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全身应用抗生素辅助手术治疗种植体周围炎的回顾性研究

Systemic Antibiotic Prophylaxis Adjunctive to Surgical Reconstructive Peri-Implantitis Treatment: A Retrospective Study.

作者信息

Ramanauskaite Ausra, Saltzer Ioanna, Padhye Ninad, Begic Amira, Obreja Karina, Dahmer Iulia, Schwarz Frank

机构信息

Department of Oral Surgery and Implantology, Goethe-University Frankfurt, Carolinum, Frankfurt, Germany.

Faculty of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt am Main, Germany.

出版信息

Clin Implant Dent Relat Res. 2025 Feb;27(1):e13429. doi: 10.1111/cid.13429. Epub 2024 Dec 15.

Abstract

AIMS

To evaluate the clinical efficacy of oral systemic antibiotic prophylaxis administered along with the surgical reconstructive peri-implantitis treatment.

METHODS

A total of 49 patients exhibiting 70 implants diagnosed with peri-implantitis underwent a surgical reconstructive peri-implantitis treatment. Of them, 27 patients (38 implants) received a single preoperative shot of antibiotics (2 g amoxicillin; Pre-op), 12 patients (19 implants) were prescribed with postoperative antibiotics for 3 days (500 mg amoxicillin, 3 x day, Post-op), and the remaining 10 patients (13 implants) did not receive any systemic antibiotics (No-Ab). Mean probing depth values (mean PDs; primary outcome), bleeding on probing (BOP), plaque (PI), suppuration (Sup), and deepest PDs values (max PD) were assessed prior to surgery (baseline), after 6 and 12 months. To assess the differences in changes in the clinical parameters, and disease resolution (PD ≤ 5 mm, ≤ 1 BOP site and no Sup) among the groups, logistic regression analyses were performed.

RESULTS

After 12 months, the mean PD reduction amounted to -1.74 ± 1.56 mm, -1.91 ± 1.88 mm, and -1.13 ± 1.05 mm in the No-Ab, Pre-op, and Post-op groups, respectively, with no significant difference detected among the groups. The BOP was reduced in 60%, 59.3%, and 83.3% of the patients after 12 months in the No-Ab, Pre-op, and Post-op groups, respectively, with no significant differences among them. The PI, Sup and max PD reductions were comparable among the groups. Disease resolution after 12 months was established in 61.5%, 73.7%, and 89.5% of patients in the No-Ab, Pre-op, and Post-op groups (No-Ab vs. Pre-op: p = 0.10, No-Ab vs. Post-op: p = 0.40, Pre-op vs. Post-op: p = 0.84).

CONCLUSION

Systemic antibiotic prophylaxis did not improve the clinical outcomes of surgical reconstructive peri-implantitis treatment.

摘要

目的

评估在种植体周围炎手术重建治疗的同时口服全身用抗生素预防的临床疗效。

方法

共有49例患者的70颗种植体被诊断为种植体周围炎,接受了种植体周围炎手术重建治疗。其中,27例患者(38颗种植体)在术前单次注射抗生素(2克阿莫西林;术前),12例患者(19颗种植体)术后服用抗生素3天(500毫克阿莫西林,每日3次,术后),其余10例患者(13颗种植体)未接受任何全身用抗生素(无抗生素)。在手术前(基线)、6个月和12个月后评估平均探诊深度值(平均PDs;主要结局)、探诊出血(BOP)、菌斑(PI)、化脓(Sup)和最深PDs值(最大PD)。为评估各组临床参数变化和疾病缓解情况(PD≤5毫米、BOP部位≤1处且无化脓)的差异,进行了逻辑回归分析。

结果

12个月后,无抗生素组、术前组和术后组的平均PD减少量分别为-1.74±1.56毫米、-1.91±1.88毫米和-1.13±1.05毫米,各组间未检测到显著差异。12个月后,无抗生素组、术前组和术后组分别有60%、59.3%和83.3%的患者BOP减少,各组间无显著差异。各组间PI、Sup和最大PD的减少情况相当。12个月后,无抗生素组、术前组和术后组分别有61.5%、73.7%和89.5%的患者疾病得到缓解(无抗生素组与术前组:p = 0.10,无抗生素组与术后组:p = 0.40,术前组与术后组:p = 0.84)。

结论

全身用抗生素预防并未改善种植体周围炎手术重建治疗的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3640/11798903/417db4f94642/CID-27-0-g001.jpg

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