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Abstract：
To improve the clinical and microbiological outcomes of non-surgical mechanical periodontal therapy, the adjunctive use of antimicrobials has been utilized in treating moderate-to-severe periodontitis. In our study, the retrospective design included previously collected health-related patient data, obtained from the printed and digital charts of patients who received systemic or local antibiotic adjuncts to SI (subgingival instrumentation). A total of 34 patients (diagnosed with generalized Stage III/IV periodontitis) met the inclusion and exclusion criteria and were evaluated. The samples were tested for the following bacterial strains: Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), Prevotella intermedia (P. intermedia), Tanererella forsythia (T. forsythia), and Treponema denticola (T. denticola). The inter-group comparisons of the bacterial species did not show statistically significant differences between groups. The present study aimed to evaluate the clinical effects after SI and the adjunctive use of systemically administered (SA) AMX (amoxicillin) + MET (metronidazole) (administered for 7 days), with locally delivered (LDD) piperacillin + tazobactam in step 2 of periodontal therapy. Results: Overall, all parameters were improved in the groups, with a significant difference in inter-group comparison regarding the full-mouth bleeding score (FMBS) (p < 0.05) in favor of the SA group, and the p-value < 0.05 was considered to be statistically significant. Statistically significant PPD (probing pocket depth) reductions and CAL (clinical attachment level) gains were observed in both groups at the 3-month follow-up. In conclusion, within the limitations, the outcomes of this study suggest that SI, with adjunctive local or systemic antibiotic therapy, provided comparable clinical improvements. Systemic AMX + MET protocols were more efficacious with regard to the reduction in FMBS. Follow-up studies with larger patient numbers are needed to further investigate this effect.
摘要：
为了改善非手术机械牙周治疗的临床和微生物学结果，辅助使用抗微生物剂已用于治疗中度至重度牙周炎。在我们的研究中,回顾性设计包括以前收集的健康相关患者数据，从接受全身或局部抗生素辅助治疗SI（龈下器械）的患者的印刷和数字图表中获得。共有34例患者（诊断为广泛性III/IV期牙周炎）符合纳入和排除标准，并进行了评估。对样品进行了以下细菌菌株的测试：放线菌聚集杆菌（A.放线菌)，牙龈卟啉单胞菌(P.牙龈)，介体间普雷沃氏菌(P.intermedia),连翘(T.连翘),和Denticola密螺旋体（T.denticola).细菌种类的组间比较未显示组间的统计学显著差异。本研究旨在评估SI后的临床效果和全身给药（SA）AMX（阿莫西林）+MET（甲硝唑）（给药7天）的辅助使用，在牙周治疗的第2步中使用局部递送（LDD）哌拉西林他唑巴坦。结果：总体而言，所有参数在组中都得到了改善，关于全口出血评分（FMBS）的组间比较有显着差异（p<0.05），有利于SA组，并且p值<0.05被认为具有统计学意义。在3个月的随访中，两组均观察到统计学上显着的PPD（探查袋深度）减少和CAL（临床依恋水平）增加。总之,在限制范围内,这项研究的结果表明，SI，辅助局部或全身抗生素治疗，提供了可比的临床改善。全身性AMX+MET方案在减少FMBS方面更有效。需要更多患者的后续研究来进一步研究这种影响。
