AIM To 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 METHODS Patients 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. RESULTS Analysis 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. CONCLUSIONS Both 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).

中文翻译：

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牙周炎治疗中全身性抗生素的决策：两个概念的回顾性比较。


目的 回顾性比较在非手术牙周治疗中辅助使用全身性抗生素的方法：一种基于检测Aggregatibacter actinomycetemcomitans（Aa，另一种基于牙周炎的年龄和严重程度（年龄和PPD）。我们还评估了抗生素在减少每组对进一步手术治疗的需求方面的额外益处。材料和方法 德国法兰克福歌德大学牙周病学系的患者在 2008 年至 2018 年期间接受了微生物学检测筛查。患者根据他们的微生物结果（Aa+/-）和人口统计学/临床数据（年龄和PPD+/-）进行分类。测试了抗生素适应症的一致性。临床评估集中在探诊口袋深度（PPDs）≥6毫米的牙齿上。结果：对425名患者的分析显示，30%被归类为年龄和PPD+，34%被归类为Aa+。63% 的患者有一致的抗生素推荐 （phi 系数 0.14，p = .004）。接受抗生素治疗的年龄和PPD+组的患者在非手术牙周治疗后，PPD≥6毫米的牙齿数量减少得最大。结论 与未接受抗生素治疗和限制抗生素使用相比，两种策略都产生了显着的临床改善，但针对不同的患者群体。患有严重牙周炎的年轻个体从抗生素中受益最大，减少了对额外手术的需求。该研究已在国际试验注册库中注册（德国临床试验注册号 DRKS00028768，注册日期 2022 年 4 月 27 日，https://drks.de/search/en/trial/DRKS00028768）。