AimTo study the clinical, radiographic and microbiological outcomes after surgical treatment of peri‐implantitis, with or without adjunctive systemic antibiotics.Materials and MethodsEighty‐four patients (113 implants) with peri‐implantitis were randomized into three groups (A, amoxicillin and metronidazole; B, phenoxymethylpenicillin and metronidazole; or C, placebo). Treatment included resective surgery and implant surface decontamination with adjunctive antibiotics or placebo. Primary outcomes were probing pocket depth (PPD) reduction and marginal bone level (MBL) stability. Secondary outcomes were treatment success (defined as PPD ≤ 5 mm, bleeding on probing [BOP] ≤ 1site, absence of suppuration on probing [SOP] and absence of progressive bone loss of >0.5 mm), changes in BOP/SOP, mucosal recession (REC), clinical attachment level (CAL), bacterial levels and adverse events. Outcomes were evaluated for up to 12 months. The impact of potential prognostic indicators on treatment success was evaluated using multilevel logistic regression analysis.ResultsA total of 76 patients (104 implants) completed the study. All groups showed clinical and radiological improvements over time. Statistically significant differences were observed between groups for MBL stability (A = 97%, B = 89%, C = 76%), treatment success (A = 68%, B = 66%, C = 28%) and bacterial levels of Aggregatibacter actinomycetemcomitans and Tannerella forsythia, favouring antibiotics compared to placebo. Multiple regression identified antibiotic use as potential prognostic indicator for treatment success. Gastrointestinal disorders were the most reported adverse events in the antibiotic groups.ConclusionsAdjunctive systemic antibiotics resulted in additional improvements in MBL stability. However, the potential clinical benefits of antibiotics need to be carefully balanced against the risk of adverse events and possible antibiotic resistance.

中文翻译：

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种植体周围炎手术治疗中的全身性抗生素：一项随机安慰剂对照试验


目的研究种植体周围炎手术治疗后的临床、放射学和微生物学结果，有或没有辅助全身性抗生素。材料和方法将 84 例种植体周围炎患者 （113 例种植体） 随机分为 3 组 （A，阿莫西林和甲硝唑;B， 苯氧甲基青霉素和甲硝唑;或 C，安慰剂）。治疗包括切除手术和用辅助抗生素或安慰剂对种植体表面进行净化。主要结局是探查袋深度 （PPD） 减少和边缘骨水平 （MBL） 稳定性。次要结局是治疗成功 （定义为 PPD ≤ 5 mm、探诊出血 [BOP] ≤ 1 个部位、探诊无化脓 [SOP] 和无进行性骨丢失 >0.5 mm）、BOP/SOP 的变化、粘膜萎缩 （REC）、临床依恋水平 （CAL） 、细菌水平和不良事件。对结局进行了长达 12 个月的评估。使用多水平 logistic 回归分析评估潜在预后指标对治疗成功的影响。结果共有 76 例患者 （104 例植入物） 完成了研究。随着时间的推移，所有组均显示出临床和放射学改善。与安慰剂相比，组间观察到 MBL 稳定性 （A = 97%， B = 89%， C = 76%） 、治疗成功 （A = 68%， B = 66%， C = 28%） 以及放线菌聚集杆菌和连翘坦纳菌细菌水平的统计学显着差异。多元回归分析发现抗生素使用是治疗成功的潜在预后指标。胃肠道疾病是抗生素组中报告最多的不良事件。结论辅助全身性抗生素导致 MBL 稳定性的额外改善。 然而，需要仔细平衡抗生素的潜在临床益处与不良事件的风险和可能的抗生素耐药性。