The effect of drug dose and duration of adjuvant Amoxicillin-plus-Metronidazole to full-mouth scaling and root planing in periodontitis: a systematic review and meta-analysis

Antibiotic resistance in the microbiota of periodontitis patients: an update of current findings

Systemic antibiotics are an effective adjunct in the treatment of periodontitis, but their judicious use is necessary as antimicrobial resistance is a growing global concern. This review aims to explore the current understanding and insight related to antibiotic resistance in the subgingival microbiota of periodontitis patients. A search of MEDLINE (PubMed) was carried out from 1 January 2012 to 25 November 2021 for studies related to antibiotic resistance in periodontitis patients. Of the 90 articles identified, 12 studies were selected for inclusion. A significant incidence of antibiotic resistant isolates was reported for Porphyromonas gingivalis, Prevotella intermedia, Prevotella denticola, Prevotella melaninogenica, Fusobacterium nucleatum, Tanerella forsythia, Aggretibacter actinomycetemcomitans, Streptococcus constellatus, Streptococcus intermedius, and Parvimonas micra, but resistance to specific antibiotics did not reach above 10% of isolates in most studies except for amoxicillin resistance in Aggretibacter actinomycetemcomitans. The highest frequency of resistance across all bacterial species was for amoxicillin, clindamycin, and metronidazole. However, resistance patterns were widely variable across geographical locations, and the high heterogeneity between antibiotic-resistant isolates across studies precludes any clinical recommendations from this study. Although antibiotic resistance has yet to reach critical levels in periodontitis patients, an emphasis on antibiotic stewardship interventions such as point-of-care diagnostics and education for key stakeholders is needed to curb a growing problem.

Tailoring Biomaterials Ameliorate Inflammatory Bone Loss

Inflammatory diseases, such as rheumatoid arthritis, periodontitis, chronic obstructive pulmonary disease, and celiac disease, disrupt the delicate balance between bone resorption and formation, leading to inflammatory bone loss. Conventional approaches to tackle this issue encompass pharmaceutical interventions and surgical procedures. Nevertheless, pharmaceutical interventions exhibit limited efficacy, while surgical treatments impose trauma and significant financial burden upon patients. Biomaterials show outstanding spatiotemporal controllability, possess a remarkable specific surface area, and demonstrate exceptional reactivity. In the present era, the advancement of emerging biomaterials has bestowed upon more efficacious solutions for combatting the detrimental consequences of inflammatory bone loss. In this review, the advances of biomaterials for ameliorating inflammatory bone loss are listed. Additionally, the advantages and disadvantages of various biomaterials-mediated strategies are summarized. Finally, the challenges and perspectives of biomaterials are analyzed. This review aims to provide new possibilities for developing more advanced biomaterials toward inflammatory bone loss.

Progress in microalgal mediated bioremediation systems for the removal of antibiotics and pharmaceuticals from wastewater

Worldwide demand for antibiotics and pharmaceutical products is continuously increasing for the control of disease and improvement of human health. Poor management and partial metabolism of these compounds result in the pollution of aquatic systems, leading to hazardous effects on flora, fauna, and ecosystems. In the past decade, the importance of microalgae in micropollutant removal has been widely reported. Microalgal systems are advantageous as their cultivation does not require additional nutrients: they can recover resources from wastewater and degrade antibiotics and pharmaceutical pollutants simultaneously. Bioadsorption, degradation, and accumulation are the main mechanisms involved in pollutant removal by microalgae. Integration of microalgae-mediated pollutant removal with other technologies, such as biodiesel, biochemical, and bioelectricity production, can make this technology more economical and efficient. This article summarizes the current scenario of antibiotic and pharmaceutical removal from wastewater using microalgae-mediated technologies.

Fabrication of Guided Tissue Regeneration Membrane Using Lignin-Mediated ZnO Nanoparticles in Biopolymer Matrix for Antimicrobial Activity

Periodontal disease is a common complication, and conventional periodontal surgery can lead to severe bleeding. Different membranes have been used for periodontal treatment with limitations, such as improper biodegradation, poor mechanical property, and no effective hemostatic property. Guided tissue regeneration (GTR) membranes favoring periodontal regeneration were prepared to overcome these shortcomings. The mucilage of the chia seed was extracted and utilized to prepare the guided tissue regeneration (GTR) membrane. Lignin having antibacterial properties was used to synthesize lignin-mediated ZnO nanoparticles (∼Lignin@ZnO) followed by characterization with analytical techniques like Fourier-transform infrared spectroscopy (FTIR), UV–visible spectroscopy, and scanning electron microscope (SEM). To fabricate the GTR membrane, extracted mucilage, Lignin@ZnO, and polyvinyl alcohol (PVA) were mixed in different ratios to obtain a thin film. The fabricated GTR membrane was evaluated using a dynamic fatigue analyzer for mechanical properties. Appropriate degradation rates were approved by degradability analysis in water for different intervals of time. The fabricated GTR membrane showed excellent antibacterial properties against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) bacterial species.

Ridge preservation in maxillary molar extraction sites with severe periodontitis: a prospective observational clinical trial

OBJECTIVES

To assess alveolar bone changes and treatment modality alterations after ridge preservation on maxillary molar extraction sockets with severe periodontitis, compared to natural healing.

MATERIAL AND METHODS

Thirty-six maxillary infected-molar teeth either receiving ridge preservation (RG group) or undergoing natural healing (NT group) were investigated. Cone-beam computed tomography (CBCT) scanning was performed immediately after surgery (the baseline) and repeated 6 months later to measure the linear and volumetric changes of the sockets.

RESULTS

Based on radiographic measurements, alveolar bone width decreased by 1.58 ± 4.61 mm in the NT group but increased by 3.74 ± 4.17 mm in the RG group (p < 0.05). Significant increases in ridge height at the center of both the NT (7.54 ± 4.54 mm) and RG (9.20 ± 3.26 mm) groups were observed. Mean sinus pneumatization was 0.19 ± 0.45 mm in the RG group and 0.59 ± 0.63 mm in the NT group (p < 0.05). The relative increase in total ridge volume was 8.0% and 35.5% in the NT and RG group, respectively (p < 0.05). Implant placement with additional sinus augmentation procedure was performed in 16.7% of the RG group cases, whereas 50% in the NT group cases.

CONCLUSIONS

Ridge preservation in the maxillary molar extraction sockets with severe periodontitis can improve alveolar ridge dimensions and decrease the necessity of advanced regenerative procedures at implant placement compared to natural healing.

CLINICAL RELEVANCE

Ridge preservation on maxillary molar extraction sockets with severe periodontitis maintained the vertical bone height more efficiently and resulted in less need for sinus augmentation procedures at 6 months compared to natural healing.