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局部抗生素治疗对微创牙周手术治疗骨内缺损后微生物学、临床及影像学结果的影响——一项随机临床试验

The Influence of Local Antibiotic Therapy on the Microbiological, Clinical, and Radiological Outcomes Following Minimally Invasive Periodontal Surgery in the Treatment of Intrabony Defects-A Randomized Clinical Trial.

作者信息

Skurska Anna, Baczewska Amelia, Milewski Robert, Majewski Piotr, Charkiewicz Radosław

机构信息

Department of Integrated Dentistry, Medical University of Bialystok, ul. M. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.

Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland.

出版信息

Antibiotics (Basel). 2025 Aug 22;14(9):850. doi: 10.3390/antibiotics14090850.

Abstract

: Comparison of clinical, radiological, and microbiological outcomes following periodontal regeneration procedures with or without local antibiotic therapy. : Forty patients, each presenting with a single vertical defect, were randomly assigned to either the test (SRP+ANB+MIST/M-MIST) or the control group (SRP+MIST/M-MIST). The periodontal regenerative procedures were carried out according to the general minimally invasive surgical technique principles, and the vertical bone defect was filled with an enamel matrix derivative (EMD-Emdogain). Periodontal condition assessments were performed two weeks before the procedure, on the day of the surgical procedure, and at follow-up visit after 6 months. Radiographs were taken two weeks before, and 6 months after the surgery. To determine the microbiological profile of the surgical sites, subgingival plaque samples were collected for PCR analysis. : In both groups, a statistically significant pocket depth (PD) reduction and clinical attachment level (CAL) gain were observed over the 6-month follow-up period. The difference between the groups for PD and CAL parameters at 6 months was not statistically significant. Both groups showed a statistically significant reduction in the radiological depth and width of intrabony defects. Microbiological analysis revealed a statistically significant difference between the groups two weeks after subgingival antibiotic application for , , and . : Periodontal tissue regeneration procedures according to minimally invasive principles (MIST/M-MIST) with the use of EMD lead to improvements in clinical and radiological parameters. Local antibiotic application results in a reduction in bacterial counts in short-term observations. Its use prior to regeneration procedures does not lead to additional improvements in clinical and radiological parameters.

摘要

有或无局部抗生素治疗的牙周再生手术后临床、放射学和微生物学结果的比较:40例均有单个垂直骨缺损的患者被随机分配至试验组(龈下刮治术+抗生素骨内袋注射+米诺环素微球/米诺环素控释微球)或对照组(龈下刮治术+米诺环素微球/米诺环素控释微球)。牙周再生手术按照一般的微创外科技术原则进行,垂直骨缺损用釉基质衍生物(Emdogain)填充。在手术前两周、手术当天以及术后6个月随访时进行牙周状况评估。在手术前两周和术后6个月拍摄X光片。为确定手术部位的微生物特征,收集龈下菌斑样本进行PCR分析。在两组中,在6个月的随访期内均观察到牙周袋深度(PD)有统计学意义的降低和临床附着水平(CAL)增加。两组在6个月时PD和CAL参数的差异无统计学意义。两组均显示骨内缺损的放射学深度和宽度有统计学意义的降低。微生物学分析显示,在龈下应用抗生素两周后,两组在 、 和 方面存在统计学意义的差异。按照微创原则(米诺环素微球/米诺环素控释微球)并使用釉基质衍生物进行的牙周组织再生手术可改善临床和放射学参数。局部应用抗生素在短期观察中可减少细菌数量。在再生手术前使用抗生素不会导致临床和放射学参数的额外改善。

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