歯周炎治療におけるメトロニダゾールと歯周組織再生を併用した場合の有効性と安全性に関する試験

[Study on the efficacy and safety of metronidazole combined with periodontal tissue regeneration in the treatment of periodontitis].

• Meng-Jia Wang
• Yu DA
• Li-Chun Zheng

抄録

目的:

歯周炎の治療におけるオルニダゾールと歯周組織再生との併用の有効性と安全性を探る。

PURPOSE: To explore the efficacy and safety of ornidazole combined with periodontal tissue regeneration in the treatment of periodontitis.

方法:

2018年3月から2019年3月にかけて、南京大学医学部附属口内病院で治療を受けた歯周炎患者100名を抽出し、再生治療群と併用治療群に無作為に分け、各群50名の患者を対象とした。再生群では歯周組織再生治療を、併用治療群ではオルニダゾール併用歯周組織再生治療を行った。歯周プローブ深さ（PPD）、歯周アタッチメントレベル（PAL）、歯の移動度（MD）、血清マロンジアルデヒド（MDA）、スーパーオキシドジスムターゼ（SOD）、グルタチオンペルオキシダーゼ（gsh-px）、インターロイキン10（IL-10）、インターロイキン4（IL-4）、c反応性蛋白質（CRP）レベル、免疫グロブリンレベルを治療前後に検出し、治療効果や合併症を記録し、比較した。データの統計解析にはSPSS 21.0ソフトウェアパッケージを使用した。

METHODS: From March 2018 to March 2019, 100 patients with periodontitis who received treatment in the Stomatological Hospital Affiliated to the School of Medicine of Nanjing University were selected and randomly divided into the regeneration group and combined treatment group with 50 patients in each group. Patients in the regeneration group received periodontal tissue regeneration treatment, while patients in the combined treatment group received ornidazole combined periodontal tissue regeneration treatment. Related periodontal indexes including periodontal probing depth(PPD), periodontal attachment level(PAL), tooth mobility degree(MD) were measured, serum malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (gsh-px) and interleukin 10 (IL-10) and interleukin 4 (IL-4), c-reactive protein(CRP) level and immune globulin level were detected before and after treatment, the therapeutic effects and complications were recorded and compared. SPSS 21.0 software package was used for statistical analysis of the data.

結果:

治療後、複合治療群のPPD、PAL、MD値は再生群に比べて有意に低かった(P<0.05)。複合治療群の血清MDA値は再生群に比べて有意に低く、SOD値、gsh-px値は再生群に比べて有意に高かった(P<0.05)。複合治療群の血清中IgA、IgM、IgG、IgE、IL-10、IL-4、CRPの値は、再生治療群と比較して有意に低かった(P<0.05)。また、複合治療群の総有効率は再生治療群に比べて有意に高く、合併症の発生率は再生治療群に比べて有意に低かった(P<0.05)。

RESULTS: After treatment, PPD, PAL and MD levels in the combined treatment groups were significantly lower than those in the regenerative group (P<0.05). Serum MDA level in the combined treatment group was significantly lower than that in the regenerative group, SOD and gsh-px levels were significantly higher than that in the regenerative group(P<0.05). The serum levels of IgA, IgM, IgG, IgE, IL-10, IL-4 and CRP in the combined treatment group were significantly lower than those in the regenerative treatment group (P<0.05). The total effective rate of the combined treatment group was significantly higher than that of the regenerative treatment group, and the incidence of complications was significantly lower than that of the regenerative group(P<0.05).

結論:

オルニダゾールと歯周組織再生を併用することで、歯周指数の改善、酸化ストレス傷害の緩和、免疫機能の改善、炎症の抑制などの効果があり、安全性の高い治療効果が期待できます。

CONCLUSIONS: Ornidazole combined with periodontal tissue regeneration can improve the level of periodontal index, alleviate oxidative stress injury, improve immune function, inhibit inflammation, and has a significant therapeutic effect with high safety.