目的:评价盐酸米诺环素联合甲硝唑与单用甲硝唑治疗种植体周围炎的疗效及对特异性炎症指标的影响。
方法:对2018年1月至2021年1月的107例种植体周围炎患者进行了回顾性研究。患者单独使用甲硝唑治疗(Con组,n=57)或额外的盐酸米诺环素(实验组,n=50)。炎症标志物,包括白细胞介素-6(IL-6),白细胞介素-1β(IL-1β),肿瘤坏死因子α(TNF-α),治疗前后测定基质金属蛋白酶-8(MMP-8)。使用菌斑指数(PLI)确定临床结果,龈沟出血指数(SBI),和牙周探诊深度(PD)。此外,受试者操作特征(ROC)曲线分析了标记物的临床相关性。采用Logistic回归分析影响患者疗效的危险因素。
结果:Exp组表现出更有利的临床结果,并显示较低水平的IL-6,IL-1β,TNF-α,和MMP-8比Con组。IL-1β,TNF-α,MMP-8水平与治疗成功率显著相关(P<0.05),但IL-6无统计学意义(P>0.05)。IL-1β和TNF-α的ROC曲线明显优于IL-6和MMP-8(P<0.05)。Logistic回归分析显示,只有IL-1β和TNF-α是影响患者疗效的独立危险因素。
结论:与单独使用甲硝唑相比,盐酸米诺环素与甲硝唑联合治疗种植体周围炎效果更好。在分析的因素中,只有IL-1β和TNF-α作为可靠的独立疗效指标出现。
OBJECTIVE: To evaluate the efficacy of minocycline hydrochloride combined with
metronidazole versus
metronidazole alone in treating peri-implantitis and their impact on specific inflammatory markers.
METHODS: A retrospective review was undertaken of 107 patients with peri-implantitis from January 2018 to January 2021. Patients were treated either with
metronidazole alone (Con group, n = 57) or with additional minocycline hydrochloride (Exp group, n = 50). Inflammatory markers, including interleukin-6 (IL-6), interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), and matrix metalloproteinase-8 (MMP-8) were determined before and after treatment. Clinical outcomes were determined using the plaque index (PLI), gingival sulcus bleeding index (SBI), and periodontal probing depth (PD). Furthermore, receiver operator characteristic (ROC) curves analyzed the clinical relevance of the markers. Logistic regression was conducted to analyze the risk factors affecting efficacy in patients.
RESULTS: The Exp group exhibited more favorable clinical outcomes and showed lower levels of IL-6, IL-1β, TNF-α, and MMP-8 than the Con group. IL-1β, TNF-α, and MMP-8 levels were significantly correlated with treatment success (P < 0.05), but IL-6 was not (P > 0.05). The ROC curves for IL-1β and TNF-α significantly outperformed those for IL-6 and MMP-8 (P < 0.05). Logistic regression analysis showed that only IL-1β and TNF-α were independent risk factors affecting efficacy in patients.
CONCLUSIONS: Combining minocycline hydrochloride with
metronidazole yields better outcomes for peri-implantitis compared to
metronidazole alone. Of the factors analyzed, only IL-1β and TNF-α emerged as dependable independent efficacy indicators.