School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Abstract
U ovom se članku ocjenjuje vrijednost sustavne protumikrobne terapije bolesti parodonta. Poznavati tip parodontne infekcije može biti važno u izboru protumikrobne terapije. Protumikrobno liječenje treba prilagoditi razlikama u osjetljivosti na antibiotike pojedinih parodontnih patogena.
U literaturi je opisano mnogo različitih vrsta antibiotske terapije što otežava odluku o izboru antibiotika u kliničkoj praksi. Vrijednost sustavne upotrebe antibiotika u zaustavljanju progresije parodontnih bolesti ispitana je u mnogobrojnim studijama. Glavni kandidati za antibiotsku terapiju jesu pacijenti kojima konvencionalnom mehaničkom terapijom nije zaustavljeno napredovanje bolesti. Opravdana je upotreba i u bolesnika s lokaliziranim agresivnim parodontitisom ili drugim rano razvijenim oblicima bolesti, te u pacijenata sa sustavskim bolestima koje utječu na parodontitis. Dokazano je da kao dodatak uobičajenoj terapiji može poboljšati ishod liječenja. Ozbiljne nuspojave koje sa sobom donosi sustavna uporaba antibiotika, kao što su razvoj rezistencije, te porast oportunističkih mikroorganizama, ne opravdavaju rutinsku uporabu antibiotika u liječenju kroničnih, sporoprogredirajućih oblika parodontnih bolesti.This paper presents a critical evaluation of the use of systemic antimicrobial treatment in periodontal disease. Recognizing specific types of periodontal infections can significantly influence the choice of antimicrobial treatment. Therapy should be tailored to differences in antibiotic susceptibility between various periodontal pathogens.
Many different antibiotic regimens have been described in the literature, making the choice in clinical practice difficult. Numerous studies have examined the impact of systemic antibiotic treatment in stopping the progression of periodontal diseases. Major candidates for antibiotic therapy are patients whose disease continues to progress despite conventional mechanical treatment. Antibiotics can also be used in patients with localized aggressive or other early developed forms of periodontitis, as well as in patients with systemic diseases affecting the course of periodontitis. They have proven to be beneficial as an adjunct to standard therapy. Serious side-effects of systemic antibiotic treatment, such as development of resistance and increase in opportunistic microorganisms, do not justify their use in the treatment of chronic, slowly-progressive forms of periodontal diseases
