- 期刊
四環黴素纖維應用於牙周病治療
The Use of Tetracycline Fibers in Periodontal Therapy
摘要
四環黴素由於具抑菌功能，並能促進纖維母細胞的附著，以及抑制膠原蛋白的活性等功能，而且在牙齦溝液內較高濃度，因此常用於牙周病的治療。四環黴素纖維則是以牙齦下局部給藥方式，以達到患部並維持長時間的抑菌濃度，減少全身性的投藥所引起藥物的副作用，而且無須依賴病患的配合度，若合併結石刮除及牙根整平，可應用於成年型牙周炎病患，或再發性或無法改善的牙周囊袋來治療，使短期內獲得較顯著的臨床效果。本文主要在回顧目前相關文獻，針對四環黴素纖維的特色、臨床及細菌反應、長期效果、國人使用效果、與其他療法的比較，作深入之探討，以供臨床上使用的參考。
並列摘要
Tetracycline-impregnated fiber is a sustained local delivery drug. The fiber has advantages of maintaining therapeutic drug levels at the treated sites without the harmful sides effects of systemic therapy and does not depend on patient compliance. Tetracycline can bind to and is slowly released from the root surface. Besides the bacteriostatic ability, tetracycline can also enhance the regeneration of tissue by promotion of the fibroblast attachment and inhibition of collagenase activity. Although clinical trials have demonstrated the clinical benefit of the use of fibers in reducing probing depths and gaining clinical attachment as compared to no subgingival therapy or placebo fibers. We cannot find the additional benefit of adjunctive tetracycline therapy in treating non-responsive sites undergoing supportive periodontal therapy. Recolonization of the bacteria from untreated sites or from the extracrevicular region may explain the insignificant response to local tetracycline therapy. This article reviews the characteristics of the tetracycline fiber, its clinical and microbiologcial response and the effect on biochemical marker in gingival crevicular fluid. Long term result and the response in comparison with other local antibiotic therapies are also assessed in order to evaluate the role of tetracycline fiber in the management of periodontal disease.