Minocycline 국소 약물 방출 제제의 치주질환 치료 효과
Effects of locally-delivered minocycline hcl on controlled periodontal disease
소속 상세정보
정미현/Mi-Hyun Chung
권영혁/허익/이만섭/박준봉/Young-Hyuk Kwon/Yeek Herr/Man-Sup Lee/Joon-Bong Park
KMID : 0363019980280010037
Abstract
결 론
진행된 치주질환 환자를 치료하기 위해서 치석 제거술 및 치근면 활택술후에 부가적인 치
료로서 minocycline strip과 gel 국소약물 방출제제를 투여후 이들 각각의 효과를 평가하고
자, 치주낭 깊이가 5-8㎜인 치아가 1/4악 각각에서 최소한 2개 이상인 진행된 치주염을 가
진 환자 25명을 대상으로 하였다. 0, 6, 10, 14, 20주에 임상지수 검사(치태지수, 치은출혈지
수, 치주낭깊이, 치은퇴축)와 미생물 검사(치주병인균 유무 판정검사, 위상차현미경하에서 세
균의 분포)를 실시하여 이들의 변화를 비교, 관찰한 결과 다음과 같은 결론을 얻었다.
1. mulocycline strip 국소약물 방출제제사용군에서 생리식염수를 사용한 군과 비교하여
치은출혈지수, 치주낭깊이와 치주병인균 유무 판정검사에서 유의성있는 감소를 보였고 위상
차 현미경 검사에서도 특히 나선형 세균과 운동성 막대형 세균의 상대적 분포가 감소하였으
며 구균형 세균의 상대적 분포는 유의성있게 증가하였다.
2. minocycline gel 국소약물 방출제제를 사용한 군에서도 생리식염수를 사용한 군과 비교
하여 치은출혈지수, 치주낭 깊이와 치주병인균 유무 판정검사에서 유의성있는 감소를 나타
냈고 위상차현미경검사에서도 strip사용군과 유사한 결과를 나타냈다.
3. minocycline strip사용군과 minocycline gel 사용군 사이에는 모든 임상검사와 미생물검
사에서 유의성 있는 차이를 보이지 않았다.
The purpose of this study was to evaluate the clinical and microbiological outcomes
following the use of 30% minocycline-loaded polycaprolacton film and 2%
minocycline-loaded gel that was applied locally Into pockets combined with scaling and
root planing. 25 human subjects who were non-pregnant, non-lactating, aged 20-50 and
diagnosed as moderate to advanced adult periodontitis were enrolled. Subjects were
excluded f they had a history of severe acute or chronic systemic disease, if they
required antibiotic prophylaxis for dental treatment fort any reason, or chronic they
reported a history suggestive of hypersensitivity reactions to minocycline or tetracycline.
4 quadrants that had several teeth with a 5-8mm probing pocket depth and radiographic
evidence of alveolar bone loss for each patient were selected and divided into test sites
and control sites according to the split-mouth design. Scaling and root planing was done
for each sites at baseline(0week). Test sites received the minocycline gel and strip and
control sites had saline irrigation. The patients received both treatments simyltaneously.
Subgingival irrigation of sterile saline was applied to the control sites for approximately
30 seconds. Minocycline strip and gel was applied alto the periodontal pocket at 1, 2, 3,
4 weeks each after scaling and root planing in the test sites. The clinical and
microbiological measurements were made at baseline and at the follow-up visits 6, 10,
14, 20 weeks.
The results of this study were as follows ;
1. The sulcular bleeding index, probing pocket depth and Periocheck test was
significantly reduced and the relative proportions of spirochetes and motile rods were
significantly reduced and the proportion of cocci was correspondingly increased, in
locally delivered minocycline strip group compared to saline irrigation group.
2. In locally delivered minocycline gel group, The effect was the same with
minocycline strip group as compared with saline irrigation therapy.
3. There was no significant differences between minocycline strip group and
minocycline gel group.
In conclusion, minocycline HCI local drug delivery combined with scaling and root
planing may provide added improvement of clinical and microbiological responses by
inhibiting bacterial recolonization of treated sites. It is suggested that the local
administration of minocycline-HCI in the periodontal pocket Is effective when combined
with subgingival mechanical debridement.
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