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Amiri MA, Amiri D, Hamedani S. Thermosensitive Hydrogels for Periodontal Regeneration: A Systematic Review of the Evidence. Clin Exp Dent Res 2024; 10:e70029. [PMID: 39539029 PMCID: PMC11561135 DOI: 10.1002/cre2.70029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 09/03/2024] [Accepted: 10/07/2024] [Indexed: 11/16/2024] Open
Abstract
OBJECTIVES Thermosensitive hydrogels are now among the most commonly used biomaterials in tissue engineering. Due to their unique characteristics, this review aimed to evaluate the suitability of thermosensitive hydrogels in periodontal regeneration. MATERIAL AND METHODS PubMed, Scopus, and Web of Science databases were searched until March 25, 2024, to retrieve relevant articles. The eligibility criteria for the included studies were determined by the designed PICO elements. Results from each included study were extracted, focusing on the three main areas: thermosensitivity, cellular characteristics, and in vivo characteristics. RESULTS Nineteen studies were included in our study. The thermosensitivity assessment of the hydrogels indicated a range of sol-gel transition times from 40 s to 20 min based on the type of polymers and the fabrication process. The cellular characterization was assessed based on three main cellular behaviors: cellular viability/proliferation, differentiation, and migration. The in vivo characterization was performed based on two main approaches: radiographic and histologic evaluation. CONCLUSIONS The results indicated that the addition of bioactive agents could enhance the in vivo efficacy of thermosensitive hydrogels in periodontal regeneration through three main areas: antimicrobial, anti-inflammatory, and regenerative effects.
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Affiliation(s)
- Mohammad Amin Amiri
- Oral and Dental Disease Research Center, School of DentistryShiraz University of Medical SciencesShirazIran
| | - Delara Amiri
- School of DentistryShiraz University of Medical SciencesShirazIran
| | - Shahram Hamedani
- Oral and Dental Disease Research Center, School of DentistryShiraz University of Medical SciencesShirazIran
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Hayashi JI, Ono K, Iwamura Y, Sasaki Y, Ohno T, Goto R, Nishida E, Yamamoto G, Kikuchi T, Higuchi N, Mitani A, Fukuda M. Suppression of subgingival bacteria by antimicrobial photodynamic therapy using transgingival irradiation: A randomized clinical trial. J Periodontol 2024; 95:718-728. [PMID: 37910482 DOI: 10.1002/jper.23-0328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/01/2023] [Accepted: 10/06/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) is an effective method for eradicating bacteria in periodontal therapy. Standard aPDT requires the insertion of a laser tip into a periodontal pocket, in which the direction of irradiation is limited. Therefore, we devised an aPDT method that uses a transgingival near-infrared wavelength and indocyanine green-encapsulated and chitosan-coated nanoparticles as a photosensitizer. METHODS Forty patients undergoing supportive periodontal therapy, who had a single root tooth with a pocket of 5 mm or deeper, were used as subjects. In the test group, aPDT was performed by laser irradiation from outside the gingiva using photosensitizer nanoparticles. In the control group, pseudo aPDT without photosensitizer was performed by transgingival irradiation. Subgingival plaque was sampled from inside the pocket before, immediately after, and 1 week after treatment, and evaluated by colony counting and real-time polymerase chain reaction. RESULTS There were no significant differences in age, sex, periodontal pocket depth, and bleeding on probing between the test and control groups. Compared with the colony count before treatment, the count in the test group was significantly reduced immediately after treatment. The number of patients with colony reduction to ≤50% and ≤10% was significantly higher in the test group than in the control group. None of the participants reported pain, although one participant reported discomfort. CONCLUSION As a bacterial control method for residual pockets in patients undergoing supportive periodontal therapy, transgingival aPDT is a promising treatment strategy that is not generally accompanied by pain or discomfort.
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Affiliation(s)
- Jun-Ichiro Hayashi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Kohta Ono
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Yuki Iwamura
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Yasuyuki Sasaki
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Tasuku Ohno
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Ryoma Goto
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Eisaku Nishida
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Genta Yamamoto
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Takeshi Kikuchi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Naoya Higuchi
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Akio Mitani
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
| | - Mitsuo Fukuda
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Aichi, Japan
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Vhanmane P, Nandy R, Mangalekar SB, Rai J, Sagare SV, Kumbhare S. A Comparative Clinical Evaluation of Subgingivally Delivered 0.5% Azithromycin Gel and 1% Chlorhexidine Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S2250-S2252. [PMID: 39346157 PMCID: PMC11426673 DOI: 10.4103/jpbs.jpbs_193_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 10/01/2024] Open
Abstract
Background Chronic periodontitis is a prevalent inflammatory condition affecting the supporting structures of teeth. Adjunctive therapies to scaling and root planing (SRP) play a crucial role in enhancing treatment outcomes. This study aimed to compare the clinical effectiveness of subgingivally delivered 0.5% azithromycin gel and 1% chlorhexidine gel as adjuncts to SRP in the management of chronic periodontitis. Materials and Methods A comparative clinical evaluation was conducted involving 60 participants diagnosed with chronic periodontitis. They were randomly assigned to two groups: Group A received subgingival application of 0.5% azithromycin gel after SRP, whereas Group B received 1% chlorhexidine gel in a similar manner. Clinical parameters including probing pocket depth (PPD), clinical attachment level (CAL), and gingival index (GI) were recorded at baseline and 3-month follow-up. Results Both groups demonstrated significant improvements in clinical parameters after treatment. However, Group A exhibited a greater reduction in PPD (mean decrease of 2.5 mm) compared with Group B (mean decrease of 1.8 mm). Similarly, Group A showed a higher gain in CAL (mean gain of 2.3 mm) compared with Group B (mean gain of 1.5 mm). In addition, a significant reduction in GI was observed in both groups, with Group A showing slightly better outcomes. Conclusion Subgingivally delivered 0.5% azithromycin gel demonstrated superior clinical efficacy as an adjunct to SRP in the treatment of chronic periodontitis compared with 1% chlorhexidine gel. The findings suggest that azithromycin gel may serve as a promising therapeutic option in managing periodontal disease.
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Affiliation(s)
- Priyanka Vhanmane
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University), Pune, Dental College and Hospital, Sangli, Maharashtra, India
| | - Rishi Nandy
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University), Pune, Dental College and Hospital, Sangli, Maharashtra, India
| | - Sachin B Mangalekar
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University), Pune, Dental College and Hospital, Sangli, Maharashtra, India
| | - Jeeth Rai
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University), Pune, Dental College and Hospital, Sangli, Maharashtra, India
| | - Shweta V Sagare
- Department of Conservative and Endodontics, Bharati Vidyapeeth (Deemed to be University), Pune, Dental College and Hospital, Sangli, Maharashtra, India
| | - Shruti Kumbhare
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University), Pune, Dental College and Hospital, Sangli, Maharashtra, India
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Takeuchi Y, Aoki A, Hiratsuka K, Chui C, Ichinose A, Aung N, Kitanaka Y, Hayashi S, Toyoshima K, Iwata T, Arakawa S. Application of Different Wavelengths of LED Lights in Antimicrobial Photodynamic Therapy for the Treatment of Periodontal Disease. Antibiotics (Basel) 2023; 12:1676. [PMID: 38136710 PMCID: PMC10740818 DOI: 10.3390/antibiotics12121676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Therapeutic light has been increasingly used in clinical dentistry for surgical ablation, disinfection, bio-stimulation, reduction in inflammation, and promotion of wound healing. Photodynamic therapy (PDT), a type of phototherapy, has been used to selectively destroy tumor cells. Antimicrobial PDT (a-PDT) is used to inactivate causative bacteria in infectious oral diseases, such as periodontitis. Several studies have reported that this minimally invasive technique has favorable therapeutic outcomes with a low probability of adverse effects. PDT is based on the photochemical reaction between light, a photosensitizer, and oxygen, which affects its efficacy. Low-power lasers have been predominantly used in phototherapy for periodontal treatments, while light-emitting diodes (LEDs) have received considerable attention as a novel light source in recent years. LEDs can emit broad wavelengths of light, from infrared to ultraviolet, and the lower directivity of LED light appears to be suitable for plaque control over large and complex surfaces. In addition, LED devices are small, lightweight, and less expensive than lasers. Although limited evidence exists on LED-based a-PDT for periodontitis, a-PDT using red or blue LED light could be effective in attenuating bacteria associated with periodontal diseases. LEDs have the potential to provide a new direction for light therapy in periodontics.
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Affiliation(s)
- Yasuo Takeuchi
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan;
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
| | - Koichi Hiratsuka
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan;
| | | | - Akiko Ichinose
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
- Waseda Research Institute for Science and Engineering, Waseda University, Tokyo 169-8555, Japan
| | - Nay Aung
- Laser Light Dental Clinic Periodontal and Implant Center, Yangon 11241, Myanmar;
| | - Yutaro Kitanaka
- Department of Oral Diagnosis and General Dentistry, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan;
| | - Sakura Hayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
| | - Keita Toyoshima
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (A.I.); (S.H.); (K.T.); (T.I.)
| | - Shinich Arakawa
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan;
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Muacevic A, Adler JR, Sudhakar U, Raghavan A, Narayan KV. Effects of Non-surgical Periodontal Therapy on Saliva and Gingival Crevicular Fluid Levels of Chemerin in Periodontitis Subjects With and Without Type 2 Diabetes Mellitus. Cureus 2023; 15:e33388. [PMID: 36751175 PMCID: PMC9899038 DOI: 10.7759/cureus.33388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/06/2023] Open
Abstract
Background Evidence had shown a bi-directional link between diabetes mellitus and periodontitis. Chemerin, an adipose tissue-specific adipokine plays a significant role in adipocyte initiation and differentiation that directly influences glucose metabolism, lipid metabolism, and inflammatory mediators. Non-surgical periodontal therapy (NSPT) for patients with periodontitis and diabetes mellitus improves the periodontal condition and regulates glycemic level. Aims and objectives To assess the impact of chemerin on periodontal disease and diabetes mellitus pathogenesis and to analyze the impact of NSPT on saliva and gingival crevicular fluid (GCF) chemerin levels in patients with periodontitis with and without type 2 diabetes mellitus (T2DM). Materials and methods A total of 60 patients were divided into four groups: Group I: Systemically and periodontally healthy subjects (n=15), Group II: Systemically healthy subjects with periodontitis (n=15), Group III: Subjects with periodontitis and T2DM (n=15), Group IV: Periodontally healthy subjects with T2DM (n=15). Indices and parameters like plaque index (PI), gingival index (GI), periodontal probing depth (PPD), and clinical attachment level (CAL) were assessed at baseline in all four groups and six weeks after NSPT in Group II and Group III. A glycated hemoglobin (HbA1c) test was taken to assess the patient's blood glucose level. Fasting blood sugar (FBS) level was taken at baseline in all the groups and six weeks after NSPT in Group II and Group III subjects. Saliva and GCF chemerin levels were assessed at baseline in all four groups and six weeks after NSPT in Group II and Group III subjects. Results A statistically significant difference was observed in comparing chemerin levels at baseline with all four groups (p < 0.001). After NSPT, there was a reduction in clinical parameters, FBS, and chemerin levels in Group II and Group III. A positive correlation was observed between salivary chemerin and FBS in Group II, GCF chemerin, PI, and FBS in Group II, and PPD and FBS in Group III. A negative correlation was observed between salivary chemerin and all parameters in Group II and between salivary chemerin and GCF chemerin in Group III. Conclusion Based on the observed relationship between chemerin and the parameters, their utility as a dual biomarker for diagnosis and prognosis in periodontal disease seems promising. However, further studies with a larger sample size on the role of chemerin in health and various states of diseases are required to substantiate the result of the study.
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Dembowska E, Samulak R, Jędrzychowska A, Dołęgowska B. Effects of a 980 nm Diode Laser as an Adjunct to Nonsurgical Periodontal Therapy on Periodontal Status and Inflammatory Markers in Patients After Myocardial Infarction: A Randomized Controlled Trial. Photobiomodul Photomed Laser Surg 2022; 40:532-542. [DOI: 10.1089/photob.2021.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Elżbieta Dembowska
- Department of Periodontology, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Renata Samulak
- Department of Periodontology, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Adriana Jędrzychowska
- Department of Medical Analytics, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Abstract
Causes of the progression of periodontitis such as an imbalance between the immune response by the host by the release of inflammatory mediators in the response of the oral pathogenic dysbiotic biofilm have been identified. New insights on specific cell signaling pathways that appear during periodontitis have attracted the attention of researchers in the study of new personalised approaches for the treatment of periodontitis. The gold standard of non-surgical therapy of periodontitis involves the removal of supra and subgingival biofilm through professional scaling and root planing (SRP) and oral hygiene instructions. In order to improve periodontal clinical outcomes and overcome the limitations of traditional SRP, additional adjuvants have been developed in recent decades, including local or systemic antibiotics, antiseptics, probiotics, anti-inflammatory and anti-resorptive drugs and host modulation therapies. This review is aimed to update the current and recent evolution of therapies of management of periodontitis based on the adjunctive and target therapies. Moreover, we discuss the advances in host modulation of periodontitis and the impact of targeting epigenetic mechanisms approaches for a personalised therapeutic success in the management of periodontitis. In conclusion, the future goal in periodontology will be to combine and personalise the periodontal treatments to the colonising microbial profile and to the specific response of the individual patient.
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Kitanaka Y, Takeuchi Y, Hiratsuka K, Aung N, Sakamaki Y, Nemoto T, Meinzer W, Izumi Y, Iwata T, Aoki A. The effect of antimicrobial photodynamic therapy using yellow-green LED and rose bengal on Porphyromonas gingivalis. Photodiagnosis Photodyn Ther 2020; 32:102033. [PMID: 33011393 DOI: 10.1016/j.pdpdt.2020.102033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION This study aimed to investigate the effects of a new antimicrobial photodynamic therapy (aPDT) system using yellow-green light-emitting diode (YGL) and rose bengal (RB) on Porphyromonas gingivalis (Pg) in vitro. MATERIALS AND METHODS Pg suspension mixed with RB was irradiated with YGL (565 nm) or blue light-emitting diode (BL, 470 nm) at 428 mW/cm2 in comparison with chlorhexidine (CHG) treatment. The cells were cultured anaerobically on agar plates, and the number of colony-forming units (CFU) was determined. The treated suspension was anaerobically incubated, and the cell density (OD600nm) was monitored for 24 h. Also, the viability of treated human gingival fibroblast (HGF-1) was measured using WST-8 assay. Pg morphology was observed with a scanning electron microscope. The RNA integrity number of aPDT-treated Pg was determined and gene expressions were evaluated by quantitative real-time polymerase chain reaction. RESULTS RB + YGL (aPDT) demonstrated a significantly higher reduction of CFU, compared to RB + BL (aPDT) and CHG, furthermore the OD value rapidly decreased. Morphological changes of Pg with RB + YGL were more severe than with CHG. Although RB + YGL reduced HGF-1 viability, aPDT's impact was significantly lower than CHG's. With RB + YGL treatment, RIN values decreased; furthermore, gene expressions associated with DNA replication and cell division were remarkably decreased after 12 h. CONCLUSION The results of this study demonstrated that a novel aPDT system using RB + YGL may have potential as a new technical modality for bacterial elimination in periodontal therapy.
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Affiliation(s)
- Yutaro Kitanaka
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koichi Hiratsuka
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan.
| | - Nay Aung
- Laser Light Dental Clinic, Yangon, Myanmar
| | - Yuriko Sakamaki
- Research Core, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takashi Nemoto
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan; Oral Care Perio Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
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Delatola C, Loos BG, Laine ML. Three periodontitis phenotypes: Bone loss patterns, antibiotic-surgical treatment and the new classification. J Clin Periodontol 2020; 47:1371-1378. [PMID: 32767568 PMCID: PMC7693056 DOI: 10.1111/jcpe.13356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 07/03/2020] [Accepted: 07/27/2020] [Indexed: 12/18/2022]
Abstract
AIM To compare three periodontitis clusters (A, B and C) for alveolar bone loss (ABL) patterns, antibiotic prescriptions and surgeries and to relate them to the new classification of periodontitis. MATERIALS AND METHODS ABL patterns, prescription of systemic antibiotics and the number of surgeries were retrieved for all patients (n = 353) in the clusters. Comparisons and possible predictors for antibiotics were assessed, and results also evaluated in relation to the new classification. RESULTS Cluster A is characterized by angular defects often affecting the first molars and localized stage III/IV grade C periodontitis. Cluster B contains mainly localized or generalized stage III/IV, grade C patients. Cluster C contains mainly patients with generalized stage III/IV grade C periodontitis. Patients in cluster A received significantly more antibiotics compared to B and C (78% vs. 23% and 17%); the predictors for antibiotic prescription were young age and localized ABL. No differences in numbers of periodontal surgeries were observed between clusters (A = 1.0 ± 1.4, B = 1.3 ± 1.4 and C = 1.3 ± 1.5). CONCLUSIONS Within stage III/IV grade C periodontitis, we could detect three clusters of patients. The distinct localized ABL pattern and younger age in cluster A presumably prompted clinicians to prescribe antibiotics.
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Affiliation(s)
- Chryssa Delatola
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Samulak R, Suwała M, Dembowska E. Nonsurgical periodontal therapy with/without 980 nm diode laser in patients after myocardial infarction: a randomized clinical trial. Lasers Med Sci 2020; 36:1003-1014. [PMID: 32885341 PMCID: PMC8222017 DOI: 10.1007/s10103-020-03136-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to evaluate the possible benefits (in terms of periodontal status improvement and periodontal bacteria count reduction) of using 980 nm diode laser in the treatment of periodontitis in patients after myocardial infarction. Thirty-six patients under 65 years of age (mean: 56.3 ± 7.9) with periodontitis, 6 weeks to 6 months after myocardial infarction, were recruited for the study. The control group (n = 18) received SRP (scaling, root planing and polishing) while the test group (n = 18) received SRP followed by laser therapy of the periodontal pockets with 980 nm diode laser, 1 W, continuous wave mode, 20 s per tooth side. Procedures were repeated twice at 5-7 day intervals. Microbiological and periodontal examination, including periodontal pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP) and plaque control record (PCR), were performed before treatment, 2 weeks and 3 months after treatment. The study was registered on ClinicalTrials.gov with Identifier: NCT04145557, 29.10.2019 "retrospectively registered". Additional use of laser resulted in a significant reduction in pockets with PPD ≥ 7 mm (p = 0.0151). The diode laser reduced total bacteria count (p = 0.0154) and delayed recolonisation during a 3-month observation period. A significant increase in the number of Capnocytophaga gingivalis was observed in the control group (p = 0.048). Additional use of the diode laser after SRP had no significant effect on BOP, CAL and PCR. Within the limitations of our study, we can conclude that 980 nm diode laser can be a useful tool in the treatment of periodontitis in patients after myocardial infarction.
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Affiliation(s)
- Renata Samulak
- Department of Periodontology, Pomeranian Medical University in Szczecin, Szczecin, Poland.
| | - Mariusz Suwała
- Department of Periodontology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Elżbieta Dembowska
- Department of Periodontology, Pomeranian Medical University in Szczecin, Szczecin, Poland
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López‐Píriz R, Cabal B, Goyos‐Ball L, Fernández A, Bartolomé JF, Moya JS, Torrecillas R. Current state‐of‐the‐art and future perspectives of the three main modern implant‐dentistry concerns: Aesthetic requirements, mechanical properties, and peri‐implantitis prevention. J Biomed Mater Res A 2019; 107:1466-1475. [DOI: 10.1002/jbm.a.36661] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/24/2019] [Accepted: 02/14/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Roberto López‐Píriz
- Nanomaterials and Nanotechnology Research Centre (CINN)Universidad de Oviedo (UO), Consejo Superior de Investigaciones Científicas (CSIC), Principado de Asturias (PA) Avenida de la Vega 4‐6, El Entrego Asturias, 33940 Spain
| | - Belén Cabal
- Nanomaterials and Nanotechnology Research Centre (CINN)Universidad de Oviedo (UO), Consejo Superior de Investigaciones Científicas (CSIC), Principado de Asturias (PA) Avenida de la Vega 4‐6, El Entrego Asturias, 33940 Spain
| | - Lidia Goyos‐Ball
- Nanoker Research, Pol. Ind. Olloniego, Department of Research and Development Parcela 22A, Nave 5, 33660, Oviedo Spain
| | - Adolfo Fernández
- Nanomaterials and Nanotechnology Research Centre (CINN)Universidad de Oviedo (UO), Consejo Superior de Investigaciones Científicas (CSIC), Principado de Asturias (PA) Avenida de la Vega 4‐6, El Entrego Asturias, 33940 Spain
| | - José F. Bartolomé
- Instituto de Ciencia de Materiales de Madrid (ICMM), Department of Energy, Environment and Health, Consejo Superior de Investigaciones Científicas (CSIC) Calle Sor Juana Inés de la Cruz 3, Madrid, 28049 Spain
| | - Jose S. Moya
- Nanomaterials and Nanotechnology Research Centre (CINN)Universidad de Oviedo (UO), Consejo Superior de Investigaciones Científicas (CSIC), Principado de Asturias (PA) Avenida de la Vega 4‐6, El Entrego Asturias, 33940 Spain
| | - Ramón Torrecillas
- Nanomaterials and Nanotechnology Research Centre (CINN)Universidad de Oviedo (UO), Consejo Superior de Investigaciones Científicas (CSIC), Principado de Asturias (PA) Avenida de la Vega 4‐6, El Entrego Asturias, 33940 Spain
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Jepsen K, Jepsen S. Antibiotics/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced periodontitis. Periodontol 2000 2017; 71:82-112. [PMID: 27045432 DOI: 10.1111/prd.12121] [Citation(s) in RCA: 179] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 02/06/2023]
Abstract
This review gives an update of the current scientific evidence on the efficacy of the adjunctive use of systemic and local antibiotics/antimicrobials in the treatment of periodontitis. In particular, it addresses whether their use can improve the results of nonsurgical mechanical therapy in mild-to-moderate forms of the disease. Large numbers of randomized clinical trials and systematic reviews with meta-analyses have clearly established that adjunctive systemic antibiotics, combined with mechanical debridement, offer clinical improvements additional to those obtained with scaling and root planing alone. These effects are more pronounced in aggressive periodontitis and in initially deep pockets, whereas more limited additional improvements, of 0.3 mm for additional pocket reduction and 0.2 mm for additional clinical attachment gain, have been documented for moderately deep sites (4-6 mm) in patients with chronic periodontitis. The marginal clinical benefit in patients with moderate disease has to be balanced against possible side effects. Notably, it has to be realized that an increasing number of warnings have been articulated against the unrestricted use of antibiotics in treating periodontal diseases because of the emerging global public health issue of bacterial resistance. The effects of the adjunctive local administration of antimicrobials have also been very well documented in several systematic reviews. Overall, in persistent or recurrent localized deep sites, the application of antimicrobials by sustained-delivery devices may offer a benefit of an additional 0.4 mm in pocket depth reduction and 0.3 mm in clinical attachment level gain. In conclusion, the slight additional benefits of adjunctive antimicrobials, which were shown for moderate forms of periodontitis, have to be balanced against their side effects and therefore their prescription should be limited as much as possible.
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Gerits E, Spincemaille P, De Cremer K, De Brucker K, Beullens S, Thevissen K, Cammue BPA, Vandamme K, Fauvart M, Verstraeten N, Michiels J. Repurposing AM404 for the treatment of oral infections by Porphyromonas gingivalis. Clin Exp Dent Res 2017; 3:69-76. [PMID: 29744181 PMCID: PMC5719815 DOI: 10.1002/cre2.65] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 03/04/2017] [Accepted: 03/14/2017] [Indexed: 01/21/2023] Open
Abstract
Porphyromonas gingivalis is a major pathogen involved in oral diseases such as periodontitis and peri‐implantitis. Management of these diseases typically includes mechanical debridement of the colonized surfaces followed by application of antiseptics or antibiotics. Disadvantages associated with the use of antiseptics and the growing worldwide problem of antibiotic resistance have necessitated the search for alternative agents. In this study, the antibacterial and antibiofilm properties of AM404, an active metabolite of paracetamol, were tested against P. gingivalis and other bacterial pathogens. The activity of AM404 was tested against 10 bacteria, including both oral and nonoral human pathogens. The minimal inhibitory concentration (MIC) of AM404 was determined by measuring optical density (OD) values. The minimum biofilm inhibitory concentration (MBIC) was detected by crystal violet staining. The activity of structural analogs of AM404 was tested by MIC determinations. The effect of AM404 on P. gingivalis biofilms formed on titanium disks as a model for dental implants was evaluated by colony forming unit counting. Potential cytotoxicity of AM404 towards HEK‐293 (human embryonic kidney cells), HepG2 (human hepatoma cells), IEC‐6 (rat intestinal cells), and Panc‐1 cells (pancreatic cancer cells) was assessed by 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide assays. To get more insight in the mode of action of AM404, we used the fluorescent dyes N‐phenyl‐1‐napthylamine and SYTOX green to investigate outer and inner membrane damage of P. gingivalis induced by AM404, respectively. Of all tested pathogens, AM404 only inhibited growth and biofilm formation of P. gingivalis. Moreover, it showed potent activity against P. gingivalis biofilms formed on titanium surfaces. A structure–activity analysis demonstrated that the unsaturated carbon chain is essential for its antibacterial activity. Importantly, AM404 was not toxic towards the tested mammalian cells up to concentrations approaching 4× the MIC. Membrane damage assays using fluorescent probes N‐phenyl‐1‐napthylamine and SYTOX green revealed that membrane permeabilization presumably is the primary antibacterial mode of action of AM404. Collectively, our results suggest that AM404 has the potential to be used for the development of new drugs specifically targeting P. gingivalis‐related infections.
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Affiliation(s)
- Evelien Gerits
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium
| | - Pieter Spincemaille
- Department of Laboratory Medicine University Hospitals Leuven Leuven Belgium
| | - Kaat De Cremer
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium.,Department of Plant Systems Biology VIB Ghent Belgium
| | - Katrijn De Brucker
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium
| | - Serge Beullens
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium
| | - Karin Thevissen
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium
| | - Bruno P A Cammue
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium.,Department of Plant Systems Biology VIB Ghent Belgium
| | - Katleen Vandamme
- Department of Oral Health Sciences UZ Leuven, Restorative Dentistry-KU Leuven, BIOMAT Leuven Belgium
| | - Maarten Fauvart
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium.,Department of Life Science Technologies imec, Smart Systems and Emerging Technologies Unit Belgium
| | - Natalie Verstraeten
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium
| | - Jan Michiels
- Department of Microbial and Molecular Systems KU Leuven, Centre of Microbial and Plant Genetics Leuven Belgium
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Gerits E, Verstraeten N, Michiels J. New approaches to combat Porphyromonas gingivalis biofilms. J Oral Microbiol 2017; 9:1300366. [PMID: 28473880 PMCID: PMC5405727 DOI: 10.1080/20002297.2017.1300366] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/01/2017] [Accepted: 02/22/2017] [Indexed: 12/14/2022] Open
Abstract
In nature, bacteria predominantly reside in structured, surface-attached communities embedded in a self-produced, extracellular matrix. These so-called biofilms play an important role in the development and pathogenesis of many infections, as they are difficult to eradicate due to their resistance to antimicrobials and host defense mechanisms. This review focusses on the biofilm-forming periodontal bacterium Porphyromonas gingivalis. Current knowledge on the virulence mechanisms underlying P. gingivalis biofilm formation is presented. In addition, oral infectious diseases in which P. gingivalis plays a key role are described, and an overview of conventional and new therapies for combating P. gingivalis biofilms is given. More insight into this intriguing pathogen might direct the development of better strategies to combat oral infections.
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Affiliation(s)
- Evelien Gerits
- Department of Microbial and Molecular Systems, KU Leuven, Centre of Microbial and Plant Genetics, Leuven, Belgium
| | - Natalie Verstraeten
- Department of Microbial and Molecular Systems, KU Leuven, Centre of Microbial and Plant Genetics, Leuven, Belgium
| | - Jan Michiels
- Department of Microbial and Molecular Systems, KU Leuven, Centre of Microbial and Plant Genetics, Leuven, Belgium
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15
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Li H, Ji Q, Chen X, Sun Y, Xu Q, Deng P, Hu F, Yang J. Accelerated bony defect healing based on chitosan thermosensitive hydrogel scaffolds embedded with chitosan nanoparticles for the delivery of BMP2 plasmid DNA. J Biomed Mater Res A 2016; 105:265-273. [PMID: 27636714 DOI: 10.1002/jbm.a.35900] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/27/2016] [Accepted: 09/13/2016] [Indexed: 01/13/2023]
Affiliation(s)
- Hui Li
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
- Department of Stomatology; Beijing Tongzhou Xinhua Hospital; Tongzhou Beijing 101100 China
| | - Qiuxia Ji
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Ximin Chen
- Orthopedic Center; Qilu Hospital of Shandong University; Qingdao Shandong 266035 China
| | - Yan Sun
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Quanchen Xu
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Panpan Deng
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Fang Hu
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Jianjun Yang
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
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16
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Shabbir A, Rashid M, Tipu HN. Propolis, A Hope for the Future in Treating Resistant Periodontal Pathogens. Cureus 2016; 8:e682. [PMID: 27563508 PMCID: PMC4985230 DOI: 10.7759/cureus.682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/12/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Periodontitis is one of the most common causes of tooth loss worldwide. Recently, special attention has been paid to natural medication for its treatment. For this purpose, propolis (bee glue) activity has also been investigated. Its antibacterial properties are mainly attributed to flavonones pinocembrin, flavonols galangin and to the caffeic acid phenethyl ester. This study is aimed at evaluating the antimicrobial effects of propolis from Pakistan on 35 clinical isolates of pigmented anaerobic periodontal pathogens. METHODS This study was conducted in the Microbiology department, University of Health Sciences, Lahore, Pakistan. Pathogens included were Porphyromonas asaccharolytica (n=9), Porphyromonas gingivalis (n=13), Prevotella intermedia (n=9), Prevotella melaninogenica (n=4). Minimum inhibitory concentration (MIC) to three antibiotics was obtained by E-test method. All strains were sensitive to amoxicillin plus clavulanic acid and metronidazole, but 100% of P asaccharolytica and P melaninogenica strains displayed intermediate resistance to tetracycline while 69.2% P gingivalis and 100% P intermedia strains exhibited complete resistance to tetracycline. Screening for antibacterial activity of propolis extract was done by agar well diffusion assay, and all strains were found sensitive to ethanolic extract of propolis. RESULTS MIC was obtained by agar incorporation technique with values ranging from 0.064 to 0.512 mg/ml. It was also noticed that percentage yield of ethanolic extract of propolis prepared from ultrasonic extraction method was higher compared to extract obtained with maceration. CONCLUSION These results indicate that propolis from this region has potent antimicrobial activity against pigmented anaerobic periodontal pathogens. Taking into consideration the increasing resistance in anaerobic bacteria, this effective antimicrobial activity of propolis gives hope in the treatment of oral cavity diseases.
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Affiliation(s)
- Ambreen Shabbir
- Pathology, Prince Sultan Military College of Health Sciences, Dhahran, KSA
| | - Maryam Rashid
- Pharmacology, Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | - Hamid N Tipu
- Immunology, Armed Forces Institute of Pathology, Pakistan
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17
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Antimicrobial Peptide P60.4Ac-Containing Creams and Gel for Eradication of Methicillin-Resistant Staphylococcus aureus from Cultured Skin and Airway Epithelial Surfaces. Antimicrob Agents Chemother 2016; 60:4063-72. [PMID: 27114278 DOI: 10.1128/aac.03001-15] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/20/2016] [Indexed: 12/28/2022] Open
Abstract
We previously found the LL-37-derived peptide P60.4Ac to be effective against methicillin-resistant Staphylococcus aureus (MRSA) on human epidermal models (EMs). The goal of this study was to identify the preferred carrier for this peptide for topical application on skin and mucosal surfaces. We prepared P60.4Ac in three formulations, i.e., a water-in-oil cream with lanolin (Softisan 649), an oil-in-water cream with polyethylene glycol hexadecyl ether (Cetomacrogol), and a hydroxypropyl methylcellulose (hypromellose) 4000 gel. We tested the antimicrobial efficacy of the peptide in these formulations against mupirocin-resistant and -sensitive MRSA strains on EMs and bronchial epithelial models (BEMs). The cytotoxic effects of formulated P60.4Ac on these models were determined using histology and WST-1 and lactate dehydrogenase assays. Moreover, we assessed the stability of the peptide in these formulations with storage for up to 3 months. Killing of MRSA by P60.4Ac in the two creams was less effective than that by P60.4Ac in the hypromellose gel. In agreement with those findings, P60.4Ac in the hypromellose gel was highly effective in eradicating the two MRSA strains from EMs. We found that even 0.1% (wt/wt) P60.4Ac in the hypromellose gel killed >99% of the viable planktonic bacteria and >85% of the biofilm-associated bacteria on EMs. Hypromellose gels containing 0.1% and 0.5% (wt/wt) P60.4Ac effectively reduced the numbers of viable MRSA cells from BEMs by >90%. No cytotoxic effects of P60.4Ac in the hypromellose gel with up to 2% (wt/wt) P60.4Ac on keratinocytes in EMs and in the hypromellose gel with up to 0.5% (wt/wt) P60.4Ac on epithelial cells in BEMs were observed. High-performance liquid chromatography analysis showed that P60.4Ac was stable in the Softisan cream and the hypromellose gel but not in the Cetomacrogol cream. We conclude that P60.4Ac formulated in hypromellose gel is both stable and highly effective in eradicating MRSA from colonized EMs and BEMs.
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Uekubo A, Hiratsuka K, Aoki A, Takeuchi Y, Abiko Y, Izumi Y. Effect of antimicrobial photodynamic therapy using rose bengal and blue light-emitting diode on Porphyromonas gingivalis in vitro: Influence of oxygen during treatment. Laser Ther 2016; 25:299-308. [PMID: 28765675 DOI: 10.5978/islsm.16-or-25] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Aims: A combination of rose bengal (RB) and blue LED (BL) has emerged as a new technical modality for antimicrobial photodynamic therapy (a-PDT). The purpose of this study was to clarify the influence of oxygen on the antimicrobial effect of RB + BL treatment on Porphyromonas gingivalis in vitro.Materials and Methods:P. gingivalis cells were treated with RB, BL (450-470 nm; 1 W/cm2, 5 s), or RB + BL under anaerobic/aerobic conditions. Cells were incubated anaerobically, and the cell density (OD600 nm) was measured after 6-48 h. Additionally, cells were cultured anaerobically on blood agar plates for 9 days, and the resulting colonies were observed. Bacterial growth within 1 h of aerobic RB + BL treatment was examined, and RNA degradation due to anaerobic/aerobic RB + BL treatment was measured after 3 h of culture. Results: Under anaerobic conditions, RB + BL significantly suppressed bacterial growth after 18 h; however, the growth after 48 h and the number of colonies after 9 days were similar to those of the untreated control. RNA degradation in the anaerobic-treatment group was not significantly different from that in the control. Under aerobic conditions, RB + BL immediately affected bacterial growth and completely inhibited growth for up to 48 h. Few colonies were detected even after 9 days of culture, and RNA was completely degraded. Conclusions: Unlike the bacteriostatic effect of anaerobic treatment, aerobic RB + BL treatment may have a bactericidal action via a-PDT effect, resulting in the destruction of RNA and bacterial cells within a short period.
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Affiliation(s)
- Ayano Uekubo
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichi Hiratsuka
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshimitsu Abiko
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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John P, Lazarus F, George JP, Selvam A, Prabhuji MLV. Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study. J Clin Diagn Res 2015; 9:ZC70-4. [PMID: 26155567 DOI: 10.7860/jcdr/2015/11534.5965] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/25/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. AIM The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). SETTINGS AND DESIGN The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. MATERIALS AND METHODS In a split-mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. RESULTS In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. CONCLUSION The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis.
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Affiliation(s)
- Priya John
- Senior Lecturer, Mar Baselious Dental College , Kothamangalam, Kerala, India
| | - Flemingson Lazarus
- Former Professor and HOD, Department of Periodontology, Best Dental College , Madurai, India
| | - Joann Pauline George
- Professor, Department of Periodontics, Krishnadevaraya College of Dental Sciences , Bangalore, India
| | - Arul Selvam
- Professor and HOD, Department of Microbiology, Krishnadevaraya College of Dental Sciences , Bangalore, India
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Heitz-Mayfield LJA, Lang NP. Surgical and nonsurgical periodontal therapy. Learned and unlearned concepts. Periodontol 2000 2014; 62:218-31. [PMID: 23574468 DOI: 10.1111/prd.12008] [Citation(s) in RCA: 182] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This review aims to highlight concepts relating to nonsurgical and surgical periodontal therapy, which have been learned and unlearned over the past few decades. A number of treatment procedures, such as gingival curettage and aggressive removal of contaminated root cementum, have been unlearned. Advances in technology have resulted in the introduction of a range of new methods for use in nonsurgical periodontal therapy, including machine-driven instruments, lasers, antimicrobial photodynamic therapy and local antimicrobial-delivery devices. However, these methods have not been shown to offer significant benefits over and above nonsurgical debridement using hand instruments. The method of debridement is therefore largely dependent on the preferences of the operator and the patient. Recent evidence indicates that specific systemic antimicrobials may be indicated for use as adjuncts to nonsurgical debridement in patients with advanced disease. Full-mouth disinfection protocols have been proven to be a relevant treatment option. We have learned that while nonsurgical and surgical methods result in similar long-term treatment outcomes, surgical therapy results in greater probing-depth reduction and clinical attachment gain in initially deep pockets. The surgical technique chosen seems to have limited influence upon changes in clinical attachment gain. What has not changed is the importance of thorough mechanical debridement and optimal plaque control for successful nonsurgical and surgical periodontal therapy.
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Chui C, Aoki A, Takeuchi Y, Sasaki Y, Hiratsuka K, Abiko Y, Izumi Y. Antimicrobial effect of photodynamic therapy using high-power blue light-emitting diode and red-dye agent on Porphyromonas gingivalis. J Periodontal Res 2013; 48:696-705. [PMID: 23441868 DOI: 10.1111/jre.12055] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Antimicrobial photodynamic therapy (a-PDT) using a combination of red-colored laser/light-emitting diode (LED) and blue dye has been employed for periodontal therapy and the antimicrobial effect seems promising. Blue light, which has favorable wavelength properties, would be more effective as a light source for a-PDT because blue light itself possesses an antimicrobial effect. This study aimed to investigate the effect of a-PDT using a novel combination of high-power blue LED and red-dye agent on Porphyromonas gingivalis in vitro. MATERIAL AND METHODS Porphyromonas gingivalis ATCC 33277 suspension was irradiated with blue LED (BL) (425-470 nm) or red LED (RL) (625-635 nm) at 30-90 J/cm(2) , or was mixed with erythrosine (ER), phloxine B (PB) or rose bengal (RB) with or without BL irradiation (30 J/cm(2) ). RL (30 J/cm(2) ) in combination with toluidine blue was employed as positive control. All the suspensions of P. gingivalis were serially diluted, plated and incubated anaerobically, and the numbers of colony-forming units (CFUs) were counted on day 7. RESULTS BL irradiation at 60 and 90 J/cm(2) demonstrated a significant reduction in the numbers of CFUs. ER, PB and RB solutions at 160 μg/mL showed almost no or only a minimal reduction in the numbers of CFUs. BL at 30 J/cm(2) combined with ER, PB or RB at 160 μg/mL resulted in a log reduction of 0.9, 1.0 and 7.1, respectively, in the numbers of CFUs; 30 J/cm(2) BL with RB at 1.6, 16 and 160 μg/mL demonstrated a log reduction of 6.3, 8.0 and 5.5, respectively; and a log reduction of 5.2 was obtained after 30 J/cm(2) RL with 16 μg/mL TB. CONCLUSION Within the limits of this study, BL was found to have an antimicrobial/growth-inhibiting effect on P. gingivalis, and a-PDT using a combination of BL and RB shows promise as a new technical modality for bacterial elimination in periodontal therapy.
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Affiliation(s)
- C Chui
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University, Tokyo, Japan
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22
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Nagahara A, Mitani A, Fukuda M, Yamamoto H, Tahara K, Morita I, Ting CC, Watanabe T, Fujimura T, Osawa K, Sato S, Takahashi S, Iwamura Y, Kuroyanagi T, Kawashima Y, Noguchi T. Antimicrobial photodynamic therapy using a diode laser with a potential new photosensitizer, indocyanine green-loaded nanospheres, may be effective for the clearance of Porphyromonas gingivalis. J Periodontal Res 2013; 48:591-9. [PMID: 23317284 DOI: 10.1111/jre.12042] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) is a new treatment method for the removal of infectious pathogens using a photosensitizer and light of a specific wavelength, e.g., toluidine blue with a wavelength of about 600 nm. We explored a new photosensitizer and focused on indocyanine green (ICG), which has high absorption at a wavelength of 800-805 nm. We investigated the bactericidal effect of PDT on Porphyromonas gingivalis using a new photosensitizer, ICG-loaded nanospheres with an 805 nm wavelength low-level diode laser irradiation. METHODS We designed ICG-loaded nanospheres coated with chitosan (ICG-Nano/c) as a photosensitizer. A solution containing Porphyromonas gingivalis (10(8) CFU/mL) with or without ICG-Nano/c (or ICG) was prepared and irradiated with a diode laser or without laser irradiation as a negative control. The irradiation settings were 0.5 W with a duty ratio of 10%, for 3-100 ms in repeated pulse (RPT) or continuous wave mode. CFU were counted after 7 d of anaerobic culture. RESULTS We observed that ICG-Nano/c could adhere to the surface of P. gingivalis. When ICG-Nano/c was used for aPDT, irradiation with RPT 100 ms mode gave the lowest increase in temperature. Laser irradiation with ICG-Nano/c significantly reduced the number of P. gingivalis (i.e., approximately 2-log10 bacterial killing). The greatest bactericidal effect was found in the RPT 100 ms group. However, laser irradiation (RPT 100 ms) with ICG, as well as without photosensitizer, had no effect on the number of bacteria. CONCLUSIONS Within the limits of this study, ICG-Nano/c with low-level diode laser (0.5 W; 805 nm) irradiation showed an aPDT-like effect, which might be useful for a potential photodynamic periodontal therapy.
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Affiliation(s)
- A Nagahara
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Aichi, Japan
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Zandbergen D, Slot DE, Cobb CM, Van der Weijden FA. The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontol 2012; 84:332-51. [PMID: 22612369 DOI: 10.1902/jop.2012.120040] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The treatment of periodontitis frequently begins with a non-surgical phase that includes scaling and root planing (SRP) and, on occasion, the use of systemic antibiotics. The goal of this review is to systematically evaluate the data concerning the effect of the concomitant administration of amoxicillin and metronidazole adjunctive to SRP in adults who are otherwise healthy. METHODS The PubMed-MEDLINE, Cochrane-Central, and EMBASE databases were searched to April 1, 2012, to identify appropriate studies. Probing depth (PD), clinical attachment level (CAL), bleeding on probing, and plaque index were selected as outcome variables. Based on the extracted mean values and number of individuals, changes in weighted means were calculated and a meta-analysis conducted. RESULTS The search yielded 526 unique titles and abstracts. Ultimately, 35 studies were selected, describing 28 clinical trials meeting the eligibility criteria. The full-mouth weighted mean change for PD showed an improvement of 1.41 mm. The full-mouth weighted mean change for CAL showed a gain of 0.94 mm. CONCLUSION Systemic antimicrobial therapy using a combination of amoxicillin and metronidazole as an adjunct to SRP can enhance the clinical benefits of non-surgical periodontal therapy in adults who are otherwise healthy.
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Affiliation(s)
- Dina Zandbergen
- Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
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Euzebio Alves VT, de Andrade AKP, Toaliar JM, Conde MC, Zezell DM, Cai S, Pannuti CM, De Micheli G. Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial. Clin Oral Investig 2012; 17:87-95. [DOI: 10.1007/s00784-012-0703-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 02/21/2012] [Indexed: 01/16/2023]
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Abstract
The oral cavity of the hospitalized or bedridden elderly is often a reservoir for opportunistic pathogens associated with respiratory diseases. Commensal flora and the host interact in a balanced fashion and oral infections are considered to appear following an imbalance in the oral resident microbiota, leading to the emergence of potentially pathogenic bacteria. The definition of the process involved in colonization by opportunistic respiratory pathogens needs to elucidate the factors responsible for the transition of the microbiota from commensal to pathogenic flora. The regulatory factors influencing the oral ecosystem can be divided into three major categories: the host defense system, commensal bacteria, and external pathogens. In this article, we review the profile of these categories including the intricate cellular interaction between immune factors and commensal bacteria and the disturbance in homeostasis in the oral cavity of hospitalized or bedridden elderly, which facilitates oral colonization by opportunistic respiratory pathogens.
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Affiliation(s)
- Akio Tada
- Department of Oral Health, National Institute of Public Health, Wako, Saitama, Japan.
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Ji QX, Deng J, Xing XM, Yuan CQ, Yu XB, Xu QC, Yue J. Biocompatibility of a chitosan-based injectable thermosensitive hydrogel and its effects on dog periodontal tissue regeneration. Carbohydr Polym 2010. [DOI: 10.1016/j.carbpol.2010.06.045] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sigusch BW, Engelbrecht M, Völpel A, Holletschke A, Pfister W, Schütze J. Full-Mouth Antimicrobial Photodynamic Therapy inFusobacterium nucleatum–Infected Periodontitis Patients. J Periodontol 2010; 81:975-81. [DOI: 10.1902/jop.2010.090246] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment: a randomized controlled trial. Lasers Med Sci 2010; 26:43-8. [DOI: 10.1007/s10103-009-0753-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Accepted: 12/22/2009] [Indexed: 10/19/2022]
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Kaner D, Bernimoulin JP, Hopfenmüller W, Kleber BM, Friedmann A. Controlled-delivery chlorhexidine chip versus amoxicillin/metronidazole as adjunctive antimicrobial therapy for generalized aggressive periodontitis: a randomized controlled clinical trial. J Clin Periodontol 2007; 34:880-91. [PMID: 17850607 DOI: 10.1111/j.1600-051x.2007.01122.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Subgingival application of chlorhexidine via a controlled-delivery device (CHX chip) improves the clinical outcome of scaling/root planing (SRP) in therapy for chronic periodontitis. Generalized aggressive periodontitis (GAP) is commonly treated with SRP and adjunctive antimicrobial medication. To date, the efficacy of CHX chips in GAP therapy has not been evaluated. AIM To compare SRP plus adjunctive CHX chip placement with SRP plus adjunctive systemic amoxicillin/metronidazole with regard to clinical efficacy in first-line therapy for GAP. MATERIAL AND METHODS Thirty-six GAP patients were treated with SRP and randomly with either placement of CHX chips or systemic amoxicillin/metronidazole. Clinical attachment level (CAL), probing depth (PD), bleeding on probing (BoP) and suppuration (Pus) were measured at baseline, 3 and 6 months after therapy. RESULTS CAL, PD, BoP and Pus were significantly reduced in both groups after 3 months. In the CHX chip group, PD significantly increased again between 3 and 6 months. Finally, amoxicillin/metronidazole patients presented significantly more CAL "gain", PD reduction and less remaining deep sites after 6 months. Pus remained detectable in CHX chip patients only. CONCLUSIONS In first-line non-surgical therapy for GAP, SRP plus adjunctive systemic amoxicillin/metronidazole was more efficacious in clinically relevant measures of outcome than SRP plus adjunctive placement of CHX chips.
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Affiliation(s)
- Doğan Kaner
- Institute for Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Mundargi RC, Srirangarajan S, Agnihotri SA, Patil SA, Ravindra S, Setty SB, Aminabhavi TM. Development and evaluation of novel biodegradable microspheres based on poly(d,l-lactide-co-glycolide) and poly(ε-caprolactone) for controlled delivery of doxycycline in the treatment of human periodontal pocket: In vitro and in vivo studies. J Control Release 2007; 119:59-68. [PMID: 17331611 DOI: 10.1016/j.jconrel.2007.01.008] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Revised: 12/15/2006] [Accepted: 01/14/2007] [Indexed: 10/23/2022]
Abstract
This study reports on the development of novel biodegradable microspheres prepared by water-in-oil-water (W/O/W) double emulsion technique using the blends of poly(d,l-lactide-co-glycolide) (PLGA) and poly(epsilon-caprolactone) (PCL) in different ratios for the controlled delivery of doxycycline (DXY). Doxycycline encapsulation of up to 24% was achieved within the polymeric microspheres. Blend placebo microspheres, drug-loaded microspheres and pristine DXY were analyzed by Fourier transform infrared spectroscopy (FT-IR), which indicated no interaction between drug and polymers. Differential scanning calorimetry (DSC) on drug-loaded microspheres confirmed the polymorphism of DXY and indicated a molecular level dispersion of DXY in the microspheres. Scanning electron microscopy (SEM) confirmed the spherical nature and smooth surfaces of the microspheres produced. Mean particle size of the microspheres as measured by dynamic laser light scattering method ranged between 90 and 200 mum. In vitro release studies performed in 7.4 pH media indicated the release of DXY from 7 to 11 days, depending upon the blend ratio of the matrix. Up to 11 days, DXY concentrations in the gingival crevicular fluid were higher than the minimum inhibitory concentration of DXY against most of the periodontal pathogens. One of the developed formulations was subjected to in vivo efficacy studies in thirty sites of human periodontal pockets. Significant results were obtained with respect to both microbiological and clinical parameters up to 3 months even as compared to commercial DXY gel. Statistical analyses of the release data and in vivo results were performed using the analysis of variance (ANOVA) method.
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Lakhssassi N, Elhajoui N, Lodter JP, Pineill JL, Sixou M. Antimicrobial susceptibility variation of 50 anaerobic periopathogens in aggressive periodontitis: an interindividual variability study. ACTA ACUST UNITED AC 2005; 20:244-52. [PMID: 15943770 DOI: 10.1111/j.1399-302x.2005.00225.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIMS The frequent use of antibiotics in developed countries has led to the emergence of widespread bacterial resistance. In this study, the interindividual variability of the antibiotic susceptibility of 50 putative microorganisms in aggressive periodontitis patients has been evaluated by means of VC (variation coefficient). MATERIAL AND METHODS A total of 60 microbial samples were collected from 20 adult patients diagnosed with aggressive periodontitis (2-4 samples by patient). Bacterial strains of Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum, and Peptostreptococcus micros were isolated according to Slots' rapid identification method. The susceptibilities to 10 antibiotics were studied: penicillin G (PEN), ampicillin (AMP), amoxicillin (AMX), amoxicillin/clavulanate (AMC), tetracycline (TET), doxycycline (DOX), ciprofloxacin (CIP), erythromycin (ERY), spiramycin (SPI) and clindamycin (CLIN), using the Disk Diffusion Susceptibility test (DDS test: Kirby-Bauer's modified method for anaerobic bacteria). The broth microdilution Minimum Inhibitory Concentration test was carried out as a control test. RESULTS Among the 50 identified bacteria, 15 were P. gingivalis, 12 P. intermedia, 8 T. forsythia, 9 F. nucleatum, and 6 P. micros. The results of the DDS test show that penicillins (especially AMC, AMP, and AMX), cyclines (especially DOX) and CLIN are highly effective against the 50 anaerobic studied bacteria. CIP and ERY have the lowest efficacy against those bacteria. CIP shows a very variable activity according to anaerobic bacteria species, being particularly inactive against P. gingivalis and very efficient against T. forsythia and P. micros. SPI is also highly efficient but not against P. micros. CONCLUSIONS The interindividual susceptibility of principal periodontal pathogens to antibiotics is not homogeneous and seems to vary according to bacterial species and antimicrobial molecules. This variability seems to be greater with older molecules (PEN, TET, ERY) than with more recent ones, which indicates more stable results (AMC, AMX, AMP, and DOX). P. intermedia appeared to be the bacteria most resistant to penicillins and showed the highest coefficient variation. Together with scaling and root planing, the combination of two antibiotics would therefore seem to be recommended in the treatment of aggressive periodontitis, particularly in the presence of P. intermedia.
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Affiliation(s)
- N Lakhssassi
- Laboratory of Epidemiology and Infectious Diseases, Clinical Research Study Group, Faculty of Dentistry, Paul-Sabatier University, Toulouse, France
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Pawlowski AP, Chen A, Hacker BM, Mancl LA, Page RC, Roberts FA. Clinical effects of scaling and root planing on untreated teeth. J Clin Periodontol 2005; 32:21-8. [PMID: 15642054 DOI: 10.1111/j.1600-051x.2004.00626.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this report is to examine whether scaling and root planing (SRP) in one area of the mouth may affect periodontal improvement in untreated areas in the same patient, possibly through systemic effects of treatment. MATERIAL AND METHODS Twenty patients diagnosed with generalized aggressive periodontitis were randomized into treatment (n=11) and no treatment (n=9) groups. Within the treatment group, three quadrants were treated by SRP at week 0, 3, 12, and 24, while a single experimental quadrant remained untreated throughout the study. The outcome for all teeth was assessed using clinical parameters, subtraction radiography, and pathogenic bacteria levels in the subgingival flora over the 24-week study period. RESULTS Compared with sites in no treatment patients, the treated sites in the treated patients showed a 1 mm decrease in probing depth (PD) (p<0.01) and a 0.5 mm increase in bone height (p<0.01) by 24 weeks. In untreated sites within treated subjects, however, PDs tended to improve (p=0.09) but at a reduced rate compared with treated sites. The levels of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythensis (Bacteroides forsythus) remained unchanged in untreated sites while levels of Prevetolla intermedia and Treponema denticola tended to decrease as compared with controls but did not reach significance. CONCLUSIONS This study indicates that untreated sites in treated periodontitis patients show a trend towards clinical improvement and exhibit reductions in some but not all periodontopathic bacterial species tested.
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