Comparative Study of Systemic vs. Local Antibiotics with Subgingival Instrumentation in Stage III-IV Periodontitis: A...

Area of Science:

• Periodontology
• Microbiology
• Pharmacology

Background:

• Periodontitis treatment often involves subgingival instrumentation (SI) with adjunctive antimicrobials.
• Systemic or local antibiotics are used to improve outcomes in moderate-to-severe periodontitis.

Purpose of the Study:

• To evaluate the clinical effects of systemic amoxicillin + metronidazole (SA) versus local piperacillin + tazobactam (LDD) as adjuncts to SI in periodontitis therapy.
• To compare the efficacy of different antimicrobial administration routes on clinical parameters and bacterial profiles.

Main Methods:

• Retrospective study of 34 patients with generalized Stage III/IV periodontitis.
• Evaluation of clinical outcomes (probing pocket depth, clinical attachment level, bleeding score) and bacterial strains (A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia, T. denticola) after SI with adjunctive systemic or local antibiotics.

Main Results:

• Both systemic and local antibiotic groups showed significant improvements in probing pocket depth and clinical attachment level at 3 months.
• The systemic amoxicillin + metronidazole group demonstrated a statistically significant reduction in full-mouth bleeding score compared to the local piperacillin + tazobactam group (p < 0.05).
• No significant inter-group differences were observed in the tested bacterial species.

Conclusions:

• Subgingival instrumentation with adjunctive local or systemic antibiotic therapy yields comparable clinical improvements in periodontitis patients.
• Systemic amoxicillin + metronidazole may offer superior efficacy in reducing bleeding scores.
• Further research with larger cohorts is warranted to confirm these findings.