非手術性牙周病治療法的臨床評估─文獻回顧

Clinical Evaluation of Non - Surgical Periodontal Therapy a Comparative Review

侯桂林(Guey Lin Hou) ； 蔡吉政(Chi-Cheng Tsai)

《臺灣齒科醫學會雜誌》 9卷1期 (1986/05) Pp. 102-117

摘要

非手術牲牙周病治療法乃是應用保守性的方法清除牙敵下積 荐的軟、硬細菌沈積物。也就是所謂牙周病治療過程中的口腔衛 清潔法(牙獻上)與牙眼下清潔法。因此非手術牙周病治療的 臨床效果,主要在於牙周囊袋內、外細菌的清除,及牙根面掃平 ,以提供病社區的牙周組織得以重新與牙根的新附著;此外,另一臨床效果的改善,乃是由於病社區致病菌的改變到健康牙周的 細菌生態;使得致病菌對牙周組織的酵素破壞受到阻斷的結果。 許多的研究報告指出,非手術性牙周病治療可以非常有效地 應用在牙周病的預防與治療,乃是建立在患者與牙醫師在牙周病 治療過程中密切合作的結果。本文的目的,乃是操討過去與最近 有關非手術性牙周病治療的臨床致果評估的文獻,歸納其臨床應 用的價值性,作為牙周病治療的參考。從非手術性牙周病治療報 告的最新趨勢與筆者的治療心得,非手術性牙周病治療法的優點 ,可以歸納為以下幾點: (1)非手術性牙周病治療法,可以有效地治療與預防牙周疾病 ,且其教果不直於手術性治療法。 (2)非手術性牙周病治療法主要包括口睦衛生清潔法、牙齒及 牙根掃平法與化學藥物療法。三者合拼應用,致果更佳。 (3)較遠的牙周囊袋探測深度(小於4毫米) ,非手術性療法 比手術療法較不易導教牙周耐著的喪失。 (4)中等深度的牙周囊袋探測深度(介於4~6臺米) ,非手 術性療法具有最佳的治療效果。 (5)較深的牙周蠹袋操測深度(大於6毫米) ,非手術性療法 拘治療效果與手術療法相近。 (6)非手術性療法的改善效果,在6個月時最大,因此,如需 手術性治療,宜選擇在非手術療法治療6個月之後進行之。 (7)非手術性牙周病治療法對牙菌斑、牙敵炎或牙結石均有明 顯的改善效果。

並列摘要

Non-surgical periodontal therapy is the conservative debridment of the subgingival and supragingivaJ soft and hard bacterial deposits. It is synonymous with oral hygiene Instruction and subgingival debridment phase of periodontal therapy. The clinical improvement of non-surgical periodontal therapy is pnmarily the elimination of bacterial plaque within the pocket and on the root surface provide biologically acceptable enviromental where healing of the diseased periodontal tissue can take place. The other clinical improvement is accompanied by a shift from a microbiologic change commonly associated with periodontaJly diseased sites to one more typical of healthy sites. Many reports indicate that effectiveness of non-surgical periodontal therapy are based on the cooperation of both the patient and the dentist in the procedure of periodontal treatment. This paper reviewed studies concerning the effects of non-surgical periodontal therapy to provide references for the c1inica] practice of periodontal treatment. fhe advantages of non-surgical periodontal therapy were summarized as follows: 1) Nonsurgical periodontal therapy consists of oral hygiene procedure, scaling and root planing wd chemotherapy. 2) There is prominant efficacy of non-surgical periodontal therapy with respect to reducing plaque, gingivitis or :a]cu]us. 3) Non-surgical periodontal therapy resuits in less attachment loss than surgical periodontal therapy for shallow pockets (＜ 4 mm). 4) For pockets initially 4-6 mm in depth, non-surgical therapy resulted in greater gain in attachment as compared to the surgical treatment at all time intervals. 5) It is possible that deep pockets (＞ 6 mm) treated non-surgical therapy can result in a sustained gain in attachment. 6) At 6 months, nonSurgical therapy resulted in a most gain of attachment level, as well as marked reduction n pocket depth. 7) It is concluded that nonsurgical periodontal is an effective method in arresting and prevention of periodontal Jiseases.

並列關鍵字

non-surgical periodontal therapy ； periodontal disease