Effects of removable periodontal splint combined with minocycline on periodontal indexes and tooth aesthetics in patients with severe periodontal disease / 中国基层医药

ABSTRACT

Objective:To investigate the effects of removable periodontal splint combined with minocycline on periodontal indexes and tooth aesthetics in patients with severe periodontal disease.Methods:A total of 102 patients with severe periodontal disease treated in the School and Hospital of Stomatology, China Medical University from November 2018 to April 2020 were included in this study. They were randomly allocated into study and control groups ( n = 51/group). The control group was subject to repair with removable periodontal splint based on routine interventions. The study group was subject to medication with minocycline in addition to the treatments used in the control group. Clinical efficacy, periodontal status (sulcus bleeding index, plaque index, periodontal pocket depth) and gingival crevicular fluid inflammatory factors (transforming growth factor β, monocyte chemoattractant protein-1, interleukin-6, matrix metalloproteinase-8) and bone metabolism indexes [osteocalcin, N-terminal procollagen of type I (PINP), N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (CTX) levels], comfort and aesthetics scores, and patient satisfaction were compared between the two groups. Results:Total response rate was significantly higher in the study group than in the control group [94.12% (48/51) vs. 80.39% (41/51), χ2 = 4.32, P < 0.05]. At 1 and 3 months after treatment, sulcus bleeding index (1.32 ± 0.41, 1.11 ± 0.36), plaque index (1.51 ± 0.44, 1.32 ± 0.51), periodontal pocket depth [(3.29 ± 0.70) mm, (2.51 ± 0.63) mm] were significantly lower in the study group than in the control group [1.65 ± 0.39, 1.45 ± 0.38, 1.92 ± 0.42, 1.88 ± 0.49, (5.05 ± 0.79) mm, (3.82 ± 0.86) mm, t = 4.16, 4.63, 4.81, 5.65, 11.90, 8.77, all P < 0.001]. At 1 and 3 months after treatment, the level of transforming growth factor β in the gingival crevicular fluid was significantly higher, and the level of matrix metalloproteinase-8 in the gingival crevicular fluid was significantly lower, in the study group compared with the control group (both P < 0.001). At 1 and 3 months after treatment, the level of osteocalcin in the gingival crevicular fluid was significantly higher, and the level of C-terminal telopeptide of type I collagen in the gingival crevicular fluid was significantly lower, in the study group compared with the control group ( t = -9.97, -10.71, -5.77, -7.40, 7.24, 16.11, all P < 0.001). At 1 and 3 months after treatment, the scores of comfort and aesthetics in the study group were significantly higher than those in the control group ( t = 7.49, 8.26, 7.84, 9.10, all P < 0.001). Patient satisfaction in the study group was significantly higher than that in the control group (94.12% vs. 80.39%, χ2 = 4.32, P < 0.05). Conclusion:Repair with a removable periodontal splint combined with minocycline can increase the therapeutic effects through reducing periodontal inflammation and regulating bone metabolism, thereby improving the periodontal condition, and improving tooth comfort and aesthetics and patient satisfaction in patients with severe periodontal disease.