The Causal Effect of Supra‐ and Sub‐Gingival Instrumentation on the Oral Microbiome of Elderly Periodontitis Patients Treated in Nursing Homes: Secondary Analysis of a Randomised Controlled Trial

IF 8.3 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology Pub Date : 2026-08-19 DOI:10.1111/jcpe.70193

Anna Greta Barbe, Daniel Hagenfeld, Carolin Walther, Dalia Beck, Fedja Farowski, Maria J. G. T. Vehreschild, Sonja H. M. Derman, Sven Kleine Bardenhorst, Dirk Bleiel

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引用次数: 0

Abstract

Aims Periodontitis among nursing home residents is increasing as more older adults retain their dentition. Evidence on the impact of periodontal therapy on their oral microbiota is limited. We aimed to assess the effect of outreach‐based supra‐ and sub‐gingival instrumentation on the periodontal microbiome. Materials and Methods In this secondary analysis of an RCT, 36 residents (mean age 85 ± 6 years) with periodontitis had been randomised to supra‐ and sub‐gingival instrumentation (mean duration 14.3 ± 5.2 min) or a 3‐month control. Supragingival and subgingival plaque samples were collected at baseline and 3 months. Bacterial 16S rRNA sequencing and mixed‐effects modelling were used to assess alpha/beta diversity, dysbiosis index and differential abundance between groups over time. Results The intervention group showed clinical improvements, with bleeding on probing decreasing from 45% ± 20% to 35% ± 16% and probing pocket depth decreasing from 4.5 ± 0.5 to 4.0 ± 0.5 mm. Dysbiosis was reduced compared with controls ( β = −1.97, p = 0.0008). Beta‐diversity confirmed microbial shifts ( R 2 = 0.0075, p = 0.025), characterised by decreases in differential abundance of Treponema and Fretibacterium and increases in Lactobacillus and Actinomyces . Conclusions A pragmatic outreach‐based supra‐ and sub‐gingival instrumentation reduced microbial dysbiosis and improved periodontal parameters in institutionalised older adults, supporting its effectiveness in nursing home care. Trial Registration German Clinical Trials Register (DRKS) registration number: DRKS00029392

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老年牙周炎患者在养老院接受治疗时，牙龈上和牙龈下器械对口腔微生物组的因果影响：一项随机对照试验的二次分析

目的随着越来越多的老年人保留牙齿，养老院居民的牙周炎正在增加。关于牙周治疗对口腔微生物群影响的证据有限。我们的目的是评估基于外展的牙龈上和牙龈下器械对牙周微生物组的影响。材料和方法在这项随机对照试验的二次分析中，36名牙周炎患者（平均年龄85±6岁）被随机分配到牙龈上和牙龈下器械组（平均持续时间14.3±5.2分钟）或3个月的对照组。在基线和3个月时收集龈上和龈下菌斑样本。细菌16S rRNA测序和混合效应模型用于评估α / β多样性、生态失调指数和组间差异丰度。结果干预组临床表现明显改善，探查出血由45%±20%减少至35%±16%，探查袋深度由4.5±0.5 mm减少至4.0±0.5 mm。与对照组相比，生态失调减少（β = - 1.97, p = 0.0008）。β‐多样性证实了微生物的变化（r2 = 0.0075, p = 0.025），其特征是密螺旋体和Fretibacterium的差异丰度减少，乳酸杆菌和放线菌的差异丰度增加。结论：一种实用的基于外展的牙龈上和牙龈下器械可减少住院老年人的微生物生态失调，改善牙周参数，支持其在养老院护理中的有效性。德国临床试验注册（DRKS）注册号：DRKS00029392

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.