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Hagenfeld D, Kleine Bardenhorst S, Matern J, Prior K, Harks I, Eickholz P, Lorenz K, Kim TS, Kocher T, Meyle J, Kaner D, Schlagenhauf U, Harmsen D, Ehmke B. Long-term changes in the subgingival microbiota in patients with stage III-IV periodontitis treated by mechanical therapy and adjunctive systemic antibiotics: A secondary analysis of a randomized controlled trial. J Clin Periodontol 2023; 50:1101-1112. [PMID: 37160709 DOI: 10.1111/jcpe.13824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/08/2023] [Accepted: 04/21/2023] [Indexed: 05/11/2023]
Abstract
AIM To explore whether adjunctive antibiotics can relevantly influence long-term microbiota changes in stage III-IV periodontitis patients. MATERIALS AND METHODS This is a secondary analysis of a randomized clinical trial on periodontal therapy with adjunctive 500 mg amoxicillin and 400 mg metronidazole or placebo thrice daily for 7 days. Subgingival plaque samples were taken before and 2, 8, 14 and 26 months after mechanical therapy. The V4-hypervariable region of the 16S rRNA gene was sequenced with Illumina MiSeq 250 base pair paired-end reads. Changes at the ribosomal sequence variant (RSV) level, diversity and subgingival-microbial dysbiosis index (SMDI) were explored with a negative binomial regression model and non-parametric tests. RESULTS Overall, 50.2% of all raw reads summed up to 72 RSVs (3.0%) that were generated from 163 stage III-IV periodontitis patients. Of those, 16 RSVs, including Porphyromonas gingivalis, Tannerella forsythia and Aggregatibacter actinomycetemcomitans, changed significantly over 26 months because of adjunctive systemic antibiotics. SMDI decreased significantly more in the antibiotic group at all timepoints, whereas the 2-month differences in alpha and beta diversity between groups were not significant at 8 and 14 months, respectively. CONCLUSIONS Mechanical periodontal therapy with adjunctive antibiotics induced a relevant and long-term sustainable change towards an oral microbiome more associated with oral health.
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Affiliation(s)
- Daniel Hagenfeld
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Sven Kleine Bardenhorst
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
- Department of Clinical Epidemiology, Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Johannes Matern
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Karola Prior
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Inga Harks
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine, Johann Wolfgang Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Katrin Lorenz
- Department of Periodontology, TU Dresden, Dresden, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Jörg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
| | - Doğan Kaner
- Department of Periodontology and Synoptic Dentistry, Charite-Universitätsmedizin Berlin, Berlin, Germany
- Department of Periodontology, Dental School, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Ulrich Schlagenhauf
- Department of Periodontology, University Hospital Würzburg, Würzburg, Germany
| | - Dag Harmsen
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Benjamin Ehmke
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
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Gaibani P, Vocale C, Ambretti S, Cavrini F, Izard J, Miragliotta L, Pellegrino MT, Sambri V. Killing of Treponema denticola by mouse peritoneal macrophages. J Dent Res 2010; 89:521-6. [PMID: 20200417 DOI: 10.1177/0022034510363105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Treponema denticola has been identified as an important cause of periodontal disease and hypothesized to be involved in extra-oral infections. The objective of this study was to investigate the role of T. denticola cell length and motility during mouse peritoneal macrophages in vitro uptake. Macrophages, incubated under aerobic and anaerobic conditions, produced a similar amount of TNF-alpha when stimulated with Escherichia coli LPS. The uptake of FlgE- and CfpA-deficient mutants of T. denticola was significantly increased compared with the wild-type strain, due to cell size or lack of motility. Opsonization with specific antibodies considerably improved the treponemes' uptake. These results suggest that macrophages, in addition to other phagocytes, could play an important role in the control of T. denticola infection, and that the raising of specific antibodies could improve the efficacy of the immune response toward T. denticola, either at an oral site or during dissemination.
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Affiliation(s)
- P Gaibani
- Department of Haematology and Oncology L. and A. Seragnoli, Section of Microbiology, University of Bologna, St. Orsola Hospital, 9 via G. Massarenti, 40138 Bologna, Italy
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Martínez-Pabón MC, Restrepo-Ospina DP, Isaza-Guzmán DM, Orozco-Rojas LM, Tobón-Arroyave SI. Detection of Treponema denticola in saliva obtained from patients with various periodontal conditions. Clin Oral Investig 2007; 12:73-81. [PMID: 17823835 DOI: 10.1007/s00784-007-0147-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Accepted: 08/16/2007] [Indexed: 10/22/2022]
Abstract
The aim of the study was to determine the prevalence of Treponema denticola in saliva of periodontally diseased and healthy patients and its relationship with the periodontal status. A 16S rRNA-based polymerase chain reaction detection method was used to determine the prevalence of T. denticola in whole saliva samples from patients with chronic periodontitis (CP, n = 37), aggressive periodontitis (AgP, n = 24), and healthy subjects (n = 28). The periodontal status of each subject was assessed by criteria based on probing depth, clinical attachment loss, and extent of periodontal breakdown. Risk factors were assessed individually and adjusted for confounding using a binary logistic regression model. The results showed that the prevalence of T. denticola in CP patients was significantly higher than those in healthy and AgP subjects (P < 0.05). Odds ratio analysis revealed a positive association for CP group/T. denticola-positive and smoking/T. denticola-positive subjects. Furthermore, all clinical measurements were significantly greater (P < 0.05) for T. denticola-positive subjects compared to T. denticola-negative subjects. After binary logistic regression analysis, both T. denticola and smoking were independently and strongly associated with development of CP. It was concluded that when used in conjunction with an optimized clinical examination protocol, this assay may offer a rapid, useful, and cost-effective tool for monitoring the presence of T. denticola in noninvasive clinical samples from both healthy and diseased patients and correlating it with the amount and extent of periodontal breakdown.
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Affiliation(s)
- María Cecilia Martínez-Pabón
- POPCAD Research Group, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Calle 64 No 52-59, P.O. Box: 1226, Medellín, Colombia
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Brissette CA, Lukehart SA. Mechanisms of decreased susceptibility to beta-defensins by Treponema denticola. Infect Immun 2007; 75:2307-15. [PMID: 17325047 PMCID: PMC1865744 DOI: 10.1128/iai.01718-06] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Treponema denticola, a periodontal pathogen, is relatively resistant to human beta-defensins, which are small cationic antimicrobial peptides produced by a number of cells, including the gingival epithelium. Using two independent methods, we previously demonstrated that T. denticola proteases are not responsible for decreased vulnerability to defensins. In this study, we confirmed that the major outer membrane protease, dentilisin, is not responsible for T. denticola insensitivity to defensins and examined several other possible mechanisms, including reduced binding to the bacterial surface and efflux pump activity. It has been suggested that some bacteria mask their surfaces with serum proteins. T. denticola grown in a serum-free medium did not exhibit increased susceptibility to human beta-defensin 2 and 3 (hbetaD-2 and hbetaD-3, respectively), suggesting that cloaking of the outer surface with host proteins is not involved in defensin resistance. Nonetheless, we demonstrated that T. denticola binds significantly less hbetaD-2 and -3 than susceptible organisms bind, suggesting that the unusual outer membrane composition of T. denticola may discourage cationic peptide binding. Efflux pumps have been shown to mediate resistance to antibiotics and cationic peptides in other bacteria, and their role in T. denticola's relative resistance to beta-defensins was investigated. Three inhibitors of bacterial ATP-binding cassette (ABC) efflux pumps had no effect on T. denticola's susceptibility to hbetaD-2 or -3. In contrast, a proton motive force inhibitor, carbonyl cyanide 3-chlorophenylhydrazone, increased the susceptibility of T. denticola to killing by hbetaD-3, demonstrating a potential role for efflux pumps (other than ABC pumps) in resistance to this peptide. Our data suggest that the combination of decreased defensin binding and efflux of any peptide which enters the cytoplasm may explain T. denticola's relative resistance to human beta-defensins.
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Affiliation(s)
- Catherine A Brissette
- Department of Pathobiology, University of Washington, Seattle, Washington 98195, USA
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