Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Medicina (Kaunas). 2023 Feb 7;59(2):303. doi: 10.3390/medicina59020303.
: this study aims to evaluate the clinical and microbiological effects of a single subgingival administration of a locally delivered antibiotic gel containing piperacillin plus tazobactam and compare it with a slow-release doxycycline (14%) gel and a placebo gel, following subgingival instrumentation (SI) in patients with severe periodontitis. sixty-four patients diagnosed with stage III-IV periodontitis were enrolled, were randomly assigned into three groups, and were treated additionally with a single subgingival administration of piperacillin plus tazobactam gel (group A); doxycycline gel (group B); and placebo gel (group C). The primary outcome variable was the change in mean probing pocket depth (PPD) 6 months after the intervention. Secondary outcome variables were changes in mean full-mouth bleeding score (FMBS); full-mouth plaque score (FMPS); overall bleeding index (BOP); pocket closure; and clinical attachment level (CAL), along with changes in the numbers of five keystone bacteria: (), () () (), and (). Intergroup and intragroup differences were evaluated at 3 and 6 months. at baseline, the three groups were comparable. An improvement in clinical parameters such as PPD, CAL, and BOP between groups was observed at 3 and 6 months, but without statistical significance ( > 0.05). At 6 months, the intragroup analysis showed a significant reduction in clinical parameters. Even though the piperacillin plus tazobactam group showed slightly higher PPD reduction, this was not statistically significant when compared to both control groups. The groups had similar results, and subgingival instrumentation can be executed without adjunctive antimicrobials, reducing the costs for the patient and the working time/load of the professional.
本研究旨在评估局部给予派拉西林-他唑巴坦含药凝胶单次给药对接受龈下刮治术（SI）的重度牙周炎患者的临床和微生物学效果，并将其与缓慢释放的多西环素（14%）凝胶和安慰剂凝胶进行比较。 共纳入 64 例 III-IV 期牙周炎患者，随机分为三组，分别接受派拉西林-他唑巴坦凝胶（A 组）、多西环素凝胶（B 组）和安慰剂凝胶（C 组）单次局部给药治疗。主要结局变量为干预后 6 个月平均探诊袋深度（PPD）的变化。次要结局变量为平均全口出血评分（FMBS）、全口菌斑评分（FMPS）、总体出血指数（BOP）、袋闭合和临床附着水平（CAL）的变化，以及 5 种关键细菌数量的变化： （）、 （） （）（）、和 （）。在 3 个月和 6 个月时评估组间和组内差异。 在基线时，三组具有可比性。在 3 个月和 6 个月时，观察到 PPD、CAL 和 BOP 等临床参数的改善，但无统计学意义（>0.05）。在 6 个月时，组内分析显示临床参数有显著降低。尽管派拉西林-他唑巴坦组显示出稍高的 PPD 降低，但与两组对照相比，这没有统计学意义。 各组结果相似，龈下刮治术可在不辅助使用抗菌药物的情况下进行，从而降低患者的成本和专业人员的工作时间/负荷。
