Abstract：
OBJECTIVE: To investigate the microbiological outcomes obtained with either subgingival debridement (SD) in conjunction with a gel containing sodium hypochlorite and amino acids followed by subsequent application of a cross-linked hyaluronic acid gel (xHyA) gel, or with SD alone.
METHODS: Forty-eight patients diagnosed with stages II-III (grades A/B) generalised periodontitis were randomly treated with either SD (control) or SD plus adjunctive sodium hypochlorite/amino acids and xHyA gel (test). Subgingival plaque samples were collected from the deepest site per quadrant in each patient at baseline and after 3 and 6 months. Pooled sample analysis was performed using a multiplex polymerase chain reaction (PCR)-based method for the identification of detection frequencies and changes in numbers of the following bacteria: Aggregatibacter actinomycetemcomitans (A.a), Porphyromonas gingivalis (P.g), Tannerella forsythia (T.f), Treponema denticola (T.d), and Prevotella intermedia (P.i).
RESULTS: In terms of detection frequency, in the test group, statistically significant reductions were found for P.g, T.f, T.d and P.i (p < 0.05) after 6 months. In the control group, the detection frequencies of all investigated bacterial species at 6 months were comparable to the baseline values (p > 0.05). The comparison of the test and control groups revealed statistically significant differences in detection frequency for P.g (p = 0.034), T.d (p < 0.01) and P.i (p = 0.02) after 6 months, favouring the test group. Regarding reduction in detection frequency scores, at 6 months, statistically significant differences in favour of the test group were observed for all investigated bacterial species: A.a (p = 0.028), P.g (p = 0.028), T.f (p = 0.004), T.d (p <0.001), and P.i (p = 0.003).
CONCLUSIONS: The present microbiological results, which are related to short-term outcomes up to 6 months post-treatment, support the adjunctive subgingival application of sodium hypochlorite/amino acids and xHyA to subgingival debridement in the treatment of periodontitis.
METHODS: Forty-eight patients diagnosed with stages II-III (grades A/B) generalised periodontitis were randomly treated with either SD (control) or SD plus adjunctive sodium hypochlorite/amino acids and xHyA gel (test). Subgingival plaque samples were collected from the deepest site per quadrant in each patient at baseline and after 3 and 6 months. Pooled sample analysis was performed using a multiplex polymerase chain reaction (PCR)-based method for the identification of detection frequencies and changes in numbers of the following bacteria: Aggregatibacter actinomycetemcomitans (A.a), Porphyromonas gingivalis (P.g), Tannerella forsythia (T.f), Treponema denticola (T.d), and Prevotella intermedia (P.i).
RESULTS: In terms of detection frequency, in the test group, statistically significant reductions were found for P.g, T.f, T.d and P.i (p < 0.05) after 6 months. In the control group, the detection frequencies of all investigated bacterial species at 6 months were comparable to the baseline values (p > 0.05). The comparison of the test and control groups revealed statistically significant differences in detection frequency for P.g (p = 0.034), T.d (p < 0.01) and P.i (p = 0.02) after 6 months, favouring the test group. Regarding reduction in detection frequency scores, at 6 months, statistically significant differences in favour of the test group were observed for all investigated bacterial species: A.a (p = 0.028), P.g (p = 0.028), T.f (p = 0.004), T.d (p <0.001), and P.i (p = 0.003).
CONCLUSIONS: The present microbiological results, which are related to short-term outcomes up to 6 months post-treatment, support the adjunctive subgingival application of sodium hypochlorite/amino acids and xHyA to subgingival debridement in the treatment of periodontitis.
摘要：
目的：研究牙龈下清创术（SD）与含有次氯酸钠和氨基酸的凝胶结合，随后应用交联透明质酸凝胶（xHyA）凝胶获得的微生物学结果，或单独使用SD。
方法：48例诊断为II-III期（A/B级）广泛性牙周炎的患者随机接受SD（对照）或SD加辅助次氯酸钠/氨基酸和xHyA凝胶（测试）治疗。在基线以及3个月和6个月后，从每位患者的每个象限的最深部位收集龈下菌斑样品。使用基于多重聚合酶链反应（PCR）的方法进行汇总样品分析，以鉴定以下细菌的检测频率和数量变化：放线菌集散菌（A.a),牙龈卟啉单胞菌(P.g),连翘糖菌(T.f),Denticola密螺旋体（T.d),和介体间普雷沃特氏菌(P.i).
结果：就检测频率而言，在测试组中，P.g发现有统计学意义的降低，T.f,6个月后T.d和P.i(p<0.05)。在对照组中，6个月时所有被调查细菌种类的检测频率与基线值相当(p>0.05).测试组和对照组的比较显示P.g的检测频率存在统计学上的显着差异（p=0.034），6个月后T.d(p<0.01)和P.i(p=0.02)，有利于测试组。关于减少检测频率分数，6个月时,对于所有研究的细菌物种，观察到有利于测试组的统计学差异：A.a（p=0.028），P.g（p=0.028），T.f(p=0.004),T.d（p<0.001），和P.i(p=0.003)。
结论：目前的微生物学结果，这与治疗后6个月的短期结果有关，支持次氯酸钠/氨基酸和xHyA辅助牙龈下应用于牙周炎的牙龈下清创术。
方法：48例诊断为II-III期（A/B级）广泛性牙周炎的患者随机接受SD（对照）或SD加辅助次氯酸钠/氨基酸和xHyA凝胶（测试）治疗。在基线以及3个月和6个月后，从每位患者的每个象限的最深部位收集龈下菌斑样品。使用基于多重聚合酶链反应（PCR）的方法进行汇总样品分析，以鉴定以下细菌的检测频率和数量变化：放线菌集散菌（A.a),牙龈卟啉单胞菌(P.g),连翘糖菌(T.f),Denticola密螺旋体（T.d),和介体间普雷沃特氏菌(P.i).
结果：就检测频率而言，在测试组中，P.g发现有统计学意义的降低，T.f,6个月后T.d和P.i(p<0.05)。在对照组中，6个月时所有被调查细菌种类的检测频率与基线值相当(p>0.05).测试组和对照组的比较显示P.g的检测频率存在统计学上的显着差异（p=0.034），6个月后T.d(p<0.01)和P.i(p=0.02)，有利于测试组。关于减少检测频率分数，6个月时,对于所有研究的细菌物种，观察到有利于测试组的统计学差异：A.a（p=0.028），P.g（p=0.028），T.f(p=0.004),T.d（p<0.001），和P.i(p=0.003)。
结论：目前的微生物学结果，这与治疗后6个月的短期结果有关，支持次氯酸钠/氨基酸和xHyA辅助牙龈下应用于牙周炎的牙龈下清创术。
