Impact of Antibiotics on the Subgingival Microbiome in Advanced Periodontitis: Secondary Analysis of a Randomized Controlled Trial
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population and Design
2.2. Clinical Outcome Measures
2.3. Subgingival Sampling
2.4. DNA Extraction and Sequencing
2.5. Microbial Data Processing and Outcome Variables
2.6. Statistical Analysis
3. Results
3.1. Nature and Size of the Patient Sample
Follow-Up | PT1 Group (n = 26) | PT2 Group (n = 25) | Control Group (n = 25) | Test | p- Value | ||||
---|---|---|---|---|---|---|---|---|---|
Age mean (SD) | Baseline | 59.2 ± 7.72 | 60.6 ± 8.37 | 59.9 ± 8.25 | † | 0.835 | |||
Female, % | Baseline | 13.8% | 17.9% | 10.7% | ‡ | 0.712 | |||
No. of teeth mean (SD) | Baseline | 21.3 ± 4.02 | 21.4 ± 4.96 | 21.6 ± 4.60 | § | 0.895 | |||
3 months | 20.5 ± 4.44 | 20.4 ± 5.25 | 21.6 ± 4.60 | § | 0.924 | ||||
12 months | 20.1 ± 4.39 | 20.5 ± 5.43 | 21.2 ± 5.28 | § | 0.518 | ||||
PISA in mm2 mean (SD) | Δ baseline to 3 months | −609 ± 324 | −312 ± 310 | −87.3 ± 200 | † | <0.001 | |||
Δ baseline to 12 months | −536 ± 376 | −300 ± 379 | −217 ± 382 | † | 0.010 | ||||
Δ 3 months to 12 months | +72.6 ± 260.1 | +12.6 ± 192.7 | −129.8 ± 423.8 | † | 0.061 | ||||
Shallow pockets in % (≤3.4 mm) | Baseline | 59.5% | A | 61.9% | A | 61.6% | A | † | 0.837 |
3 months | 67.0% | A | 64.7% | A, B | 55.1% | B | † | 0.013 | |
12 months | 66.9% | A | 63.8% | A | 58.1% | A | † | 0.102 | |
Δ baseline to 3 months | +7.52 ± 9.71 | +2.86 ± 7.19 | −6.43 ± 8.40 | † | <0.001 | ||||
Δ baseline to 12 months | +6.92 ± 12.5 | −0.32 ± 12.5 | −6.08 ± 11.37 | † | 0.001 | ||||
Δ 3 months to 12 months | −0.15 ± 11.05 | −3.40 ± 10.08 | +1.04 ± 10.94 | † | 0.321 | ||||
Moderate pockets in % (3.5–5.4 mm) | Baseline | 31.4% | A | 29.1% | A | 26.1% | A | † | 0.137 |
3 months | 27.7% | A | 28.3% | A | 30.6% | A | † | 0.573 | |
12 months | 27.7% | A | 28.6% | A | 32.3% | A | † | 0.224 | |
Δ baseline to 3 months | −3.66 ± 8.81 | −0.75 ± 5.43 | +4.54 ± 7.65 | † | <0.001 | ||||
Δ baseline to 12 months | −3.46 ± 9.33 | +0.88 ± 8.81 | +6.52 ± 7.64 | † | <0.001 | ||||
Δ 3 months to 12 months | −0.19 ± 9.40 | +2.08 ± 6.73 | +1.20 ± 8.61 | † | 0.619 | ||||
Advanced pockets in % (≥5.5 mm) | Baseline | 9.1% | A | 9.1% | A | 12.4% | A | † | 0.419 |
3 months | 5.3% | A | 6.9% | A | 14.3% | B | † | 0.004 | |
12 months | 5.5% | A | 7.5% | A | 10.1% | A | † | 0.077 | |
Δ baseline to 3 months | −3.86 ± 5.15 | −2.21 ± 4.45 | +1.86 ± 2.93 | † | <0.001 | ||||
Δ baseline to 12 months | −3.38 ± 6.53 | −0.56 ± 7.12 | −0.04 ± 9.84 | † | 0.275 | ||||
Δ 3 months to 12 months | +0.42 ± 4.24 | +1.40 ± 5.52 | −1.80 ± 9.83 | † | 0.252 |
Interval | Parameter | PT1 Group vs. PT2 Group | PT2 Group vs. Control Group | PT1 Group vs. Control Group | |||
---|---|---|---|---|---|---|---|
Δ from baseline to 3 months | PISA, mm2 | ↓↓ | p = 0.001 | ↓↓ | p = 0.018 | ↓↓ | p < 0.001 |
Shallow pockets, % | ↑↑ | n.s. | ↑↓ | p < 0.001 | ↑↓ | p < 0.001 | |
Moderate pockets, % | ↓↓ | n.s. | ↓↑ | p = 0.026 | ↓↑ | p < 0.001 | |
Advanced pockets, % | ↓↓ | n.s. | ↓↑ | p = 0.002 | ↓↑ | p < 0.001 | |
Δ from baseline to 12 months | PISA, mm2 | ↓↓ | n.s. | ↓↓ | n.s. | ↓↓ | p = 0.010 |
Shallow pockets, % | ↑↓ | n.s. | ↓↓ | n.s. | ↑↓ | p < 0.001 | |
Moderate pockets, % | ↓↑ | n.s. | ↑↑ | n.s. | ↓↑ | p < 0.001 | |
Advanced pockets, % | ↓↓ | n.s. | ↓↓ | n.s. | ↓↓ | n.s. | |
Δ from 3 months to 12 months | PISA, mm2 | ↑↑ | n.s. | ↑↓ | n.s. | ↑↓ | n.s. |
Shallow pockets, % | ↓↓ | n.s. | ↓↑ | n.s. | ↓↑ | n.s. | |
Moderate pockets, % | ↓↑ | n.s. | ↑↑ | n.s. | ↓↑ | n.s. | |
Advanced pockets, % | ↑↑ | n.s. | ↑↓ | n.s. | ↑↓ | n.s. |
3.2. Differential Developments in PISA Scores
3.3. Depth Distributions of Subgingival Pockets
3.4. Microbial-Community Findings
3.5. Alpha-Diversity Findings
3.6. Beta-Diversity Findings
3.7. Differential Abundances of Taxa Between the Three Timepoints
4. Discussion
4.1. PISA Scores and Pocket Depths
4.2. Alpha and Beta Diversities
4.3. Differential Abundances of Taxa
4.4. Limitations and Future Directions
4.5. Implications for Periodontal Therapy
4.6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Group | Alpha Diversity | Beta Diversity | ||||||
---|---|---|---|---|---|---|---|---|
Time | vs. | Time | Shannon Index | Observed Species | Phylogenetic Diversity | |||
PT1 group | Baseline | vs. | 3 months | adj. p | 0.000078 ** | 0.000025 ** | 0.000001 ** | 0.003 * |
Baseline | vs. | 12 months | adj. p | 0.083 | 0.065 | 0.007 * | 0.003 * | |
3 months | vs. | 12 months | adj. p | 0.007 * | 0.011 * | 0.005 * | 0.003 * | |
PT2 group | Baseline | vs. | 3 months | adj. p | ↓ | ↓ | 0.005 * | ↓ |
Baseline | vs. | 12 months | adj. p | 0.095 | 0.057 | 0.025 * | 0.228 | |
3 months | vs. | 12 months | adj. p | ↑ | ↑ | 0.706 | ↑ | |
Control group | Baseline | vs. | 3 months | adj. p | 0.034 * | ↓ | 0.028 * | ↓ |
Baseline | vs. | 12 months | adj. p | 0.975 | 0.094 | 0.321 | 0.929 | |
3 months | vs. | 12 months | adj. p | 0.275 | ↑ | 0.275 | ↑ |
PT1 Group | PT2 Group | Control Group | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Time | vs. | Time | C − 1 | C0 | C1 | C − 1 | C0 | C1 | C − 1 | C0 | C1 | |
Baseline | vs. | 3 months | n of taxa | 31 * | 119 | 11 * | 0 | 159 | 0 | 0 | 154 | 0 |
Baseline | vs. | 12 months | n of taxa | 8 * | 150 | 3 * | 0 | 159 | 0 | 0 | 154 | 0 |
3 months | vs. | 12 months | n of taxa | 1 * | 152 | 8 * | 0 | 159 | 0 | 0 | 154 | 0 |
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Arefnia, B.; Klymiuk, I.; Peikert, S.A.; Bernhard, J.S.; Seinost, G.; Wimmer, G. Impact of Antibiotics on the Subgingival Microbiome in Advanced Periodontitis: Secondary Analysis of a Randomized Controlled Trial. Diagnostics 2025, 15, 2012. https://doi.org/10.3390/diagnostics15162012
Arefnia B, Klymiuk I, Peikert SA, Bernhard JS, Seinost G, Wimmer G. Impact of Antibiotics on the Subgingival Microbiome in Advanced Periodontitis: Secondary Analysis of a Randomized Controlled Trial. Diagnostics. 2025; 15(16):2012. https://doi.org/10.3390/diagnostics15162012
Chicago/Turabian StyleArefnia, Behrouz, Ingeborg Klymiuk, Stefanie Anna Peikert, Jakob Sebastian Bernhard, Gerald Seinost, and Gernot Wimmer. 2025. "Impact of Antibiotics on the Subgingival Microbiome in Advanced Periodontitis: Secondary Analysis of a Randomized Controlled Trial" Diagnostics 15, no. 16: 2012. https://doi.org/10.3390/diagnostics15162012
APA StyleArefnia, B., Klymiuk, I., Peikert, S. A., Bernhard, J. S., Seinost, G., & Wimmer, G. (2025). Impact of Antibiotics on the Subgingival Microbiome in Advanced Periodontitis: Secondary Analysis of a Randomized Controlled Trial. Diagnostics, 15(16), 2012. https://doi.org/10.3390/diagnostics15162012