Nils Werner, Vinay Pitchika, Katrin Heck, Christina Ern, Richard Heym, Ali Al-Ahmad, Fabian Cieplik, Falk Schwendicke, Caspar Victor Bumm, Matthias Folwaczny
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Subgingival biofilm samples were quantitatively analysed for selected PAB using DNA-DNA-hybridisation-based detection assays for microbial loads of PAB before and 6 months after treatment. Changes in the microbial load of PAB and achievement of a \"treat-to-target\" endpoint (T2T) (≤4 sites with probing depth ≥5 mm) were analysed. Patients' subgingival microbial load was significantly reduced following therapy.</p><p><strong>Results: </strong>38.2% of the patients achieved T2T. Binary logistic regression adjusted for confounders indicated a relationship between residual PAB levels and not achieving T2T. In patients not receiving systemic antibiotics a 2.4-fold increased risk of not reaching T2T after steps I and II therapy was observed (none vs. MET aOR = 2.38 <i>p</i> = 0.44). Linear regression analysis adjusted for T0 PAB concentration and confounders revealed an increased reduction of PAB levels in patients with systemic antibiotics. No difference in PAB reduction or chance of achieving T2T was observed between MET and MET + AMOX.</p><p><strong>Discussion: </strong>Microbial loads of PAB were found directly associated with periodontal status. As antibiotic treatment with both MET and MET + AMOX similarly reduced microbial loads of PAB, treatment with MET alone may be sufficiently effective as adjunctive to non-surgical periodontal treatment. To confirm this, further prospective studies with bigger sample size are needed.</p>","PeriodicalId":94016,"journal":{"name":"Frontiers in oral health","volume":"6 ","pages":"1578484"},"PeriodicalIF":3.0000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116549/pdf/","citationCount":"0","resultStr":"{\"title\":\"A retrospective study on the impact of different antibiotic regimens in non-surgical periodontal therapy on microbial loads and therapy outcomes.\",\"authors\":\"Nils Werner, Vinay Pitchika, Katrin Heck, Christina Ern, Richard Heym, Ali Al-Ahmad, Fabian Cieplik, Falk Schwendicke, Caspar Victor Bumm, Matthias Folwaczny\",\"doi\":\"10.3389/froh.2025.1578484\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study aimed to analyse the impact of different antibiotic regimens during non-surgical periodontal therapy on the microbial load of selected periodontitis-associated bacteria (PAB) and the primary therapy outcomes.</p><p><strong>Methods: </strong>For this aim, 259 patients received steps I and II of periodontal therapy and were included in this clinical trial. 202 patients were treated without the adjunctive use of systemic antibiotics, 18 received amoxicillin (AMOX) as well as metronidazole (MET) and 39 only MET. 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引用次数: 0
摘要
简介：本研究旨在分析非手术牙周治疗中不同抗生素方案对选定牙周炎相关细菌（PAB）微生物负荷和主要治疗结果的影响。方法：为此，259例患者接受牙周治疗I和II步，并纳入本临床试验。202例患者未辅助使用全身抗生素，18例接受阿莫西林（AMOX）和甲硝唑（MET）治疗，39例仅接受MET治疗。在治疗前和治疗后6个月，采用基于dna - dna杂交的PAB微生物负荷检测方法，定量分析龈下生物膜样品中所选择的PAB。分析了PAB微生物负荷的变化和“治疗到目标”终点（T2T）（≤4个点，探测深度≥5 mm）的实现情况。治疗后患者龈下微生物负荷显著降低。结果：38.2%的患者达到T2T。经混杂因素调整后的二元逻辑回归表明，残留PAB水平与未达到T2T之间存在关系。在未接受全身抗生素治疗的患者中，观察到在步骤I和II治疗后未达到T2T的风险增加2.4倍（无vs. MET aOR = 2.38 p = 0.44）。调整了T0 PAB浓度和混杂因素的线性回归分析显示，全体抗生素患者PAB水平的降低增加。MET和MET + AMOX在PAB减少或达到T2T的机会上没有差异。讨论：发现PAB的微生物负荷与牙周状况直接相关。由于MET和MET + AMOX的抗生素治疗同样减少了PAB的微生物负荷，因此单独使用MET治疗作为非手术牙周治疗的辅助治疗可能足够有效。为了证实这一点，需要进一步进行更大样本量的前瞻性研究。
A retrospective study on the impact of different antibiotic regimens in non-surgical periodontal therapy on microbial loads and therapy outcomes.
Introduction: This study aimed to analyse the impact of different antibiotic regimens during non-surgical periodontal therapy on the microbial load of selected periodontitis-associated bacteria (PAB) and the primary therapy outcomes.
Methods: For this aim, 259 patients received steps I and II of periodontal therapy and were included in this clinical trial. 202 patients were treated without the adjunctive use of systemic antibiotics, 18 received amoxicillin (AMOX) as well as metronidazole (MET) and 39 only MET. Subgingival biofilm samples were quantitatively analysed for selected PAB using DNA-DNA-hybridisation-based detection assays for microbial loads of PAB before and 6 months after treatment. Changes in the microbial load of PAB and achievement of a "treat-to-target" endpoint (T2T) (≤4 sites with probing depth ≥5 mm) were analysed. Patients' subgingival microbial load was significantly reduced following therapy.
Results: 38.2% of the patients achieved T2T. Binary logistic regression adjusted for confounders indicated a relationship between residual PAB levels and not achieving T2T. In patients not receiving systemic antibiotics a 2.4-fold increased risk of not reaching T2T after steps I and II therapy was observed (none vs. MET aOR = 2.38 p = 0.44). Linear regression analysis adjusted for T0 PAB concentration and confounders revealed an increased reduction of PAB levels in patients with systemic antibiotics. No difference in PAB reduction or chance of achieving T2T was observed between MET and MET + AMOX.
Discussion: Microbial loads of PAB were found directly associated with periodontal status. As antibiotic treatment with both MET and MET + AMOX similarly reduced microbial loads of PAB, treatment with MET alone may be sufficiently effective as adjunctive to non-surgical periodontal treatment. To confirm this, further prospective studies with bigger sample size are needed.
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