The dynamic elimination effect of local adjuvant therapy on the periodontal microbiota.

BACKGROUND

Implementing local adjunctive therapy during scaling and root planing has become increasingly crucial for optimizing the therapeutic efficacy of periodontitis and reshaping the periodontal microecological environment.

OBJECTIVE

This study aimed to reveal the additional clearance effect of local adjunctive therapy on the microbiota of periodontitis.

DESIGN

An autologous randomized controlled trial included 25 periodontitis patients. After scaling and root planing, one oral side randomly received laser or minocycline, the other as control. Three hundred and seventy-six subgingival samples were collected at nine time points within 1 month for integrated analysis of microbiota and clinical indicators.

RESULTS

Compared with laser adjunctive therapy, minocycline hydrochloride adjunctive therapy showed no difference in pathogen clearance rate within 6 h, but significant differences emerged in days 1, 3 and 7 (χ² test, P < 0.05). Meanwhile, within the 7-day period, the number of core bacteria of periodontitis with significant intergroup differences increased progressively over time (LDA > 2.0, P < 0.05). After 4 weeks, minocycline hydrochloride adjunctive therapy eliminated 12 more core bacteria of periodontitis than scaling and root planing alone, while significantly reduced the bleeding on probing (Wilcoxon test, p = 0.0085) and clinical attachment loss indicators (Wilcoxon test, p = 0.0456). In the long term, minocycline hydrochloride adjunctive therapy weakened microbial network connectivity, strongly influencing bacterial interactions involving Leptotrichia, Dialister and Atopobium.

CONCLUSIONS

Minocycline hydrochloride local adjunctive therapy outperforms semiconductor laser local adjunctive therapy in terms of eliminating periodontitis core bacteria, improving the microbial community structure, and enhancing clinical indicators.