Decision‐making on systemic antibiotics in the management of periodontitis: A retrospective comparison of two concepts

Author:

Winkler Patrizia C.1,Benz Leander1,Nickles Katrin1ORCID,Petsos Hari C.1ORCID,Eickholz Peter1ORCID,Dannewitz Bettina12ORCID

Affiliation:

1. Department of Periodontology Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt/Main Frankfurt Germany

2. Private Dental Practice Weilburg Germany

Abstract

AbstractAimTo retrospectively compare two approaches for the adjunctive use of systemic antibiotics in non‐surgical periodontal therapy: one based on the detection of Aggregatibacter actinomycetemcomitans (Aa) and the other on age and severity of periodontitis (Age & PPD). We also assessed the additional benefit of antibiotics in reducing the need for further surgical therapy in each group.Materials and MethodsPatients of the Department of Periodontology, Goethe University Frankfurt, Germany, were screened for microbiological testing between 2008 and 2018. Patients were categorized by their microbiological result (Aa+/−) and demographic/clinical data (Age & PPD+/−). Agreement on antibiotic indication was tested. The clinical evaluation focussed on teeth with probing pocket depths (PPDs) ≥ 6 mm.ResultsAnalysis of 425 patients revealed 30% categorized as Age & PPD+ and 34% as Aa+. Sixty‐three percent had consistent antibiotic recommendations (phi coefficient 0.14, p = .004). Patients in the Age & PPD+ group receiving antibiotics showed the most substantial reduction in the number of teeth with PPD ≥ 6 mm after non‐surgical periodontal therapy.ConclusionsBoth strategies resulted in a significant clinical improvement compared with those without antibiotic treatment and restricted antibiotic use similarly, but targeted different patient groups. Younger individuals with severe periodontitis benefited most from antibiotics, reducing the need for additional surgeries. The study was registered in an international trial register (German Clinical Trial Register number DRKS00028768, registration date 27 April 2022, https://drks.de/search/en/trial/DRKS00028768).

Publisher

Wiley

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5. Mikrobiologische Diagnostikin der Parodontitistherapie. Gemeinsame Stellungnahme der Deutschen Gesellschaft für Parodontologie (DGP) und der Deutschen Gesellschaft für Zahn‐, Mund‐ und Kieferheilkunde (DGZMK);Beikler T.;Deutsche zahnärztliche Zeitschrift,2005

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