Efeito das terapias antibiótica e probiótica no tratamento adjuvante da periodontite:estudo clínico controlado e randomizado.
Carregando...
Data
2020-03-10
Autores
Ramos, Tatiane Caroline de Souza [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Índice de Placa (IP), Sangramento à Sondagem (SS), Profundidade de sondagem (PS), Recessão gengival (RG) e Nível de Inserção Clínica (NIC) e PISA, diante da comparação de duas diferentes terapias adjuvantes (antibiótico e probiótico) para o tratamento da periodontite (Grau B Estágios II e III). Para tal, 45 pacientes foram incluídos no estudo divididos aleatoriamente em 3 grupos com n=15: grupo DEB (Debridamento); grupo DEB+ATB (Debridamento + Amoxicilina 500mg + Metronidazol 400mg) e grupo DEB+PROBI (Debridamento+Probiótico Lactobacillus reuteri). As análises dos parâmetros clínicos foram realizadas no Baseline, 30 dias e 90 dias. Para os dados não paramétricos foi realizado o teste de variância Kruskal-Wallis através do software BioEstat 5.3 (Belém, PA, Brazil) e teste de Dunn post hoc para as comparações múltiplas. Para os dados com distribuição normal, foi utilizado o teste Qui-Quadrado e One Way ANOVA, todos com α = 5%. Em relação ao IP o grupo DEB+PROBI apresentou menores valores em relação aos demais grupos em 30 dias (0,43 ± 0,13, p=0,008) e em 90 dias (0,43 ± 0,11, p= 0,001). Para SS na comparação intergrupos o grupo DEB+ATB apresentou menores valores em 90 dias (0,28 ± 0,07, p= 0,03). Para PS e NIC de boca toda na comparação intergrupos não houve diferença estatística entre os valores. Para RG de boca toda o grupo DEB+PROBI apresentou diferença estatística (0,35± 0,15, p=0,006). Os valores de PISA não apresentaram diferenças estatisticamente significantes na comparação intergrupos. Em relação à estratificação das bolsas (moderadas e profundas), a PS para bolsas profundas apresentou na comparação intergrupos menores valores em 90 dias para o grupo DEB+ATB (4,31 ± 0,84, p=0,02) e em relação a quantidade de bolsas residuais, na comparação intergrupos o grupo DEB+ATB apresentou uma menor quantidade de sítios (0,93 ± 1,28, p=0,04) em 30 dias. O grupo DEB+ATB apresentou uma maior quantidade de efeitos adversos quando comparado ao grupo DEB+PROBI, o qual nenhum paciente relatou a ocorrência de efeitos adversos. Podemos concluir que ambas terapias adjuvantes, durante o período de avaliação de 90 dias, apresentaram resultados sem diferenças estatísticamente significantes na redução da profundidade de sondagem, porém, clinicamente, apesar de uma maior incidência de efeitos adversos, o antibiótico mostrou-se mais eficaz na redução de bolsas profundas.
The objective of this project was to evaluate the response of clinical periodontal parameters: Plaque Index (IP), Bleeding on Probing (BoP), Probing Depth (PD), Gingival Recession (GR), Clinical Attachment Level (CAL) and PISA, comparing two different adjuvant therapies (antibiotic and probiotic) for the treatment of periodontitis (Grade B Stages II and III). For this, 45 patients were included in the study, randomly divided into 3 groups with n = 15: DEB group (Debridement); DEB + ATB group (Debridement + Amoxicillin 500mg + Metronidazole 400mg) and DEB + PROBI group (Debridement + Lactobacillus reuteri probiotic). The analyzes of clinical parameters were performed at baseline, 30 days and 90 days. For non-parametric data, the Kruskal-Wallis variation test was performed using the BioEstat 5.3 software (Belém, PA, Brazil) and Dunn post hoc test for multiple comparisons. For data with normal distribution, the Chi-Square and One Way ANOVA tests were used, all with α = 5%. Regarding PI, DEB + PROBI group presents lower values in relation to the other groups in 30 days (0.43 ± 0.13, p = 0.008) and in 90 days (0.43 ± 0.11, p = 0.001). For BoP in the intergroup comparison of the DEB + ATB group, the values are lower in 90 days (0.28 ± 0.07, p = 0.03). For PD and CAL of full mouth parameters the comparative comparison showed that there was no statistical difference between the values. For full mouth GR, DEB + PROBI group shows statistical difference (0.35 ± 0.15, p = 0.006). The PISA values did not show statistically significant differences in the comparison between groups. Regarding the pockets stratification (moderate and deep), a PD for deep pockets shows at the intergroup comparison lower values in 90 days for the DEB + ATB group (4.31 ± 0.84, p = 0.02) and in relation to the number of residual pockets, in the comparison between groups, the group DEB + ATB, presents a smaller number of sites (0.93 ± 1.28, p = 0.04) in 30 days. The DEB + ATB group had a higher number of adverse effects when compared to the DEB + PROBI group in which no patient related to the occurrence of adverse effects. we can conclude that both adjunct therapies during the 3-month evaluation period showed results without statistically significant differences, however clinically, despite having a higher incidence of adverse effects, the antibiotic proved to be more effective in reducing deep pockets.
The objective of this project was to evaluate the response of clinical periodontal parameters: Plaque Index (IP), Bleeding on Probing (BoP), Probing Depth (PD), Gingival Recession (GR), Clinical Attachment Level (CAL) and PISA, comparing two different adjuvant therapies (antibiotic and probiotic) for the treatment of periodontitis (Grade B Stages II and III). For this, 45 patients were included in the study, randomly divided into 3 groups with n = 15: DEB group (Debridement); DEB + ATB group (Debridement + Amoxicillin 500mg + Metronidazole 400mg) and DEB + PROBI group (Debridement + Lactobacillus reuteri probiotic). The analyzes of clinical parameters were performed at baseline, 30 days and 90 days. For non-parametric data, the Kruskal-Wallis variation test was performed using the BioEstat 5.3 software (Belém, PA, Brazil) and Dunn post hoc test for multiple comparisons. For data with normal distribution, the Chi-Square and One Way ANOVA tests were used, all with α = 5%. Regarding PI, DEB + PROBI group presents lower values in relation to the other groups in 30 days (0.43 ± 0.13, p = 0.008) and in 90 days (0.43 ± 0.11, p = 0.001). For BoP in the intergroup comparison of the DEB + ATB group, the values are lower in 90 days (0.28 ± 0.07, p = 0.03). For PD and CAL of full mouth parameters the comparative comparison showed that there was no statistical difference between the values. For full mouth GR, DEB + PROBI group shows statistical difference (0.35 ± 0.15, p = 0.006). The PISA values did not show statistically significant differences in the comparison between groups. Regarding the pockets stratification (moderate and deep), a PD for deep pockets shows at the intergroup comparison lower values in 90 days for the DEB + ATB group (4.31 ± 0.84, p = 0.02) and in relation to the number of residual pockets, in the comparison between groups, the group DEB + ATB, presents a smaller number of sites (0.93 ± 1.28, p = 0.04) in 30 days. The DEB + ATB group had a higher number of adverse effects when compared to the DEB + PROBI group in which no patient related to the occurrence of adverse effects. we can conclude that both adjunct therapies during the 3-month evaluation period showed results without statistically significant differences, however clinically, despite having a higher incidence of adverse effects, the antibiotic proved to be more effective in reducing deep pockets.
Descrição
Palavras-chave
Periodontite, Debridamento periodontal, Antibióticos, Probióticos, Periodontitis, Periodontal debridement, Antibiotics, Probiotics