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Laforgia A, Inchingolo AD, Piras F, Colonna V, Giorgio RV, Carone C, Rapone B, Malcangi G, Inchingolo AM, Inchingolo F, Palermo A, Dipalma G. Therapeutic Strategies and Genetic Implications for Periodontal Disease Management: A Systematic Review. Int J Mol Sci 2024; 25:7217. [PMID: 39000324 PMCID: PMC11242487 DOI: 10.3390/ijms25137217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/23/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
The objective of this review is to identify the microbiological alterations caused by various therapy modalities by critically analyzing the current findings. We limited our search to English-language papers published between 1 January 2004 and 7 May 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "microbio*" AND "periodontitis" were used. A total of 5152 papers were obtained from the databases Web of Science (2205), PubMed (1793), and Scopus (1154). This resulted in 3266 articles after eliminating duplicates (1886), and 1411 entries were eliminated after their titles and abstracts were examined. The qualitative analysis of the 22 final articles is included in this study. Research on periodontal disease shows that periodontitis alters the oral microbiome and increases antibiotic resistance. Treatments like scaling and root planing (SRP), especially when combined with minocycline, improve clinical outcomes by reducing harmful bacteria. Comprehensive mechanical debridement with antibiotics, probiotics, EMD with bone grafts, and other adjunctive therapies enhances periodontal health. Personalized treatment strategies and advanced microbial analyses are crucial for effective periodontal management and antibiotic resistance control.
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Affiliation(s)
- Alessandra Laforgia
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Valeria Colonna
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Roberto Vito Giorgio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Claudio Carone
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry, CoMD Birmingham Campus, Birmingham B4 6BN, UK
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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Biewer B, Rompen E, Mittelbronn M, Hammer GP, Quatresooz P, Borgmann FK. Effects of Minocycline Hydrochloride as an Adjuvant Therapy for a Guided Bone Augmentation Procedure in The Rat Calvarium. Dent J (Basel) 2023; 11:dj11040092. [PMID: 37185470 PMCID: PMC10136768 DOI: 10.3390/dj11040092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
This in vivo study reports the influence of minocycline-HCl administration on extra-skeletal bone generation in a Guided Bone Augmentation model, utilizing titanium caps placed on the intact as well as perforated calvaria of rats. The test group was administered 0.5 mg/mL minocycline-HCl with the drinking water, and the amount of bone tissue in the caps was quantified at three time points (4, 8 and 16 weeks). A continuously increased tissue fill was observed in all groups over time. The administration of minocycline-HCl as well as perforation of the calvaria increased this effect, especially with regard to mineralization. The strongest tissue augmentation, with 1.8 times that of the untreated control group, and, at the same time, the most mineralized tissue (2.3× over untreated control), was produced in the combination of both treatments, indicating that systemic administration of minocycline-HCl has an accelerating and enhancing effect on vertical bone augmentation.
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qPCR Detection and Quantification of Aggregatibacter actinomycetemcomitans and Other Periodontal Pathogens in Saliva and Gingival Crevicular Fluid among Periodontitis Patients. Pathogens 2023; 12:pathogens12010076. [PMID: 36678429 PMCID: PMC9861831 DOI: 10.3390/pathogens12010076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/14/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The detection of special bacterial species in patients with periodontitis is considered useful for clinical diagnosis and treatment. The aim of this study was to investigate the presence of specific periopathogens and investigate whether there is a correlation between the results of different bacterial species in whole saliva and pooled subgingival plaque samples (healthy and diseased sites) from individuals with periodontitis and periodontally healthy subjects. MATERIALS AND METHODS In total, 52 patients were recruited and divided into two groups: non-periodontitis and periodontitis patients. For each group, the following periodontal pathogens were detected using real-time polymerase chain reaction: A. actinomycetemcomitans JP2 clone, A. actinomycetemcomitans non JP2 clone, Porphyromonasgingivalis, and total eubacteria. RESULTS Higher levels of the various studied bacteria were present in both saliva and plaque samples from the periodontitis group in comparison to non-periodontitis subjects. There were significant differences in P. gingivalis and A. actinomycetemcomitans JP2 clones in the saliva of periodontitis patient compared to the control group. Subgingival plaque of diseased sites presented a significant and strong positive correlation between A. actinomycetemcomitans and P. gingivalis. In saliva samples, there was a significant positive correlation between A. actinomycetemcomitans JP2 clone and P. gingivalis (p ≤ 0.002). CONCLUSION Quantifying and differentiating these periodontal species from subgingival plaque and saliva samples showed a good potential as diagnostic markers for periodontal disease. Regarding the prevalence of the studied bacteria, specifically A. actinomycetemcomitans JP2 clone, found in this work, and the high rate of susceptibility to periodontal species in Africa, future larger studies are recommended.
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Hodovanyi OV. NON-SURGICAL PERIODONTAL TREATMENT AS AN IMPORTANT COMPONENT OF EFFECTIVE PERIODONTAL DISEASES PREVENTION MEASURES. BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-3-166-523-539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Alblowi JA, Gamal-Abdel Naser A. Metagenomic Assessment of Different Interventions for Treatment of Chronic Periodontitis: A Systematic Review and Meta-Analysis. Open Dent J 2019. [DOI: 10.2174/1874210601913010557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Chronic periodontitis is attributed to oral microbial imbalance and host inflammatory reaction.
Objective:
Our review addresses the question of: Are the available interventions able to regain oral microbial balance in patients having chronic periodontitis?
Data Sources:
We performed a comprehensive systematic search of MEDLine via Pubmed, Cochrane CENTRAL, Clinicalkey, Clarivate Analytics, Springer materials, Wiley, SAGE, Elsevier, Taylor & Francis group, and Wolter Kluwer, together with hand searching and searching the grey literature.
Eligibility Criteria:
We included interventional studies testing the microbiome analysis using metagenomic techniques as an outcome to any intervention for chronic periodontitis.
Study Appraisal and Synthesis Methods:
All studies were imported in Mendeley. The risk of bias was assessed using the specific tool for each study design. The results were analysed using RevMan. All the review steps were performed in duplicates.
Results:
The search yielded 2700 records. After exclusion steps, 10 records were found eligible. We included 5 RCTs, 1 non-RCT, 3 before-and-after studies, and 1 ongoing study. The studies tested non-surgical periodontal treatment with and without antibiotic coverage, probiotics, sodium hypochlorite rinse, and different toothpaste ingredients. One RCT tested the use of enamel matrix derivatives in cases with furcation involvement.
Limitations:
The eligible available studies were small in number. Also, the risk of bias and lack of a standardized protocol impaired the ability to pool all the results.
Conclusions:
The body of the available evidence is not sufficient, and future studies are recommended to better evaluate the effect of periodontal treatments on the periodontal microbiome.
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Pretzl B, Paul J, Krigar DM, Uhlmann L, Eickholz P, Dannewitz B. Reproducibility of a commercially available subgingival plaque sampling strategy and analysis strategy with oligonucleotide probes. Acta Odontol Scand 2017; 75:302-307. [PMID: 28325127 DOI: 10.1080/00016357.2017.1303192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The aim was to evaluate the intra-test agreement of pooled samples from the deepest periodontal pocket of each quadrant with a commercially available test kit based on hybridization of 16S rRNA. MATERIAL AND METHODS Plaque samples of 50 patients with generalized severe chronic periodontitis before therapy were pooled in two separate vials in order to detect and compare counts of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. Cohen's κ and interclass correlation coefficients were calculated to judge intra-test agreement. RESULTS Cohen's κ for detection and counts of Tannerella forsythia and Treponema denticola showed a perfect agreement. Porphyromonas ginigivalis was identified in both tests with a substantial agreement, whereas detection of Aggregatibacter actinomycetemcomitans varied in eight patients resulting in a good agreement. Possible confounding factors could not be identified statistically. CONCLUSION Test results of the commercial 16S rRNA test are perfectly reproducible regarding detection of red complex pathogens. Intra-test agreement concerning detection of Aggregatibacter actinomycetemcomitans was less favorable. CLINICAL RELEVANCE Detection of certain periodontal pathogens may alter the treatment and lead to prescription of antibiotics parallel to mechanical debridement. It is quite important not to use antibiotics excessively. Thus, the basis for decision-making in favor of antibiotics should be solid.
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Affiliation(s)
- Bernadette Pretzl
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Jule Paul
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Diana M. Krigar
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
- Private Practice, Heidelberg, Germany
| | - Lorenz Uhlmann
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
| | - Bettina Dannewitz
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany
- Private Practice, Weilburg, Germany
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Nickles K, Scharf S, Röllke L, Dannewitz B, Eickholz P. Comparison of Two Different Sampling Methods for Subgingival Plaque: Subgingival Paper Points or Mouthrinse Sample? J Periodontol 2017; 88:399-406. [DOI: 10.1902/jop.2016.160249] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Katrin Nickles
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Goethe University, Frankfurt, Germany
| | - Susanne Scharf
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Goethe University, Frankfurt, Germany
| | - Lasse Röllke
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Goethe University, Frankfurt, Germany
| | - Bettina Dannewitz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Goethe University, Frankfurt, Germany
- Department of Conservative Dentistry; Clinic for Oral, Dental and Maxillofacial Diseases; Heidelberg University; Heidelberg, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Goethe University, Frankfurt, Germany
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Jentsch HFR, Buchmann A, Friedrich A, Eick S. Nonsurgical therapy of chronic periodontitis with adjunctive systemic azithromycin or amoxicillin/metronidazole. Clin Oral Investig 2015; 20:1765-73. [PMID: 26685849 DOI: 10.1007/s00784-015-1683-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/30/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The objective of the present study is to compare the effect of systemic adjunctive use of azithromycin with amoxicillin/metronidazole to scaling and root planing (SRP) in a clinical study. MATERIALS AND METHODS Data from 60 individuals with chronic periodontitis were evaluated after full-mouth SRP. Antibiotics were given from the first day of SRP, in the test group (n = 29), azithromycin for 3 days and, in the control group (n = 31), amoxicillin/metronidazole for7 days. Probing depth (PD), attachment level (AL), and bleeding on probing (BOP) were recorded at baseline and after 3 and 12 months. Gingival crevicular fluid was analyzed for matrix metalloprotease (MMP)-8 and interleukin (IL)-1beta levels. Subgingival plaque was taken for assessment of the major bacteria associated with periodontitis. RESULTS In both groups, PD, AL, and BOP were significantly reduced (p < 0.001). A few significant differences between the groups were found; AL and BOP were significantly better in the test than in the control group at the end of the study (p = 0.020 and 0.009). Periodontopathogens were reduced most in the test group. CONCLUSIONS A noninferiority of the treatment with azithromycin in comparison with amoxicillin/metronidazole can be stated. The administration of azithromycin could be an alternative to the use of amoxicillin/metronidazole adjunctive to SRP in patients with moderate or severe chronic periodontitis; however, a randomized placebo-controlled multicenter study is needed. CLINICAL RELEVANCE Application of azithromycin as a single antibiotic for 3 days might be considered as an additional adjunctive antibiotic to SRP in selected patients.
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Affiliation(s)
- Holger F R Jentsch
- Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Liebigstr. 12, Haus 1, 04103, Leipzig, Germany.
| | | | | | - Sigrun Eick
- Department of Periodontology, Laboratory of Oral Microbiology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Nickles K, Scharf S, Röllke L, Mayer I, Mayer M, Eickholz P. Detection of subgingival periodontal pathogens--comparison of two sampling strategies. Clin Oral Investig 2015; 20:571-9. [PMID: 26193958 DOI: 10.1007/s00784-015-1530-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 07/03/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of the study is to compare detection frequency of periodontal pathogens in patients with aggressive/severe chronic periodontitis using pooled plaque samples from the deepest pockets per quadrant/per sextant. METHODS In 100 patients with aggressive/chronic periodontitis, subgingival plaque was sampled from the deepest pockets per quadrant (MT4) and per sextant (MT6). Plaque samples were taken using two sterile paper points simultaneously. One paper point from each pocket was pooled with the three other paper points of the pockets (MT4). Subsequently, the remaining four paper points were pooled with two paper points from the deepest pockets from the two remaining sextants (MT6). The content of each vial was analyzed with nucleic-acid based methods for Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia, Parvimonas micra, Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, and Capnocytophaga sp. RESULTS The detection frequency of A. actinomycetemcomitans (MT4/MT6) at 22/24 %, T. forsythia at 93/96 %, P. gingivalis at 78/79 %, T. denticola at 88/90 %, P. intermedia at 40/46 %, P. micra at 75/79 %, F. nucleatum at both 99 %, C. rectus at 84/89 %, E. nodatum at 62/65 %, E. corrodens at 80/87 %, and Capnocytophaga sp. at 49/58 % was higher with MT6 than with MT4. None of these differences were statistically significant. CONCLUSION The detection frequency of the investigated periopathogens was statistically insignificant higher with the sampling method MT6 compared with MT4. CLINICAL RELEVANCE In daily dental practice, the plaque sampling of the deepest pockets per quadrant seems to be sufficient.
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Affiliation(s)
- Katrin Nickles
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany.
| | - Susanne Scharf
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Lasse Röllke
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Irina Mayer
- , Siesmayerstr. 44, 60323, Frankfurt/Main, Germany
| | - Matthias Mayer
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany.,, Arndstr. 14, 60325, Frankfurt/Main, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
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