抄録
Periodontitis which is defined as inflammation with the destruction of the connective tissue attachment to the root surface and alveolar bone loss, finally causing tooth loss, is caused by the infection of periodontopathic bacteria in periodontal pockets. Based on this knowledge, various antibiotics and antimicrobial agents have been applied to kill such pathogenic bacteria during periodontal treatment. Currently, it is possible to apply antibiotics based products such as PERIOCLINE® (Sunstar Inc., Osaka, Japan) during periodontal therapy, increasing effectiveness and decreasing adverse reaction. The microbiological examination is not practically performed, however, it might be essential to diagnose periodontal diseases and monitor the results of treatment, because no practical method to evaluate subgingival pathogenic bacteria has been usable in dental clinics. In recent years, PERIOCHECK® (Sunstar Inc.), which is a diagnostic kit which can easily and quickly determine the enzymatic activity derived from periodontopathic bacteria has been developed and various microbiological and clinical properties have been reported. In the present study, in order to determine the suitable application period of local chemotherapy, fifty-five test sites affected by adult periodontitis were divided into three groups 2 weeks after initial preparation. The first group which had seventeen sites that indicated negative by PERIOCHECK test 2 weeks after initial treatment showed good healing without further treatment. The second group which had twenty-five sited that still indicated positive by PERIOCHECK and then applied PERIOCLINE for four consecutive weeks 2 to 5 weeks after initial treatment showed good results with significant pocket reduction and attachment gain. On the other hand, the thrill group of which had thirteen sited that indicated positive by PERIOCHECK 2 weeks after initial treatment and applied PERIOCLINE 6 to 9 weeks later showed some pocket reduction but a minute attachment gain. These results reveal that if local chemotherapy with PERIOCLINE is performed just after obtaining microbiological results indicating that pathogenic bacteria are remaining in periodontal pockets, it should be more effective as compared with the usual application. It is also suggested that PERIOCHECK is useful for monitoring periodontal therapy.
