Abstract：
OBJECTIVE: To test the effect of locally delivered doxycycline (DOX) administered 2 weeks prior to minimally invasive periodontal regeneration in terms of presurgical inflammatory status and cytokine expression profile in the gingival crevicular fluid (GCF). Secondary aim was to assess the early wound healing index (EHI) at 2 weeks after surgery.
BACKGROUND: It is hypothesized that healing after periodontal regeneration is dependent on preoperative soft tissue condition, and that local antibiotics may improve the site-specific inflammatory status at short time.
METHODS: Sites associated with periodontal intrabony defects requiring regenerative surgery and showing bleeding on probing (BoP) were included. At T0, experimental sites were randomly treated with subgingival instrumentation with or without topic DOX application. After 2 weeks (T1), defects were approached by means of minimally invasive surgical technique. GCF was sampled at both T0 and T1 for inflammatory biomarker analysis. Two weeks after surgery, the EHI was evaluated (T2).
RESULTS: Forty-four patients were included. At T1, the number of BoP+ sites was statistically significantly less in the test group (27.3% vs. 72.7%; p < .01). The total amount of interleukin (IL)-1β (p < .001), matrix-metalloproteinases (MMP)-8 (p < .001), and MMP-9 (p = .010) in the GCF significantly decreased in the test group at T1, with relevant differences compared to controls. At T2, the EHI had an average value of 1.45 ± 0.86 in the test group while in the control, it was 2.31 ± 1.43 (p = .027). A statistically significantly positive correlation was observed between the amount of IL-1β and MMP-9 and EHI scores.
CONCLUSIONS: Within the limitations of this study, sites treated with DOX showed improved clinical and molecular inflammatory parameters before surgery, as well as soft tissue healing 2 weeks after surgery.
BACKGROUND: It is hypothesized that healing after periodontal regeneration is dependent on preoperative soft tissue condition, and that local antibiotics may improve the site-specific inflammatory status at short time.
METHODS: Sites associated with periodontal intrabony defects requiring regenerative surgery and showing bleeding on probing (BoP) were included. At T0, experimental sites were randomly treated with subgingival instrumentation with or without topic DOX application. After 2 weeks (T1), defects were approached by means of minimally invasive surgical technique. GCF was sampled at both T0 and T1 for inflammatory biomarker analysis. Two weeks after surgery, the EHI was evaluated (T2).
RESULTS: Forty-four patients were included. At T1, the number of BoP+ sites was statistically significantly less in the test group (27.3% vs. 72.7%; p < .01). The total amount of interleukin (IL)-1β (p < .001), matrix-metalloproteinases (MMP)-8 (p < .001), and MMP-9 (p = .010) in the GCF significantly decreased in the test group at T1, with relevant differences compared to controls. At T2, the EHI had an average value of 1.45 ± 0.86 in the test group while in the control, it was 2.31 ± 1.43 (p = .027). A statistically significantly positive correlation was observed between the amount of IL-1β and MMP-9 and EHI scores.
CONCLUSIONS: Within the limitations of this study, sites treated with DOX showed improved clinical and molecular inflammatory parameters before surgery, as well as soft tissue healing 2 weeks after surgery.
摘要：
目的：测试微创牙周再生前2周局部递送多西环素（DOX）对术前炎症状态和龈沟液（GCF）中细胞因子表达谱的影响。次要目的是评估手术后2周的早期伤口愈合指数（EHI）。
背景：假设牙周再生后的愈合取决于术前软组织状况，局部抗生素可以在短时间内改善部位特异性炎症状态。
方法：包括与牙周内缺损相关的部位，需要进行再生手术并显示探查出血（BoP）。在T0时，用牙龈下仪器在有或没有主题DOX应用的情况下随机处理实验部位。2周后（T1），通过微创手术技术解决了缺陷。在T0和T1采样GCF用于炎性生物标志物分析。手术两周后,评估EHI（T2）。
结果：纳入44例患者。在T1时，测试组中BoP+位点的数量在统计学上显着减少（27.3%vs.72.7%；p<0.01）。白细胞介素（IL）-1β的总量（p<.001），基质金属蛋白酶（MMP）-8（p<.001），GCF中的MMP-9（p=.010）在T1时显着降低，与对照组相比具有相关差异。在T2时，EHI在测试组中的平均值为1.45±0.86，而在对照组中，为2.31±1.43(p=.027)。在IL-1β和MMP-9的量与EHI评分之间观察到统计学上显著的正相关。
结论：在本研究的局限性内，DOX治疗的部位在手术前显示出改善的临床和分子炎症参数，以及手术后2周的软组织愈合。
背景：假设牙周再生后的愈合取决于术前软组织状况，局部抗生素可以在短时间内改善部位特异性炎症状态。
方法：包括与牙周内缺损相关的部位，需要进行再生手术并显示探查出血（BoP）。在T0时，用牙龈下仪器在有或没有主题DOX应用的情况下随机处理实验部位。2周后（T1），通过微创手术技术解决了缺陷。在T0和T1采样GCF用于炎性生物标志物分析。手术两周后,评估EHI（T2）。
结果：纳入44例患者。在T1时，测试组中BoP+位点的数量在统计学上显着减少（27.3%vs.72.7%；p<0.01）。白细胞介素（IL）-1β的总量（p<.001），基质金属蛋白酶（MMP）-8（p<.001），GCF中的MMP-9（p=.010）在T1时显着降低，与对照组相比具有相关差异。在T2时，EHI在测试组中的平均值为1.45±0.86，而在对照组中，为2.31±1.43(p=.027)。在IL-1β和MMP-9的量与EHI评分之间观察到统计学上显著的正相关。
结论：在本研究的局限性内，DOX治疗的部位在手术前显示出改善的临床和分子炎症参数，以及手术后2周的软组织愈合。
