Abdulkareem Ali, Abdulbaqi Hayder, Gul Sarhang, Milward Mike, Chasib Nibras, Alhashimi Raghad
College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq.
College of Dentistry, University of Sulaimani, Sulaymaniyah 40062, Iraq.
Antibiotics (Basel). 2021 Dec 22;11(1):9. doi: 10.3390/antibiotics11010009.
Periodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. However, in view of the growing concern about bacterial resistance, alternative approaches have been investigated. Currently, a range of antimicrobial agents and protocols have been used in clinical management, but these remain largely non-validated. This review aimed to evaluate the efficacy of adjunctive antibiotic use in periodontal management and to compare them to recently suggested alternatives. Evidence from in vitro, observational and clinical trial studies suggests efficacy in the use of adjunctive antimicrobials in patients with grade C periodontitis of young age or where the associated risk factors are inconsistent with the amount of bone loss present. Meanwhile, alternative approaches such as photodynamic therapy, bacteriophage therapy and probiotics showed limited supportive evidence, and more studies are warranted to validate their efficiency.
牙周炎是一种多因素慢性炎症性疾病，会影响牙列的牙齿支持性软/硬组织。牙菌斑生物膜被认为是易感患者的主要病因；然而，其他因素也会导致病情进展，如糖尿病和吸烟。目前的治疗以机械清除生物膜作为金标准。在某些情况下，抗菌剂可能作为这种机械方法的辅助手段使用。然而，鉴于对细菌耐药性的日益关注，人们已经研究了替代方法。目前，一系列抗菌剂和方案已用于临床治疗，但这些方法在很大程度上仍未得到验证。本综述旨在评估辅助使用抗生素在牙周治疗中的疗效，并将其与最近提出的替代方法进行比较。体外、观察性和临床试验研究的证据表明，在年轻的C级牙周炎患者或相关风险因素与现有骨量丢失不一致的情况下，辅助使用抗菌剂是有效的。同时，光动力疗法、噬菌体疗法和益生菌等替代方法的支持证据有限，需要更多研究来验证其有效性。
