구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제37권4호
  • /
  • Pages.294-300
  • /
  • 2021
  • /
  • 2384-4353(pISSN)
  • /
  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
권호 표지
DOI QR코드

DOI QR Code

괴사성 치주질환 환자에서 비외과적 치주치료의 임상적 미생물학적 효과: 증례 보고

The clinical and microbiological effects of non-surgical periodontal treatments in necrotizing periodontal disease: case report

  • 김상민 (단국대학교 치과대학 치주과학교실) ;
  • 이재민 (단국대학교 치과대학 치주과학교실) ;
  • 강대영 (단국대학교 치과대학 치과병원 치주과) ;
  • 신현승 (단국대학교 치과대학 치주과학교실)
  • Kim, Sangmin (Department of Periodontology, College of Dentistry, Dankook University) ;
  • Lee, Jaemin (Department of Periodontology, College of Dentistry, Dankook University) ;
  • Kang, Dae-Young (Department of Periodontology, Dankook University Dental Hospital) ;
  • Shin, Hyun-Seung (Department of Periodontology, College of Dentistry, Dankook University)
  • 투고 : 2021.11.29
  • 심사 : 2021.12.14
  • 발행 : 2021.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

치태세균에 의해 야기되는 괴사성 치주질환은 감염부위에서 위막과 치간사이의 연조직 괴사 및 출혈, 촉진시 통증과 치은 출혈이 관찰된다. 환자들의 구내 세균을 조사해보면 방추균과 나선균이 혼합하여 존재하는 방추스피로헤타 세균총을 가지고 있다. 본 증례는 괴사성 치주질환으로 잠정 진단된 환자 2명을 대상으로 비외과적 치주치료, 3% 과산화수소를 적신 면봉을 이용한 드레싱 후 국소전달항생제를 도포하였고, 치료 전과 초기 치료 3 - 5일 후 치은열구액을 채득하여 실시간 연쇄중합반응법을 이용한 정량분석으로 구강내 미생물수를 측정하였다. 비외과적 치주치료 후 감염부위 치은이 정상으로 회복되었고, 7종 이상 검출되던 치주질환 관련 미생물도 1종만 검출되었다. 결과적으로 비외과적 치주치료를 통해 괴사성 치주질환 환자들의 치주 조직을 정상으로 회복하였다.

Necrotizing periodontal disease caused by plaque bacteria is showed clinical findings including pseudo-membrane, interproximal necrosis of the affected area, pain on palpation and gingiva bleeding. Microbiological examination is showed that patients have fusospirochetal bacteria. Two patients who were provisionally diagnosed as necrotizing periodontal disease received nonsurgical periodontal treatments in conjunction with dressing using 3% hydrogen peroxide and local antibiotic delivery. Before and 3 - 5 days after initial treatment, the levels of periodontal bacteria in gingival crevicular fluid obtained using quantitative PCR were compared. After treatment, patients recovered normal gingiva. The number of periodontal diseases related bacterial species decreased from seven or eight to one. As a result, periodontium of patients with necrotizing periodontal disease was recovered to normal periodontium by nonsurgical periodontal treatments.

키워드

참고문헌

  1. Park JB. Symptoms & treatment of ulcerative conditions. J Korean Dent Assoc 1983;21:449-52.
  2. Horning GM, Cohen ME. Necrotizing ulcerative gingivitis, periodontitis and stomatitis: Clinical staging and predisposing factors. J Periodontol 1995;66:990-8. https://doi.org/10.1902/jop.1995.66.11.990
  3. Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endoperiodontal lesions. J Clin Periodontol 2018;45:S78-S94. https://doi.org/10.1111/jcpe.12941
  4. Newman MG, Takei H, Klokkevold PR, Carranza FA. Carranza's clinical periodontology. 12th ed. Amsterdam; Elsevier health sciences; 2011. p. 271-9, 350-3.
  5. Rosebury T. The etiology of Vincent's infection. In: Gordon SM, editor. Dental science and dental art. Philadelphia; Lea & Febiger; 1938. p. 415.
  6. Loesche WJ, Syed SA, Laughon BE, Stoll J. The bacteriology of acute necrotizing ulcerative gingivitis. J Periodontol 1982;53:223-30. https://doi.org/10.1902/jop.1982.53.4.223
  7. Lang NP, Berglundh T, Giannobile WV, Sanz M. Lindhe's clinical periodontology and implant dentistry. 6th ed. Hoboken; John Wiley & Sons; 2021. p. 428-33.
  8. Gomes EWB, Casarin M, Martins TM, da Silva AF. Local delivery therapies as adjuvants to non-surgical periodontal treatment of periodontitis grade C: a systematic review. Clin Oral Investig 2020;24:4213-24. https://doi.org/10.1007/s00784-020-03631-8
  9. Nakagawa T, Yamada S, Oosuka Y, Saito A, Hosaka Y, Ishikawa T, Okuda K. Clinical and microbiological study of local minocycline delivery (Periocline) following scaling and root planing in recurrent periodontal pockets. Bull Tokyo Dent Coll 1991;32:63-70.
  10. Pfaffl MW. A new mathematical model for relative quantification in real-time RT-PCR. Nucleic Acids Res 2001;29:e45. https://doi.org/10.1093/nar/29.9.e45
  11. Haffajee AD, Socransky SS, Patel MR, Song X. Microbial complexes in supragingival plaque. Oral Microbiol Immunol 2008;23:196-205. https://doi.org/10.1111/j.1399-302X.2007.00411.x
  12. Malek R, Gharibi A, Khlil N, Kissa J. Necrotizing ulcerative gingivitis. Contemp Clin Dent 2017;8:496-500. https://doi.org/10.4103/ccd.ccd_1181_16
  13. Klotz H. Differentiation between necrotic ulcerative gingivitis and primary herpetic gingivostomatitis. N Y State Dent J 1973;39:283-94.
  14. Novak MJ. Necrotizing ulcerative periodontitis. Ann Periodontol 1999;4:74-8. https://doi.org/10.1902/annals.1999.4.1.74
  15. Formicola AJ, Witte ET, Curran PM. A study of personality traits and acute necrotizing ulcerative gingivitis. J Periodontol 1970;41:36-8. https://doi.org/10.1902/jop.1970.41.1.36
  16. O'Connor BC, Newman HN, Wilson M. Susceptibility and resistance of plaque bacteria to minocycline. J Periodontol 1990;61:228-33. https://doi.org/10.1902/jop.1990.61.4.228
  17. Wennstrom J, Lindhe J. Effect of hydrogen peroxide on developing plaque and gingivitis in man. J Clin Periodontol 1979;6:115-30. https://doi.org/10.1111/j.1600-051X.1979.tb02190.x