-SI group when lower baseline <i>Pg</i> levels were detected.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The FM-SI was more effective than the Q-SI in reducing the mean PPD and number of periodontal pathogens in periodontitis patients over a 6-month follow-up period. Higher baseline PPD and <i>Pg</i> levels had a negative impact on PPD reduction at 6 months after FM-SI.</p>\\n </section>\\n </div>\",\"PeriodicalId\":16715,\"journal\":{\"name\":\"Journal of periodontal research\",\"volume\":\"59 4\",\"pages\":\"647-656\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-04-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of periodontal research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jre.13279\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of periodontal research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jre.13279","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Effect of quadrantwise versus full-mouth subgingival instrumentation on clinical and microbiological parameters in periodontitis patients: A randomized clinical trial
Aim
This study evaluated the efficacy of quadrantwise subgingival instrumentation (Q-SI) versus one-stage full-mouth subgingival instrumentation (FM-SI) on probing depth and periodontal pathogen reduction over a 6-month follow-up period, as well as whether baseline periodontal pathogens influenced the impact of periodontal treatment protocols on outcomes.
Methods
Patients with periodontitis were randomized to receive Q-SI (n = 43) or FM-SI (n = 45). Patients were instructed and motivated to maintain optimal oral hygiene during the treatment sessions. Clinical (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) and periodontal pathogens were assessed at baseline and after 30, 90, and 180 days. Total bacterial load and periodontal pathogens were analysed via real-time PCR.
Results
At the 6-month follow-up, the median PPD decreased from 4.8 mm (interquartile range [IQR]: 4.3–5.2) to 2.6 mm (IQR: 2.3–2.9) in FM-SI patients and from 4.7 mm (IQR: 4.1–5.2) to 3.2 mm (IQR: 2.4–3.5) in Q-SI patients (p < .001). At 6 months, FM-SI was more effective at reducing the median proportions of Porphyromonas gingivalis (Pg), Aggregatibacter actinocomyctemcomitans, and Tannerella forsythia (Tf) (p < .001 for each value). Multilevel linear regression analysis demonstrated that high baseline PPD (p = .029), Pg (p = .014), and Tf (p < .001) levels and the FM-SI protocol (p < .001) were statistically significant predictors of PPD reduction at 6 months. Furthermore, PPD reduction was significantly greater in the FM-SI group when lower baseline Pg levels were detected.
Conclusion
The FM-SI was more effective than the Q-SI in reducing the mean PPD and number of periodontal pathogens in periodontitis patients over a 6-month follow-up period. Higher baseline PPD and Pg levels had a negative impact on PPD reduction at 6 months after FM-SI.
期刊介绍：
The Journal of Periodontal Research is an international research periodical the purpose of which is to publish original clinical and basic investigations and review articles concerned with every aspect of periodontology and related sciences. Brief communications (1-3 journal pages) are also accepted and a special effort is made to ensure their rapid publication. Reports of scientific meetings in periodontology and related fields are also published.
One volume of six issues is published annually.
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