目的：研究在治疗步骤I-II后，在开放口袋[残余探查袋深度（PPD）≥6mm和PPD4-5mm，探查出血（BoP）]中，一个或两个重复的龈下器械（RSI）在达到治疗终点（EoT）中的作用。
方法：患有III-IV期牙周炎的25例患者（总共3,552个部位；1,450个开放口袋）接受了牙周治疗的I-II步骤，并在4-6周后重新评估周（T1）。残余袋在T1和3个月(T2)时接受RSI。计算T1，T2和6个月（T3）时的EoT（PPD<4或PPD<6BoP-）率。计算所需手术次数和治疗费用。
结果：在T1时，67.6％的开放口袋达到了EoT。T1时残余PPD≥6mm(n=172)，在T2和T3时，一次和两次RSI分别导致33.1％和45.9％的EoT。在残余PPD为4-5mm时，在T1时使用BoP（n=298），在T2和T3时，一次和两次RSI分别导致66.8%和72.1%的EoT。在两种情况下，T1时的PPD预测了RSI后的EoT，而牙齿类型仅在残余PPD4-5mmBoP+。在T1时，每位患者的平均手术次数和相关费用显着高于一次/两次RSI后。
结论：在相当多的情况下，RSI可能在残留PPD4-5mmBoP和PPD≥6mm中达到EoT。
结论：这些发现可能支持在手术入路之前给予一个/两个周期的RSI。
背景：ClinicalTrials.gov标识号：NCT04826926。
OBJECTIVE: To study the effects of one or two repeated subgingival instrumentations (RSI) in achieving the endpoints of therapy (EoT) in open pockets [residual probing pocket depth (PPD) ≥ 6 mm and PPD 4-5 mm with bleeding on probing (BoP)] after steps I-II of therapy.
METHODS: Twenty-five patients (3,552 total sites; 1,450 open pockets) with stage III-IV periodontitis received steps I-II of periodontal therapy and were re-evaluated after 4-6 weeks (T1). Residual pockets received RSI at T1 and at 3 months (T2). EoT (PPD < 4 or PPD < 6 BoP-) rate at T1, T2 and 6 months (T3) was computed. The number of needed surgeries and treatment costs were calculated.
RESULTS: At T1, 67.6% of open pockets achieved EoT. At residual PPD ≥ 6 mm at T1 (n = 172), one and two RSI resulted in 33.1% and 45.9% of EoT at T2 and T3, respectively. At residual PPD 4-5 mm with BoP at T1 (n = 298), one and two RSI resulted in 66.8% and 72.1% of EoT at T2 and T3, respectively. PPD at T1 predicted EoT after RSI in both cases, while tooth type only in residual PPD 4-5 mm BoP + . At T1, mean number of surgeries per patient and associated costs were significantly higher than after one/two RSI.
CONCLUSIONS: RSI may achieve EoT in residual PPD 4-5 mm BoP + and PPD ≥ 6 mm in a considerable number of cases.
CONCLUSIONS: These findings may support the administration of one/two cycles of RSI prior to surgical approach.
BACKGROUND: ClinicalTrials.gov identification number: NCT04826926.
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