Periodontitis hastalarında flep operasyonu sonrası subgingival flora periodontopatojen bakterilerin miktarlarındaki değişimin mikrobiyolojik olarak incelenmesi
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Dosyalar
Tarih
2022
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Yayıncı
Trakya Üniversitesi, Diş Hekimliği Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmanın amacı şiddetli periodontitis vakalarında, derin ceplerde konvansiyonel flep cerrahisinin etkinliğini klinik ve mikrobiyolojik parametreler ile değerlendirmektir. Split-mouth olarak tasarlanan çalışmamıza, sistemik olarak sağlıklı 20 hasta dahil edilmiştir. SRP sonrası hastalara, test grubunda flep operasyonu uygulanmış, kontrol grubuna uygulanmamıştır. Operasyon öncesi ve işlem sonrası 21.günde hastaların sondlamada cep derinliği, gingival indeks, plak indeksi, sondlamada kanama yüzdesi ve klinik ataşman seviyesi gibi klinik parametreleri kaydedilmiştir. Ek olarak steril kağıt konlar ile subgingival plak örnekleri alınarak RT-PCR yöntemiyle P.gingivalis, T.denticola ve T.forsythia olmak üzere kırmızı kompleks periodontopatojen bakterilerin başlangıca göre değişim miktarları analiz edilmiştir. İstatistiksel analizler sonucunda, hem klinik hem de mikrobiyolojik parametreler karşılaştırıldığında test grubunda kontrol grubuna kıyasla anlamlı derecede düşüş kaydedilmiştir. 21.günde ölçülen SCD, KAS, SKY ve Gİ değerleri test grubunda azalırken (p<0,001), kontrol grubunda istatistiksel olarak anlamlı bir değişiklik gözlenmemiştir (p>0,05). Pİ her iki grupta da azalmış ancak test grubunda daha fazla azalma tespit edilmiştir. Mikrobiyolojik analizler sonucunda ise test grubunda P.gingivalis ve T.denticola 12 kat, T.forsythia 18 kat azalma görülmüştür (p<0,001). Çalışmamızın sonucunda, şiddetli periodontitis vakalarında yalnızca SRP ile sınırlı bir iyileşme sağlanabileceği ve özellikle 6 mm ve üzeri ceplerde periodontal cerrahi ile daha etkin bir tedavi sağlanabileceği görülmüştür. Bu veriler uzun dönem takipli, daha büyük hasta popülasyonları ile yapılan çalışmalarla desteklenmelidir.
The aim of this study is to evaluate the effectiveness of conventional flap surgery in deep pockets with clinical and microbiological parameters in severe periodontitis cases. Twenty systemically healthy patients were included in this research, which was designed as a split-mouth study. After SRP(scaling and root planing) flap operation was performed in the test group. Clinical parameters such as pocket depth on probing (PDP), gingival index (GI), plaque index (Pı), percentage of bleeding on probing (BOP) and clinical attachment level (CAL) were recorded before the operation and on the 21 day after the procedure. In addition, sterile paper cones and subgingival plaque samples were taken and the amount of change from the baseline of red complex periodontopathogenic bacteria, including P.gingivalis, T.denticola, and T.forsythia was analyzed by RT-PCR (real time polymerase chain reaction) method. The results were compared using Mann-Whitney U and Wilcoxon Test statistical methods. As a result of statistical analysis, a significant decrease was recorded in the test group compared to the control group when with regard to the clinical and microbiological parameters. Whilst PDP, CAL, BOP and GI values on the 21 st day decreased in the test group (p<0.001), no statistically significant change was observed in the control group (p>0.05). PI decreased in both groups, but a greater decrease was detected in the test group. As a result of microbiological st analysis, P.gingivalis and T.denticola decreased 12-fold and T.forsythia 18-fold in the test group (p<0.001). This study demonstrated that a limited improvement can be achieved with SRP only in severe periodontitis cases, and a more effective treatment can be provided with periodontal surgery, especially in pockets with depth of 6 mm and above. The data should be corroborated by studies with larger patient populations with long-term follow-ups.
The aim of this study is to evaluate the effectiveness of conventional flap surgery in deep pockets with clinical and microbiological parameters in severe periodontitis cases. Twenty systemically healthy patients were included in this research, which was designed as a split-mouth study. After SRP(scaling and root planing) flap operation was performed in the test group. Clinical parameters such as pocket depth on probing (PDP), gingival index (GI), plaque index (Pı), percentage of bleeding on probing (BOP) and clinical attachment level (CAL) were recorded before the operation and on the 21 day after the procedure. In addition, sterile paper cones and subgingival plaque samples were taken and the amount of change from the baseline of red complex periodontopathogenic bacteria, including P.gingivalis, T.denticola, and T.forsythia was analyzed by RT-PCR (real time polymerase chain reaction) method. The results were compared using Mann-Whitney U and Wilcoxon Test statistical methods. As a result of statistical analysis, a significant decrease was recorded in the test group compared to the control group when with regard to the clinical and microbiological parameters. Whilst PDP, CAL, BOP and GI values on the 21 st day decreased in the test group (p<0.001), no statistically significant change was observed in the control group (p>0.05). PI decreased in both groups, but a greater decrease was detected in the test group. As a result of microbiological st analysis, P.gingivalis and T.denticola decreased 12-fold and T.forsythia 18-fold in the test group (p<0.001). This study demonstrated that a limited improvement can be achieved with SRP only in severe periodontitis cases, and a more effective treatment can be provided with periodontal surgery, especially in pockets with depth of 6 mm and above. The data should be corroborated by studies with larger patient populations with long-term follow-ups.
Açıklama
Anahtar Kelimeler
Periodontitis, Cerrahi periodontal tedavi, RT-PCR, TaqMan Prob, Surgical periodontal treatment, TaqMan Probe
