Untersuchung von Parodontitispatienten mit Full-Mouth-Scaling und mikrobiologisch orientierter systemischer Antibiotikagabe -Auswirkungen einer Lebenspartnertherapie-

Hintergrund: In der vorliegenden prospektiven klinischen Studie über einen Zeitraum von drei Jahren wurde der Therapieerfolg einer Kombinationstherapie mittels systemischer Antibiotikagabe mit vorausgegangenem Full-Mouth-Scaling mit Wurzelglättung bei an chronischer oder aggressiver Parodontitis erk...

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Bibliographic Details
Main Author: Hahn, Simone
Contributors: Stelzel, Michael (PD Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2010
Online Access:PDF Full Text
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Background: This clinical study, which ran over a period of three years, examined the therapeutical effect of a combined therapie consisting of systematic antibiotics and full-mouth scaling and root planning. This study was conducted on patients with either a chronical or an aggressive form of periodontitis, taking into account the effects of this therapie on family members. Materials and methods: 26 patients were divided into groups. 20 patients, which were diagnosed with periodontitis, received a combination of full-mouth scaling and root planning, along with Amoxicillin and Metronidazol for eight days. The six healthy family members were not treated. Due to the fact that in several families more than one partner had periodonitis, the group was divided into primary and secondary diseased patients, on the basis of the baseline clinical findings and x-rays. The primary group showed a greater destruction of the alveolar bone as compared to the secondary group. The clinical measurements plaque index (API), probing pocket depth (ST) and bleeding on probing (BoP) were taken before the initial therapie and were reevaluated annually for a period of three years. Additionally, a sample of the sulcular fluid was taken from all subjects before therapy, as well as after the completion of therapy, to gain information on the therapeutical success regarding the periodontal pathogenic germs. Results: Within the group of patients with periodontitis, a significant improvement (p < 0.05) of the clinical parameters was observed. The therapy effect became apparent within the first year of treatment and remained constant within the entire examination period. None of the family members of the treated patients were diagnosed with a periodontal disease. A significant reduction of most periodontitis incuring germs (Aggregatibacter actinomycetemcomittans, Porphyromonas gingivalis, Fusobacterium nucleatum and Tannerella forsythensis) could be established. Solely Prevotella intermedia remained at higher concentrations throughout the study. Furthermore, all patients showed a reduced API by means of regular professional supragingival cleaning, combined with motivation and oral hygienic instructions. Conclusion: As shown in past studies, the effectiveness of the adjunction was proven through the improvement of the clinical situation of the periodontitis patients. Moreover, a progression of the disease was prevented, thus justifying the use of antibiotics in the periodontitis therapy. The study also demonstrates a transmission of pathogenic bacteria between the diseased patients and their family members. However, this did not lead to an outbreak of a periodontic disease, unlike results in prior studies. The positive influence of an excellent oral hygiene during and after the periodontal therapy was proven through the fact that no disease progression could be observed within the time frame specified.