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Figuero E, Serrano J, Arweiler NB, Auschill TM, Gürkan A, Emingil G. Supra and subgingival application of antiseptics or antibiotics during periodontal therapy. Periodontol 2000 2023. [PMID: 37766668 DOI: 10.1111/prd.12511] [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: 02/16/2023] [Revised: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 09/29/2023]
Abstract
Periodontal diseases (gingivitis and periodontitis) are characterized by inflammatory processes which arise as a result of disruption of the balance in the oral ecosystem. According to the current S3 level clinical practice guidelines, therapy of patients with periodontitis involves a stepwise approach that includes the control of the patient's risk factors and the debridement of supra and subgingival biofilm. This debridement can be performed with or without the use of some adjuvant therapies, including physical or chemical agents, host modulating agents, subgingivally locally delivered antimicrobials, or systemic antimicrobials. Therefore, the main aim of this article is to review in a narrative manner the existing literature regarding the adjuvant application of local agents, either subgingivally delivered antibiotics and antiseptics or supragingivally applied rinses and dentifrices, during the different steps in periodontal therapy performed in Europe.
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Affiliation(s)
- Elena Figuero
- Department of Dental Clinical Specialties, Etiology and Therapy of Periodontal and Peri-implant Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
- Etiology and Therapy of Periodontal and Peri-implant Research Group, University Complutense of Madrid, Madrid, Spain
| | - Jorge Serrano
- Etiology and Therapy of Periodontal and Peri-implant Research Group, University Complutense of Madrid, Madrid, Spain
| | - Nicole Birgit Arweiler
- Department of Periodontology and Peri-implant Diseases, Philipps University of Marburg, Marburg, Germany
| | - Thorsten Mathias Auschill
- Department of Periodontology and Peri-implant Diseases, Philipps University of Marburg, Marburg, Germany
| | - Ali Gürkan
- Department of Peridontology, Ege University School of Dentistry, Bornova, Turkey
| | - Gülnur Emingil
- Department of Peridontology, Ege University School of Dentistry, Bornova, Turkey
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Miyazawa H, Nakajima T, Horimizu M, Okuda K, Sugita N, Yamazaki K, Li L, Hayashi-Okada Y, Arita T, Nishimoto M, Nishida M, Genco RJ, Yamazaki K. Impact of Local Drug Delivery of Minocycline on the Subgingival Microbiota during Supportive Periodontal Therapy: A Randomized Controlled Pilot Study. Dent J (Basel) 2020; 8:E123. [PMID: 33121117 PMCID: PMC7711502 DOI: 10.3390/dj8040123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/09/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to examine the effect of adjunct local minocycline administration on the microbiological parameters of subgingival plaque samples in the residual periodontal pockets. Ten chronic periodontitis patients under a supportive periodontal therapy regimen were recruited. After subgingival debridement, either 2% minocycline gel, Periocline™, (Test Group) or a placebo (Control Group) was administered to the selected sites once a week for three weeks. Subgingival plaque was collected at baseline, and at four weeks and eight weeks. The microbiological composition was analyzed by 16S ribosomal RNA sequencing. In the Test Group, α-diversity (evenness) decreased compared to the baseline (p = 0.005) and was lower compared to the control group at four weeks (p = 0.003). The microbial community composition between the two groups was significantly different at four weeks (p = 0.029). These changes were attributable to a decrease in the bacteria associated with periodontitis and an increase in the bacteria associated with periodontal health. Additionally, the improvement in bleeding on probing continued at eight weeks; however, there were little microbial effects of 2% minocycline gel observed at eight weeks. The control group demonstrated no change throughout the eight-week experimental period. Thus, local minocycline administration can change the subgingival microbial community of residual periodontal pockets.
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Affiliation(s)
- Haruna Miyazawa
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (H.M.); (T.N.); (K.Y.)
| | - Takako Nakajima
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (H.M.); (T.N.); (K.Y.)
| | - Makoto Horimizu
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (M.H.); (K.O.); (N.S.)
| | - Kazuhiro Okuda
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (M.H.); (K.O.); (N.S.)
| | - Noriko Sugita
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (M.H.); (K.O.); (N.S.)
| | - Kyoko Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (H.M.); (T.N.); (K.Y.)
| | - Lu Li
- Department of Computer Science and Engineering, State University of New York at Buffalo, 338 Davis Hall, Buffalo, NY 14214, USA;
| | - Yoshiko Hayashi-Okada
- Sunstar Inc., 3-1, Asahimachi, Takatsuki-shi, Osaka 569-1134, Japan; (Y.H.-O.); (T.A.); (M.N.)
| | - Takuya Arita
- Sunstar Inc., 3-1, Asahimachi, Takatsuki-shi, Osaka 569-1134, Japan; (Y.H.-O.); (T.A.); (M.N.)
| | - Misa Nishimoto
- Sunstar Inc., 3-1, Asahimachi, Takatsuki-shi, Osaka 569-1134, Japan; (Y.H.-O.); (T.A.); (M.N.)
| | - Mieko Nishida
- Sunstar Inc., 3-1, Asahimachi, Takatsuki-shi, Osaka 569-1134, Japan; (Y.H.-O.); (T.A.); (M.N.)
| | - Robert J. Genco
- Departments of Oral Biology, and Microbiology and Immunology, and Center for Microbiome Research, University at Buffalo, 135 Foster Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Kazuhisa Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (H.M.); (T.N.); (K.Y.)
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Development and Evaluation of a Polyvinylalcohol -Cellulose Derivative-Based Film with Povidone-Iodine Predicted for Wound Treatment. Polymers (Basel) 2020; 12:polym12061271. [PMID: 32498239 PMCID: PMC7362206 DOI: 10.3390/polym12061271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to develop and assess a polyvinyl alcohol-cellulose derivatives-based film with incorporated povidone-iodine (PVP-I) predicted for applications in the treatment of periodontitis. Films were fabricated by solvent-casting, and their physical characteristics, such as their surface and structure morphology, mechanical properties, and disintegrating time, were evaluated. For in vitro iodine release studies and evaluation, the antimicrobial activity was tested using a modified disc diffusion method against five microbial strains. For further use, we selected the film with polyvinyl alcohol-hydroxypropyl methylcellulose (PVA/HPMC_B) based on acceptable physicochemical properties. To assess the subacute toxicity of the film composition, the tissue regeneration process was tested in rats and compared to a conventional dressing commonly used in wound healing (Spongostan). Seven days after implantation, dorsal skin sections and blood samples (n = 10, in total n = 30) were examined. The wound area, epithelium, and dermis were evaluated microscopically, while the blood collected from the rats underwent biochemical analysis. The blood biochemistry results were comparable in all three groups. No significant histological differences between the Spongostan and the placebo film developed after subcutaneous implantation were observed. In contrast, the inflammation stage was reduced and the “scar” in the dermis was smaller when PVP-I and PVA/HPMC_B films were used. A smaller local inflammatory response inflicted less tissue damage, leading to the activation of subsequent regeneration phases and restoration of the area to its original state. The results obtained confirmed that PVP-I incorporated into PVA-hydroxypropyl methylcellulose film is a promising drug carrier, working faster and more effectively than the other two dressing materials evaluated. These developments provide a promising alternative in tissue regeneration and the wound healing process.
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Kim HY, Park SY, Choung SY. Enhancing effects of myricetin on the osteogenic differentiation of human periodontal ligament stem cells via BMP-2/Smad and ERK/JNK/p38 mitogen-activated protein kinase signaling pathway. Eur J Pharmacol 2018; 834:84-91. [DOI: 10.1016/j.ejphar.2018.07.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 01/12/2023]
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Madhumathi K, Rubaiya Y, Doble M, Venkateswari R, Sampath Kumar TS. Antibacterial, anti-inflammatory, and bone-regenerative dual-drug-loaded calcium phosphate nanocarriers—in vitro and in vivo studies. Drug Deliv Transl Res 2018; 8:1066-1077. [DOI: 10.1007/s13346-018-0532-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Qiu Y, Zhang N, An YH, Wen X. Biomaterial Strategies to Reduce Implant-Associated Infections. Int J Artif Organs 2018; 30:828-41. [DOI: 10.1177/039139880703000913] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Although the prophylaxis in controlling sterility within the operating room environment has been greatly improved, implant-associated infection is still one of the most serious complications in implant surgeries due to the existence of immune depression in the peri-implant area. The antibacterial ability of materials themselves logically becomes an important factor in preventing implant-associated infections. With the understanding of the pathogenesis of implant-associated infections, many approaches have been developed through providing an anti-adhesive surface, delivering antibacterial agents to disrupt cell-cell communication and preventing bacteria aggregation or biofilm formation, or killing bacteria directly (lysing the cell membrane). In this article, we review the current strategies in improving the antibacterial ability of materials to prevent implant infection and further present promising tactics in materials design and applications.
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Affiliation(s)
- Y. Qiu
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, South Carolina - USA
| | - N. Zhang
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, South Carolina - USA
- Department of Cell Biology and Anatomy, Medical University of South Carolina, Charleston, South Carolina - USA
| | - Y. H. An
- Department of Orthopedic Surgery, Medical University of South Carolina, Charleston, South Carolina - USA
| | - X. Wen
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, Charleston, South Carolina - USA
- Department of Cell Biology and Anatomy, Medical University of South Carolina, Charleston, South Carolina - USA
- Department of Orthopedic Surgery, Medical University of South Carolina, Charleston, South Carolina - USA
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Lof M, Janus MM, Krom BP. Metabolic Interactions between Bacteria and Fungi in Commensal Oral Biofilms. J Fungi (Basel) 2017; 3:jof3030040. [PMID: 29371557 PMCID: PMC5715944 DOI: 10.3390/jof3030040] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 07/10/2017] [Accepted: 07/12/2017] [Indexed: 12/14/2022] Open
Abstract
Oral health is more than just the absence of disease. The key to oral health is a diverse microbiome in an ecological balance. The oral microbiota is one of the most complex and diverse microbial communities in the human body. To maintain oral health, balance between the human host and the intrinsic microorganisms is essential. The healthy oral cavity is represented by a great microbial diversity, including both bacteria and fungi. The bacterial microbiome is very well studied. In contrast, fungi inhabiting the oral cavity are often overlooked. All microbial species in the oral cavity form communities which establish a variety of micro-niches and inter- and intra-species interactions. These interactions can be classified into three main groups: physical, chemical and metabolic interactions. Different metabolic interactions are reviewed in this report, among which are the metabolism of sugars, carbon, lactate and oxygen. This review set out with the aim of assessing the importance of metabolic interactions between fungi and bacteria in the healthy oral cavity.
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Affiliation(s)
- Marloes Lof
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and the University of Amsterdam, Amsterdam, 1081 LA, The Netherlands.
| | - Marleen M Janus
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and the University of Amsterdam, Amsterdam, 1081 LA, The Netherlands.
| | - Bastiaan P Krom
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and the University of Amsterdam, Amsterdam, 1081 LA, The Netherlands.
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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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Comparison of antibacterial effect of photodynamic therapy using indocyanine green (Emundo) with 2% metronidazole and 2% chlorhexidine gel on Porphyromonas gingivalis (an in-vitro study). Photodiagnosis Photodyn Ther 2016; 15:28-33. [DOI: 10.1016/j.pdpdt.2016.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 04/05/2016] [Accepted: 04/10/2016] [Indexed: 11/18/2022]
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Alamanda M, Denthumdas SK, Wadgave U, Pharne PM, Patil SJ, Kondreddi S, Deshpande P, Koppikar RS. Comparative Evaluation of Ciprofloxacin Levels in GCF and Plasma of Chronic Periodontitis Patients: Quasi Experimental Study. J Clin Diagn Res 2016; 10:ZC47-50. [PMID: 27504410 DOI: 10.7860/jcdr/2016/18446.7987] [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] [Received: 12/21/2015] [Accepted: 04/16/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION For any antimicrobial approach to be successful in periodontal therapy, it is important that the antimicrobial agent targets the sub-gingival biofilm by attaining sufficient concentration at the sub-gingival site. AIM The purpose of the present study was to determine and compare the concentrations of ciprofloxacin present in Gingival Crevicular Fluid (GCF) and plasma after its systemic administration. MATERIALS AND METHODS A total of 20 subjects, in the age group of 30-60 years satisfying the inclusion and exclusion criteria, were chosen from the outpatient Department of Periodontology, Government Dental College and Hospital, Hyderabad and consent was obtained. Subjects were put on oral ciprofloxacin therapy (Baycip, Bayer Corporation) of 500mg twice daily doses for five days to establish steady state tissue levels of the agent. GCF and serum samples were collected at the 72(nd) hour after the first dose of ciprofloxacin and were compared using unpaired t test. RESULTS The mean gingival index value of the subjects was 1.8 ± 0.59 and the mean probing depth of the subjects taken in the study was 5.724 ± 0.47mm. The results of this study showed that ciprofloxacin concentrations were significantly higher (p<0.001) in GCF than in plasma. CONCLUSION Results from the present study and those from the earlier studies clearly indicate the ciprofloxacin's ability to reach and concentrate in infected periodontal sites via GCF. This property of ciprofloxacin may be useful for eradication of periodontal pathogens, thus improving the outcome of periodontal therapy.
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Affiliation(s)
- Madhavi Alamanda
- Reader, Department of Periodontics, Ahmedabad Dental College , Ahmedabad, Gujurat, India
| | - Sunil Kumar Denthumdas
- Associate Professor, Department of Periodontics, Bharati Vidyapeeth Deemed University Dental College and Hospital , Sangli, Maharashtra, India
| | - Umesh Wadgave
- Assistant Professor, Department of Public Health Dentistry, Bharati Vidyapeeth Deemed University Dental College and Hospital , Sangli, Maharashtra, India
| | - Pooja Mohan Pharne
- Assistant Professor, Department of Periodontics, Bharati Vidyapeeth Deemed University Dental College and Hospital , Sangli, Maharashtra, India
| | - Sandeep Jambukumar Patil
- Assistant Professor, Department of Periodontics, Bharati Vidyapeeth Deemed University Dental College and Hospital , Sangli, Maharashtra, India
| | - Sirisha Kondreddi
- Reader, Department of Periodontics, Drs Sudha & Nageswara Rao Siddhartha Institute of Dental Sciences , Chinoutapally, Krishna District, Andhra Pradesh, India
| | - Pavan Deshpande
- Assistant Professor, Department of Periodontics, Bharati Vidyapeeth Deemed University Dental College and Hospital , Sangli, Maharashtra, India
| | - Rajesh Suresh Koppikar
- Professor and Head, Department of Periodontics, Bharati Vidyapeeth Deemed University Dental College and Hospital , Sangli, Maharashtra, India
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Lecic J, Cakic S, Janjic Pavlovic O, Cicmil A, Vukotic O, Petrovic V, Cicmil S. Different methods for subgingival application of chlorhexidine in the treatment of patients with chronic periodontitis. Acta Odontol Scand 2016; 74:502-7. [PMID: 27409799 DOI: 10.1080/00016357.2016.1206964] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate clinical efficacy of different chlorhexidine gluconate (CHX) preparations applied subgingivally as an adjunct to scaling and root planing (SRP). MATERIAL AND METHODS A total of 120 periodontal pockets was included in this randomized, controlled, split mouth designed study. According to protocols used in treatment, periodontal pockets were assigned to experimental and control groups as follows: CHX solution as an addition to SRP versus control SRP group; CHX gel as an addition to SRP versus control SRP; CHX chip as an addition to SRP versus control SRP group. Following clinical parameters were recorded at baseline, one and three months after the baseline: plaque index (PI), probing pocket depth (PPD), bleeding index (BI) and clinical attachment level (CAL). RESULTS The most significant improvements were found concerning PI in CHX solution with SRP and CHX gel with SRP groups over controls at one month recall, as well as concerning BI and PPD in CHX chip with SRP group over SRP alone at three-month recall. CONCLUSION Results of this study favour combination therapy using CHX chip as an adjunct to SRP due to greater improvements in BI and PPD compared to those obtained by SRP alone in the treatment of chronic periodontitis.
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Microbiological and Clinical Effects of Sitafloxacin and Azithromycin in Periodontitis Patients Receiving Supportive Periodontal Therapy. Antimicrob Agents Chemother 2016; 60:1779-87. [PMID: 26729495 DOI: 10.1128/aac.02575-15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 12/28/2015] [Indexed: 11/20/2022] Open
Abstract
Sitafloxacin (STFX) is a newly developed quinolone that has robust antimicrobial activity against periodontopathic bacteria. We previously reported that oral administration of STFX during supportive periodontal therapy was as effective as conventional mechanical debridement under local anesthesia microbiologically and clinically for 3 months. The aim of the present study was to examine the short-term and long-term microbiological and clinical effects of systemic STFX and azithromycin (AZM) on active periodontal pockets during supportive periodontal therapy. Fifty-one patients receiving supportive periodontal therapy were randomly allocated to the STFX group (200 mg/day of STFX for 5 days) or the AZM group (500 mg/day of AZM for 3 days). The microbiological and clinical parameters were examined until 12 months after the systemic administration of each drug. The concentration of each drug in periodontal pockets and the antimicrobial susceptibility of clinical isolates were also analyzed. The proportions of red complex bacteria, i.e., Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, which are the representative periodontopathic bacteria, were significantly reduced at 1 month and remained lower at 12 months than those at baseline in both the STFX and AZM groups. Clinical parameters were significantly improved over the 12-month period in both groups. An increase in the MIC of AZM against clinical isolates was observed in the AZM group. These results indicate that monotherapy with systemic STFX and AZM might be an alternative treatment during supportive periodontal therapy in patients for whom invasive mechanical treatment is inappropriate. (This study has been registered with the University Hospital Medical Information Network-Clinical Trials Registry [UMIN-CTR] under registration number UMIN000007834.).
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Kütan E, Duygu-Çapar G, Özçakir-Tomruk C, Dilek OC, Özen F, Erdoğan Ö, Özdemir I, Korachi M, Gürel A. Efficacy of doxycycline release collagen membrane on surgically created and contaminated defects in rat tibiae: A histopathological and microbiological study. Arch Oral Biol 2015; 63:15-21. [PMID: 26658367 DOI: 10.1016/j.archoralbio.2015.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 06/29/2015] [Accepted: 11/02/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The effects of systemic antibiotics on controlling infective pathogens after guided bone regeneration(GBR) procedures especially in membrane exposures are limited. However, local administrations of antibiotics are rare in GBR techniques. AIM The aim of this study was to investigate the osteogenesis potential and the antibacterial effect of a doxycycline releasing collagen membrane in surgically created and contaminated defects in rat tibiae. MATERIAL AND METHODS Defects were created in 20 rats that were randomly divided in to two groups: control group (defect contaminated by Porphyromonas gingivalis, filled with bone graft and covered by collagen membrane); test group (defect contaminated by P. gingivalis filled with bone graft and covered by collagen membrane containing 1mg/cm(2) doxycycline. Animals were sacrificed post surgically on the 14th day for microbiologic evaluation and on the 28th day for histopathological evaluation. RESULTS The degree of osteogenesis in the test group was seen to be significantly higher than control group (p: 0.011; p<0.05). Furthermore in test group, no bacterial growth was observed. The bacteria counts were determined between 1×104 and 268×104CFU/g with a median of 1.32×104 for control group. CONCLUSIONS Within the limitations of this study, the results of the present study suggests that the use of a doxycycline releasing membrane has a positive effect on contaminated GBR procedures for limiting P. gingivalis infections leading to bone formation following GBR procedures in a rat model.
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Affiliation(s)
- Esma Kütan
- Department of Oral Implantology, Faculty of Dentistry, Yeditepe University,Göztepe, Istanbul, Turkey.
| | - Gonca Duygu-Çapar
- Department of Oral and Maxillofacial Surgery, Trakya University, Edirne, Turkey
| | - Ceyda Özçakir-Tomruk
- Department of Oral and Maxillofacial Surgery, Yeditepe University, Göztepe, Istanbul, Turkey
| | - Ozkan Cem Dilek
- Department of Oral Implantology, Faculty of Dentistry, Yeditepe University, Göztepe, Istanbul, Turkey
| | - Fatma Özen
- Department of Genetics and Bioengineering, Faculty of Engineering and Architecture, Yeditepe University, Kayışdaği, Istanbul, Turkey
| | - Özge Erdoğan
- Department of Pathology, Faculty of Veterinary, Istanbul University, Avcilar, Istanbul, Turkey
| | - Ipek Özdemir
- Department of Biological Sciences and Bioengineering, Faculty of Engineering and Natural Sciences, Sabanci University, Tuzla, Istanbul, Turkey
| | - May Korachi
- Department of Genetics and Bioengineering, Faculty of Engineering and Architecture, Yeditepe University, Kayışdaği, Istanbul, Turkey
| | - Aydin Gürel
- Department of Pathology, Faculty of Veterinary,Istanbul University, Avcilar, Istanbul, Turkey
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Samiei M, Farjami A, Dizaj SM, Lotfipour F. Nanoparticles for antimicrobial purposes in Endodontics: A systematic review of in vitro studies. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 58:1269-78. [PMID: 26478430 DOI: 10.1016/j.msec.2015.08.070] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 07/12/2015] [Accepted: 08/30/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Antimicrobial nanoparticles with enhanced physiochemical properties have attracted attention as modern antimicrobials, especially in the complicated oral cavity environment. The goal of the present article is to review the current state of nanoparticles used for antimicrobial purposes in root canal infections. METHODS A review was conducted in electronic databases using MeSH keywords to identify relevant published literature in English. The analysis and eligibility criteria were documented according to the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA-guidelines). No restrictions on publication date were imposed. Data regarding root canal disinfections, general antimicrobial mechanisms of nanoparticles, type of nanoparticles as antimicrobial agent and antimicrobial effect of nanoparticles in endodontics were collected and subjected to descriptive data analysis. RESULTS The literature search in electronic databases according to the inclusion criteria provided 83 titles and abstracts. Among them 15 papers were related to antimicrobial effect of nanoparticles in Endodontics. Silver nanoparticles with sustainable activity were the most studied agent for its antimicrobial behavior in root canal infection. Aided polymeric nanoparticles with photo or ultrasound, glass bioactive nanoparticles as well as Calcium derivative based nanoparticles, with improved activity in comparison with the non-nano counterparts, are of importance in infection control of dental root canal. Bioactive Non-organic nanoparticles with structural capabilities present enhanced antimicrobial activity in root canal infections. DISCUSSION All included studies showed an enhanced or at least equal effect of nanoparticulate systems to combat dental root canal infections compared to conventional antimicrobial procedures. However, it is crucial to understand their shortcomings and their probable cellular effects and toxicity as well as environmental effects.
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Affiliation(s)
- Mohammad Samiei
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran; School of Advanced Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Afsaneh Farjami
- Hematology & Oncology Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Maleki Dizaj
- Hematology & Oncology Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzaneh Lotfipour
- School of Advanced Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Hematology & Oncology Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
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Madhumathi K, Sampath Kumar TS. Regenerative potential and anti-bacterial activity of tetracycline loaded apatitic nanocarriers for the treatment of periodontitis. Biomed Mater 2014; 9:035002. [DOI: 10.1088/1748-6041/9/3/035002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kulik Kunz EM, Lenkeit K, Waltimo T, Weiger R, Walter C. Combinatorial effects of amoxicillin and metronidazole on selected periodontal bacteria and whole plaque samples. Arch Oral Biol 2014; 59:608-15. [PMID: 24727003 DOI: 10.1016/j.archoralbio.2014.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 02/13/2014] [Accepted: 03/18/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of the present study was to analyze in vitro the combinatorial effects of the antibiotic combination of amoxicillin plus metronidazole on subgingival bacterial isolates. DESIGN Aggregatibacter (Actinobacillus) actinomycetemcomitans, Prevotella intermedia/nigrescens, Fusobacterium nucleatum and Eikenella corrodens from our strain collection and subgingival bacteria isolated from patients with periodontitis were tested for their susceptibility to amoxicillin and metronidazole using the Etest. The fractional inhibitory concentration index (FICI), which is commonly used to describe drug interactions, was calculated. RESULTS Synergy, i.e. FICI values ≤ 0.5, between amoxicillin and metronidazole was shown for two A. actinomycetemcomitans (FICI: 0.3), two F. nucleatum (FICI: 0.3 and 0.5, respectively) and one E. corrodens (FICI: 0.4) isolates. Indifference, i.e. FIC indices of >0.5 but ≤4, occurred for other isolates and the 14 P. intermedia/nigrescens strains tested. Microorganisms resistant to either amoxicillin or metronidazole were detected in all samples by Etest. CONCLUSION Combinatorial effects occur between amoxicillin and metronidazole on some strains of A. actinomycetemcomitans, F. nucleatum and E. corrodens. Synergy was shown for a few strains only.
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Affiliation(s)
- Eva M Kulik Kunz
- Department of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Switzerland.
| | - Krystyna Lenkeit
- Department of Periodontology, Endodontology and Cariology, School of Dentistry, University of Basel, Switzerland
| | - Tuomas Waltimo
- Department of Preventive Dentistry and Oral Microbiology, School of Dental Medicine, University of Basel, Switzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, School of Dentistry, University of Basel, Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, School of Dentistry, University of Basel, Switzerland
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Roberts AP, Mullany P. Oral biofilms: a reservoir of transferable, bacterial, antimicrobial resistance. Expert Rev Anti Infect Ther 2014; 8:1441-50. [DOI: 10.1586/eri.10.106] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Periodontal diseases (gingivitis and periodontitis) are chronic bacterial infections with a remarkably high prevalence and morbidity. Periodontitis, in contrast to gingivitis, is not reversible, is associated with certain bacterial species and affects all of the soft tissue and bone that support teeth. Among the periodontal pathogens, species, such as Aggregatibacter (Actinobacillus) actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and several forms of uncultivable spirochetes play the major role in the pathogenesis. In severe chronic, recurrent and especially aggressive forms of periodontitis, diagnosis of the species involved and, whenever possible, an optimized evidence-based antimicrobial treatment is indicated. In order to monitor alarming bacterial changes in the periodontal pocket, several techniques, namely microscopy, culture, immunoassays, enzyme tests and DNA-based techniques, have been established and the methods are described in the first part of this review. In the second part, the selection and use of locally delivered (topical) and systemic antibiotics used adjunctively in periodontal therapy are discussed.
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Affiliation(s)
- Hans-Peter Horz
- Division of Oral Microbiology and Immunology, Department of Operative and Preventive Dentistry and Periodontology, University Hospital RWTH Aachen, Aachen, Germany.
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Donkor ES, Badoe EV. Insights into Pneumococcal Pathogenesis and Antibiotic Resistance. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/aim.2014.410069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Donkor ES. Sequencing of bacterial genomes: principles and insights into pathogenesis and development of antibiotics. Genes (Basel) 2013; 4:556-72. [PMID: 24705262 PMCID: PMC3927574 DOI: 10.3390/genes4040556] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 07/24/2013] [Accepted: 08/27/2013] [Indexed: 11/17/2022] Open
Abstract
The impact of bacterial diseases on public health has become enormous, and is partly due to the increasing trend of antibiotic resistance displayed by bacterial pathogens. Sequencing of bacterial genomes has significantly improved our understanding about the biology of many bacterial pathogens as well as identification of novel antibiotic targets. Since the advent of genome sequencing two decades ago, about 1,800 bacterial genomes have been fully sequenced and these include important aetiological agents such as Streptococcus pneumoniae, Mycobacterium tuberculosis, Escherichia coli O157:H7, Vibrio cholerae, Clostridium difficile and Staphylococcus aureus. Very recently, there has been an explosion of bacterial genome data and is due to the development of next generation sequencing technologies, which are evolving so rapidly. Indeed, the field of microbial genomics is advancing at a very fast rate and it is difficult for researchers to be abreast with the new developments. This highlights the need for regular updates in microbial genomics through comprehensive reviews. This review paper seeks to provide an update on bacterial genome sequencing generally, and to analyze insights gained from sequencing in two areas, including bacterial pathogenesis and the development of antibiotics.
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Affiliation(s)
- Eric S Donkor
- Department of Microbiology, University of Ghana Medical School, P. O. Box 4236, Accra, Ghana.
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Sağlam M, Arslan U, Buket Bozkurt Ş, Hakki SS. Boric Acid Irrigation as an Adjunct to Mechanical Periodontal Therapy in Patients With Chronic Periodontitis: A Randomized Clinical Trial. J Periodontol 2013; 84:1297-308. [DOI: 10.1902/jop.2012.120467] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pandit N, Dahiya R, Gupta R, Bali D, Kathuria A. Comparative evaluation of locally delivered minocycline and metronidazole in the treatment of periodontitis. Contemp Clin Dent 2013; 4:48-53. [PMID: 23853452 PMCID: PMC3703694 DOI: 10.4103/0976-237x.111615] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective: The aim of this study was to evaluate and compare the efficacy of subgingivally delivered Minocycline microspheres and 25% Metronidazole gel when used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Materials and Methods: A randomized, controlled, single center study was conducted involving 60 sites in 20 patients suffering from moderate to advanced chronic periodontitis. Each patient contributed three sites which were randomized to three treatment groups: SRP + insertion of Minocycline microspheres at day 1 (Group A), SRP + insertion of Metronidazole gel at day 1 and at day 7 (Group B), and SRP alone (Group C). Gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at day 1, 1 month, and 3 months post therapy. Results: All treatments showed significant reductions in PPD and CAL at 1 and 3 months when compared to baseline values (P < 0.001). At 3 months, sites treated with minocycline showed an additional reduction in PPD of 0.85 ± 0.03 mm, significantly greater than SRP alone. Differences in mean PPD reduction between Group B and Group C and between Group A and Group B were not significant. At 3 months, difference in CAL gain between Group A and C was 0.50 ± 0.45, which was statistically significant and between Group B and C was 0.35 ± 0.11, which was not found to be statistically significant (P = 0.20). Differences in relative CAL between Group A and Group B were also not found to be statistically significant (P = 0.53). Conclusion: The results concluded that treatment with Minocycline microspheres and Metronidazole gel improve PPD and CAL in patients with periodontitis compared to SRP alone.
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Affiliation(s)
- Nymphea Pandit
- Department of Periodontology and Implantology, D.A.V. (c) Dental College, Model Town, Yamuna Nagar, Haryana, India
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Abstract
Periodontitis is a complex infectious disease that affects low-income individuals disproportionately. Periodontitis is associated with specific bacterial species and herpesviruses, and successful prevention and treatment of the disease is contingent upon effective control of these pathogens. This article presents an efficacious, highly safe, minimally invasive, practical and low-cost periodontal therapy that involves professional and patient-administered mechanical therapy and antimicrobial agents. The major components are scaling for calculus removal, periodontal pocket irrigation with potent antiseptics, and treatment with systemic antibiotics for advanced disease. Povidone-iodine and sodium hypochlorite have all the characteristics for becoming the first-choice antiseptics in the management of periodontal diseases. Both agents show excellent antibacterial and antiviral properties, are readily available throughout the world, have been safely used in periodontal therapy for decades, offer significant benefits for individuals with very limited financial resources, and are well accepted by most dental professionals and patients. Four per cent chlorhexidine applied with a toothbrush to the most posterior part to the tongue dorsum can markedly reduce or eliminate halitosis in most individuals. Systemic antibiotics are used to treat periodontopathic bacteria that are not readily reached by topical therapy, such as pathogens within gingival tissue, within furcation defects, at the base of periodontal pockets, and on the tongue, tonsils and buccal mucosae. Valuable antibiotic therapies are amoxicillin-metronidazole (250 mg of amoxicillin and 250 mg of metronidazole, three times daily for 8 days) for young and middle-aged patients, and ciprofloxacin-metronidazole (500 mg of each, twice daily for 8 days) for elderly patients and for patients in developing countries who frequently harbor enteric rods subgingivally. Scaling to remove dental calculus and the prudent use of inexpensive antimicrobial agents can significantly retard or arrest progressive periodontitis in the great majority of patients.
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Soares GMS, Figueiredo LC, Faveri M, Cortelli SC, Duarte PM, Feres M. Mechanisms of action of systemic antibiotics used in periodontal treatment and mechanisms of bacterial resistance to these drugs. J Appl Oral Sci 2013; 20:295-309. [PMID: 22858695 PMCID: PMC3881775 DOI: 10.1590/s1678-77572012000300002] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 09/20/2011] [Indexed: 11/22/2022] Open
Abstract
Antibiotics are important adjuncts in the treatment of infectious diseases, including periodontitis. The most severe criticisms to the indiscriminate use of these drugs are their side effects and, especially, the development of bacterial resistance. The knowledge of the biological mechanisms involved with the antibiotic usage would help the medical and dental communities to overcome these two problems. Therefore, the aim of this manuscript was to review the mechanisms of action of the antibiotics most commonly used in the periodontal treatment (i.e. penicillin, tetracycline, macrolide and metronidazole) and the main mechanisms of bacterial resistance to these drugs. Antimicrobial resistance can be classified into three groups: intrinsic, mutational and acquired. Penicillin, tetracycline and erythromycin are broad-spectrum drugs, effective against gram-positive and gram-negative microorganisms. Bacterial resistance to penicillin may occur due to diminished permeability of the bacterial cell to the antibiotic; alteration of the penicillin-binding proteins, or production of β-lactamases. However, a very small proportion of the subgingival microbiota is resistant to penicillins. Bacteria become resistant to tetracyclines or macrolides by limiting their access to the cell, by altering the ribosome in order to prevent effective binding of the drug, or by producing tetracycline/macrolide-inactivating enzymes. Periodontal pathogens may become resistant to these drugs. Finally, metronidazole can be considered a prodrug in the sense that it requires metabolic activation by strict anaerobe microorganisms. Acquired resistance to this drug has rarely been reported. Due to these low rates of resistance and to its high activity against the gram-negative anaerobic bacterial species, metronidazole is a promising drug for treating periodontal infections.
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Affiliation(s)
- Geisla Mary Silva Soares
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
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Gamal AY, Kumper RM. A Novel Approach to the Use of Doxycycline-Loaded Biodegradable Membrane and EDTA Root Surface Etching in Chronic Periodontitis: A Randomized Clinical Trial. J Periodontol 2012; 83:1086-94. [DOI: 10.1902/jop.2011.110476] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nakajima T, Okui T, Miyauchi S, Honda T, Shimada Y, Ito H, Akazawa K, Yamazaki K. Effects of systemic sitafloxacin on periodontal infection control in elderly patients. Gerodontology 2012; 29:e1024-32. [PMID: 22616908 DOI: 10.1111/j.1741-2358.2011.00605.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the microbiological and clinical effects of the systemic administration of sitafloxacin (STFX) on periodontal pockets in elderly patients receiving supportive periodontal therapy (SPT). BACKGROUND Periodontitis is a risk factor for atherosclerosis. Better periodontal health contributes to reduce atherosclerosis-related diseases in elderly population. MATERIALS AND METHODS Forty-four patients undergoing SPT were randomly assigned to two groups: a test group took 100 mg/day of STFX for five consecutive days, or a control group received scaling and root planing (SRP) under local anaesthesia. Microbiological and clinical parameters were examined at baseline and at 1 and 3 months after therapy. RESULTS The presence of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia was significantly reduced at 1 month after treatment in both groups. The median reductions of the bacteria between the baseline and 1 month were 3.08 and 2.54% in the STFX- and SRP-treated groups, respectively. Both treatments significantly decreased the probing depth at 1 and 3 months compared to the baseline. CONCLUSION The systemic administration of STFX is effective at improving periodontal health during SPT and could be an alternative to SRP for elderly patients who cannot undergo anaesthesia or are at risk of tissue injury.
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Affiliation(s)
- Takako Nakajima
- Center for Transdisciplinary Research, Niigata University, Niigata, Japan
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In vitro studies of the ablation mechanism of periodontopathic bacteria and decontamination effect on periodontally diseased root surfaces by erbium:yttrium-aluminum-garnet laser. Lasers Med Sci 2010; 26:193-204. [PMID: 20309597 DOI: 10.1007/s10103-010-0763-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Accepted: 01/21/2010] [Indexed: 12/11/2022]
Abstract
The erbium:yttrium-aluminum-garnet (Er:YAG) laser is now increasingly used in periodontal therapy. The purpose of this study was to investigate the effect of Er:YAG laser irradiation on the morphology of periodontopathic bacteria and to compare the bacterial elimination effect of the laser and the ultrasonic scaler on diseased root surfaces in vitro. Colonies of Porphyromonas gingivalis were exposed to a single-pulse Er:YAG laser at 40 mJ and were examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Also, 20 pairs of periodontally diseased root surfaces with subgingival calculi of freshly extracted teeth were treated by Er:YAG laser scaling at 40 mJ/pulse (14.2 J/cm(2) per pulse) and 10 Hz with water spray or ultrasonic scaling, or were not treated. The efficiency of each treatment was determined as the area treated per second, and the treated surfaces were examined by SEM. The material scraped from the treated root surfaces was cultured in aerobic and anaerobic conditions, and the numbers of colony forming units (CFUs) were compared. SEM and TEM showed that the Er:YAG laser had easily ablated the bacterial colony, leaving an ablation spot with a crater and the surrounding affected area showing melted branch-like structures. The laser irradiation was as equally effective and efficient as the ultrasonic scaler in performing root surface debridement. The CFUs after laser treatment were significantly fewer than those after ultrasonic scaling in aerobic and anaerobic culture conditions. Er:YAG laser ablates periodontopathic bacteria with thermal vaporization, and its bacterial elimination effect on the diseased root surfaces appears to be superior to that of the ultrasonic scaler.
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Agnihotri R, Bhat KM, Bhat GS, Pandurang P. Periodontal management of a patient with severe aplastic anemia: a case report. SPECIAL CARE IN DENTISTRY 2009; 29:141-4. [PMID: 19938255 DOI: 10.1111/j.1754-4505.2009.00079.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This article describes the periodontal management of a patient with severe aplastic anemia. A 51-year-old female patient was hospitalized with aplastic anemia and was referred for the management of her cyclosporine-induced gingival enlargement and bleeding from her gums. She also complained of pain in the palatal area and the mandibular anterior region. The patient was managed successfully with supra- and subgingival instrumentation, local drug delivery (LDD), electrosurgery, repeated oral hygiene instruction, and constant supervision. The treatment resulted in dramatic improvement in the patient's oral health and quality of life. This report highlights the importance of nonsurgical therapy followed by electrosurgery for the management of residual gingival enlargement.
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Affiliation(s)
- Rupali Agnihotri
- Department of Periodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India.
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de Araújo FRG, de Castro CMMB, Severo MS, Diniz MDFA, Viana MT, Evêncio LB. Effect of Mercurius solubilis on the bacteriological response in the alveolitis process in rats. HOMEOPATHY 2009; 98:160-4. [DOI: 10.1016/j.homp.2009.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 05/07/2009] [Accepted: 05/19/2009] [Indexed: 11/16/2022]
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Shaddox LM, Walker C. Microbial testing in periodontics: value, limitations and future directions. Periodontol 2000 2009; 50:25-38. [DOI: 10.1111/j.1600-0757.2008.00285.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Hellström MK, McClain PK, Schallhorn RG, Bellis L, Hanlon AL, Ramberg P. Local minocycline as an adjunct to surgical therapy in moderate to severe, chronic periodontitis. J Clin Periodontol 2008; 35:525-31. [DOI: 10.1111/j.1600-051x.2008.01219.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Preshaw PM, Novak MJ, Mellonig J, Magnusson I, Polson A, Giannobile WV, Rowland RW, Thomas J, Walker C, Dawson DR, Sharkey D, Bradshaw MH. Modified-Release Subantimicrobial Dose Doxycycline Enhances Scaling and Root Planing in Subjects With Periodontal Disease. J Periodontol 2008; 79:440-52. [DOI: 10.1902/jop.2008.070375] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Paolantonio M, D'Angelo M, Grassi RF, Perinetti G, Piccolomini R, Pizzo G, Annunziata M, D'Archivio D, D'Ercole S, Nardi G, Guida L. Clinical and Microbiologic Effects of Subgingival Controlled-Release Delivery of Chlorhexidine Chip in the Treatment of Periodontitis: A Multicenter Study. J Periodontol 2008; 79:271-82. [DOI: 10.1902/jop.2008.070308] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Rossi-Fedele G, Roberts AP. A preliminary study investigating the survival of tetracycline resistant Enterococcus faecalis after root canal irrigation with high concentrations of tetracycline. Int Endod J 2007; 40:772-7. [PMID: 17697106 DOI: 10.1111/j.1365-2591.2007.01285.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To compare the ability of two Enterococcus faecalis strains to survive exposure to an irrigation solution containing a high concentration of tetracycline in the root canals of bovine teeth. METHODOLOGY The root canals of twelve bovine incisor root sections were chemo-mechanically prepared using commercially available drills, sodium hypochlorite and ethylenediamine tetra-acetic acid. The root sections were divided into two groups and inoculated with either a tetracycline sensitive or resistant strain of E. faecalis. The strains are isogenic, however one contains a conjugative transposon related to Tn916 which confers resistance to tetracycline, and the other strain is sensitive to the antibiotic. After 26 days of incubation the root canals were irrigated using one of three solutions (sterile distilled water, 50% ethanol or tetracycline at a concentration of 30 mg mL(-1)). The roots were sampled by grinding dentine and canal contents and the debris collected were incubated in broth to assess growth. RESULTS Irrigation with sterile distilled water or 50% ethanol did not remove all of the cells present. The tetracycline containing solution was efficient in preventing any growth of sensitive E. faecalis, however the resistant strain was able to survive a 5 min exposure at 30 mg mL(-1). CONCLUSIONS The presence of the Tn916-like conjugative transposon containing the tetracycline resistance gene tet(M) allowed an E. faecalis strain to survive irrigation using a solution containing an extremely high concentration of tetracycline in a root canal model.
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Affiliation(s)
- G Rossi-Fedele
- Endodontic Unit, UCL Eastman Dental Institute, London, UK.
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36
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Sedlacek MJ, Walker C. Antibiotic resistance in an in vitro subgingival biofilm model. ORAL MICROBIOLOGY AND IMMUNOLOGY 2007; 22:333-9. [PMID: 17803631 PMCID: PMC2040071 DOI: 10.1111/j.1399-302x.2007.00366.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The purpose of this study was to utilize an in vitro biofilm model of subgingival plaque to investigate resistances in subgingival biofilm communities to antibiotics commonly used as adjuncts to periodontal therapy. METHODS Biofilms were grown on saliva-coated hydroxyapatite supports in trypticase-soy broth for 4 h-10 days and then exposed for 48 h to either increasing twofold concentrations of tetracycline, amoxicillin, clindamycin, and erythromycin or therapeutically achievable concentrations of tetracycline, doxycycline, minocycline, amoxicillin, metronidazole, amoxicillin/clavulanate, and amoxicillin/metronidazole. RESULTS Concentrations necessary to inhibit bacterial strains in steady-state biofilms were up to 250 times greater than the concentrations needed to inhibit the same strains grown planktonically. In the presence of therapeutically available antibiotic concentrations, significantly higher proportions of the biofilms remained viable as the biofilms reached steady-state growth. The combinations of amoxicillin/clavulanate and amoxicillin/metronidazole were the most effective in suppressing growth. These combinations were particularly effective against biofilms up to and including 7 days of age and inhibited 90% or more of the bacteria present relative to untreated controls. As the biofilms approached steady state, these combinations were less effective with 50-60% of the bacteria retaining viability. CONCLUSION Most, but not all, species of subgingival bacteria are considerably more resistant in biofilms than in planktonic cultures. Resistance appeared to be age-related because biofilms demonstrated progressive antibiotic resistance as they matured with maximum resistance coinciding with the steady-state phase of biofilm growth.
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Affiliation(s)
- M J Sedlacek
- Department of Oral Biology, University of Florida, Gainesville, FL 32610-0424, USA
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Kaner D, Christan C, Dietrich T, Bernimoulin JP, Kleber BM, Friedmann A. Timing Affects the Clinical Outcome of Adjunctive Systemic Antibiotic Therapy for Generalized Aggressive Periodontitis. J Periodontol 2007; 78:1201-8. [PMID: 17608574 DOI: 10.1902/jop.2007.060437] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Systemic antibiotics improve the outcome of scaling and root planing (SRP) in patients exhibiting severe periodontitis. This study evaluated the influence of timing of adjunctive systemic antibiotics in the sequence of periodontal therapy. METHODS Two cohorts of patients with generalized aggressive periodontitis and treated by SRP, adjunctive antibiotics, and supportive periodontal therapy (SPT) were analyzed retrospectively. Cohort A (17 patients; 36 +/- 5 years of age) received systemic amoxicillin/metronidazole immediately after SRP ("immediate"); cohort B (17 patients; 36 +/- 4 years of age) received the same regimen 3 months after SRP, following SPT, including subgingival reinstrumentation ("late"). Clinical parameters, including probing depth (PD), relative attachment level (RAL), bleeding on probing (BOP), and suppuration, were recorded with a pressure-sensitive electronic probe at baseline and 3 and 6 months after SRP. RESULTS Significant time*group interactions were found for all clinical parameters except BOP, i.e., timing of antibiotic therapy affected the course of clinical changes over time. Immediate antibiotic therapy produced significantly higher initial changes (0 to 3 months) in PD and RAL. Late antibiotic therapy at 3 months resulted in additional significant improvements in all clinical parameters between 3 and 6 months. In initially deep sites (baseline PD >6 mm), improvements in PD and RAL over 6 months were significantly higher with immediate antibiotic therapy compared to late antibiotic therapy. CONCLUSION Within the limits of a retrospective analysis, these findings indicate that administration of amoxicillin/metronidazole immediately after initial SRP provides more PD reduction and RAL "gain" in initially deep sites than late administration at SPT with reinstrumentation after 3 months.
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Affiliation(s)
- Doğan Kaner
- Institute for Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Carvalho J, Novak MJ, Mota LF. Evaluation of the Effect of Subgingival Placement of Chlorhexidine Chips as an Adjunct to Scaling and Root Planing. J Periodontol 2007; 78:997-1001. [PMID: 17539711 DOI: 10.1902/jop.2007.060122] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this 9-month study was to compare the effect of scaling and root planing alone (control) to that of scaling and root planing plus application of chlorhexidine chips (test). METHODS Twenty-six subjects having two non-adjacent sites in non-molar teeth with probing depth > or =5 mm and bleeding on probing participated in this split-mouth trial. At baseline, the patients received full-mouth scaling and root planing followed by placement of chlorhexidine chips secured by cyanoacrylate at test sites and placement of cyanoacrylate alone at control sites. Test sites still > or =5 mm deep at 3 and 6 months were retreated with renewed chlorhexidine chip application. Recordings of bleeding on probing, probing depths, and clinical attachment levels were performed at baseline, after 6 weeks, and after 3, 6, and 9 months. RESULTS Improvements of bleeding scores, probing depths and clinical attachment levels were observed for both test and control sites at 6 weeks compared to baseline. Subsequently, all three measurements remained comparatively stable throughout the study. No differences in improvements were found comparing test and control sites. CONCLUSION This study failed to observe any adjunctive effect of subgingival placement of chlorhexidine chips after scaling and root planing.
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Affiliation(s)
- Juliana Carvalho
- Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA.
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Affiliation(s)
- Anne C R Tanner
- Department of Molecular Genetics, The Forsyth Institute, Boston, Massachusetts, USA
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Prates RA, Yamada AM, Suzuki LC, Eiko Hashimoto MC, Cai S, Gouw-Soares S, Gomes L, Ribeiro MS. Bactericidal effect of malachite green and red laser on Actinobacillus actinomycetemcomitans. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2006; 86:70-6. [PMID: 16979345 DOI: 10.1016/j.jphotobiol.2006.07.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Revised: 07/20/2006] [Accepted: 07/21/2006] [Indexed: 10/24/2022]
Abstract
The aim of this study was to investigate the ability of malachite green (MG) combined with a low-power red laser to kill Actinobacillus actinomycetemcomitans and to investigate MG photodegradation after photodynamic therapy (PDT) by optical absorption spectroscopy. The etiology of periodontal disease is that microorganisms form a bacterial biofilm on the surface of the teeth. It is an infectious disease and A. actinomycetemcomitans is considered an important agent in biofilm ecology. Instead of using antibiotics, PDT is an alternative approach to eradicate bacteria. Cultures of A. actinomycetemcomitans were exposed to a 30 mW diode red laser, in the presence or absence of MG. A group of cultures was treated in dark conditions in the presence of MG (0.01% w/v) for 5 min. In the presence of MG, two exposure times for laser irradiation were used: t=3 min (energy dose=5.4 J/cm(2)), and t=5 min (energy dose=9 J/cm(2)). The samples were diluted and bacterial colonies were counted and converted into colony forming units. Absorption spectra of the bacterial suspensions, MG, MG-stained bacterial suspensions, and photosensitized bacterial suspensions were obtained. A. actinomycetemcomitans can be photoinactivated by a red laser in the presence of MG. Significant differences were observed between the two energy doses used (p<0.05). Red laser alone and MG alone were not able to kill bacteria. Optical absorption showed that MG is photobleached after irradiation. These results indicate that A. actinomycetemcomitans can be photosensitized by red laser combined with MG and that the dye is photodegraded following irradiation.
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Affiliation(s)
- Renato Araújo Prates
- Center for Lasers and Applications, IPEN-CNEN/SP, Av. Prof. Lineu Prestes, 2242, Cidade Universitária, São Paulo SP 05508-000, Brazil.
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Abstract
The periodontal diseases are highly prevalent and can affect up to 90% of the worldwide population. Gingivitis, the mildest form of periodontal disease, is caused by the bacterial biofilm (dental plaque) that accumulates on teeth adjacent to the gingiva (gums). However, gingivitis does not affect the underlying supporting structures of the teeth and is reversible. Periodontitis results in loss of connective tissue and bone support and is a major cause of tooth loss in adults. In addition to pathogenic microorganisms in the biofilm, genetic and environmental factors, especially tobacco use, contribute to the cause of these diseases. Genetic, dermatological, haematological, granulomatous, immunosuppressive, and neoplastic disorders can also have periodontal manifestations. Common forms of periodontal disease have been associated with adverse pregnancy outcomes, cardiovascular disease, stroke, pulmonary disease, and diabetes, but the causal relations have not been established. Prevention and treatment are aimed at controlling the bacterial biofilm and other risk factors, arresting progressive disease, and restoring lost tooth support.
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Affiliation(s)
- Bruce L Pihlstrom
- Center for Clinical Research, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892-6401, USA.
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Maeda R, Ishihara K, Hosaka Y, Nakagawa T. Antibacterial Activity of Antibiotics against Periodontopathic Bacteria. ACTA ACUST UNITED AC 2005. [DOI: 10.2329/perio.47.146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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