1
|
Miguel MMV, Shaddox LM. Grade C Molar-Incisor Pattern Periodontitis in Young Adults: What Have We Learned So Far? Pathogens 2024; 13:580. [PMID: 39057807 PMCID: PMC11279578 DOI: 10.3390/pathogens13070580] [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: 06/08/2024] [Revised: 06/26/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Grade C molar-incisor pattern periodontitis (C-MIP) is a disease that affects specific teeth with an early onset and aggressive progression. It occurs in systemically healthy patients, mostly African descendants, at an early age, with familial involvement, minimal biofilm accumulation, and minor inflammation. Severe and rapidly progressive bone loss is observed around the first molars and incisors. This clinical condition has been usually diagnosed in children and young adults with permanent dentition under 30 years of age. However, this disease can also affect the primary dentition, which is not as frequently discussed in the literature. Radiographic records have shown that most patients diagnosed in the permanent dentition already presented disease signs in the primary dentition. A hyperresponsive immunological profile is observed in local (gingival crevicular fluid-GCF) and systemic environments. Siblings have also displayed a heightened inflammatory profile even without clinical signs of disease. A. actinomycetemcomitans has been classified as a key pathogen in C-MIP in both dentitions. Scaling and root planning associated with systemic antibiotics is the current gold standard to treat C-MIP, leading to GCF biomarker reduction, some systemic inflammatory response modulation and microbiome profile changes to a healthy-site profile. Further studies should focus on other possible disease-contributing risk factors.
Collapse
Affiliation(s)
- Manuela Maria Viana Miguel
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY 40508, USA;
| | - Luciana Macchion Shaddox
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY 40508, USA;
- Department of Oral Health Practice, Periodontology Division, College of Dentistry, University of Kentucky, Lexington, KY 40508, USA
| |
Collapse
|
2
|
Koo SS, Fernandes JG, Li L, Huang H, Aukhil I, Harrison P, Diaz PI, Shaddox LM. Evaluation of microbiome in primary and permanent dentition in grade C periodontitis in young individuals. J Periodontol 2024; 95:650-661. [PMID: 38476115 PMCID: PMC11265979 DOI: 10.1002/jper.23-0504] [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: 08/22/2023] [Revised: 12/01/2023] [Accepted: 01/09/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND The aim of the present study was to evaluate the subgingival microbiome in patients with grade C molar-incisor pattern periodontitis (C-MIP) affecting the primary or permanent dentitions. METHODS DNA was isolated from subgingival biofilm samples from diseased and healthy sites from 45 C-MIP patients and subjected to phylogenetic microarray analysis. C-MIP sites were compared between children affected in the primary to those affected in the permanent dentitions. Within-subject differences between C-MIP-affected sites and dentition-matched healthy sites were also evaluated. RESULTS C-MIP sites of subjects affected in the primary dentition showed partially overlapping but distinct microbial communities from C-MIP permanent dentition sites (p < 0.05). Differences were due to increased levels in primary C-MIP sites of certain species of the genera Capnocytophaga and Leptotrichia, while C-MIP permanent dentition sites showed higher prevalence of Filifactor alocis. Aggregatibacter actinomycetemcomitans (Aa) was among species seen in high prevalence and levels in both primary and permanent C-MIP sites. Moreover, both permanent and primary C-MIP sites showed distinct microbial communities when compared to dentition-matched healthy sites in the same subject (p < 0.01). CONCLUSIONS Primary and permanent teeth with C-MIP showed a dysbiotic microbiome, with children affected in the primary dentition showing a distinct profile from those affected in the permanent dentition. However, Aa was enriched in both primary and permanent diseased sites, confirming that this microorganism is implicated in C-MIP in both dentitions.
Collapse
Affiliation(s)
- Sungeun Stephanie Koo
- Department of Periodontology, School of Dental Medicine, University of Connecticut, Farmington, Connecticut, USA
| | - Jussara G Fernandes
- Department of Oral Health Practice, Periodontology Division and Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Lu Li
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA
- UB Microbiome Center, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Hong Huang
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Ikramuddin Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Peter Harrison
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
- Department of Periodontology, School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | - Patricia I Diaz
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA
- UB Microbiome Center, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Luciana M Shaddox
- Department of Oral Health Practice, Periodontology Division and Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
3
|
Li Z, Baidoun R, Brown AC. Toxin-triggered liposomes for the controlled release of antibiotics to treat infections associated with the gram-negative bacterium, Aggregatibacter actinomycetemcomitans. Colloids Surf B Biointerfaces 2024; 238:113870. [PMID: 38555763 PMCID: PMC11148792 DOI: 10.1016/j.colsurfb.2024.113870] [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: 12/08/2023] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 04/02/2024]
Abstract
Antibiotic resistance has become an urgent threat to health care in recent years. The use of drug delivery systems provides advantages over conventional administration of antibiotics and can slow the development of antibiotic resistance. In the current study, we developed a toxin-triggered liposomal antibiotic delivery system, in which the drug release is enabled by the leukotoxin (LtxA) produced by the Gram-negative pathogen, Aggregatibacter actinomycetemcomitans. LtxA has previously been shown to mediate membrane disruption by promoting a lipid phase change in nonlamellar lipids, such as 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methyl (N-methyl-DOPE). In addition, LtxA has been observed to bind strongly and nearly irreversibly to membranes containing large amounts of cholesterol. Here, we designed a liposomal delivery system composed of N-methyl-DOPE and cholesterol to take advantage of these interactions. Specifically, we hypothesized that liposomes composed of N-methyl-DOPE and cholesterol, encapsulating antibiotics, would be sensitive to LtxA, enabling controlled antibiotic release. We observed that liposomes composed of N-methyl-DOPE were sensitive to the presence of low concentrations of LtxA, and cholesterol increased the extent and kinetics of content release. The liposomes were stable under various storage conditions for at least 7 days. Finally, we showed that antibiotic release occurs selectively in the presence of an LtxA-producing strain of A. actinomycetemcomitans but not in the presence of a non-LtxA-expressing strain. Together, these results demonstrate that the designed liposomal vehicle enables toxin-triggered delivery of antibiotics to LtxA-producing strains of A. actinomycetemcomitans.
Collapse
Affiliation(s)
- Ziang Li
- Department of Chemical and Biomolecular Engineering, Lehigh University, 5 E Packer Ave, Bethlehem, PA 18015, USA
| | - Rani Baidoun
- Department of Chemical and Biomolecular Engineering, Lehigh University, 5 E Packer Ave, Bethlehem, PA 18015, USA
| | - Angela C Brown
- Department of Chemical and Biomolecular Engineering, Lehigh University, 5 E Packer Ave, Bethlehem, PA 18015, USA.
| |
Collapse
|
4
|
Huang X, Zhu L, Gong Y. Rhein induces bone regeneration via alleviating inflammation in murine periodontitis model. Oral Dis 2024; 30:1506-1515. [PMID: 36630585 DOI: 10.1111/odi.14502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/06/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the effect of rhein on eliminating the inflammation and promoting bone regeneration of periodontitis after local administration. MATERIALS AND METHODS In vivo, periodontitis model was established in murine mandibular first molar by using ligature for 7 days, followed by ligature removal and local administration of rhein/vehicle for 7 consecutive days. In vitro, periodontal ligament fibroblasts were treated by LPS, along with the applications of rhein/vehicle. Histology and molecular biology approaches were applied for analysis. RESULTS In vivo, rhein alleviated periodontitis inflammation through downregulating the inflammatory index and promoted the osteogenic potential of PDL fibroblasts in a dosage-dependent manner. The result of micro-CT validated this phenomenon. In vitro, rhein administration inhibited the phosphorylation and nuclear translocation of P65, along with the arose runx2 level of PDL fibroblasts with the stimulus of LPS in mimicking periodontitis. CONCLUSION Rhein played its inhibitory role on inflammation via curbing the activation of P65 but uprising the activities of Runx2 in PDL fibroblasts in periodontitis microenvironment. These data suggested that rhein could be an effective and potential clinical choice for the treatment of periodontitis.
Collapse
Affiliation(s)
- Xi Huang
- Department of Stomatology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lifang Zhu
- Department of Stomatology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yin Gong
- Department of Stomatology, First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
5
|
Moja L, Zanichelli V, Mertz D, Gandra S, Cappello B, Cooke GS, Chuki P, Harbarth S, Pulcini C, Mendelson M, Tacconelli E, Ombajo LA, Chitatanga R, Zeng M, Imi M, Elias C, Ashorn P, Marata A, Paulin S, Muller A, Aidara-Kane A, Wi TE, Were WM, Tayler E, Figueras A, Da Silva CP, Van Weezenbeek C, Magrini N, Sharland M, Huttner B, Loeb M. WHO's essential medicines and AWaRe: recommendations on first- and second-choice antibiotics for empiric treatment of clinical infections. Clin Microbiol Infect 2024; 30 Suppl 2:S1-S51. [PMID: 38342438 DOI: 10.1016/j.cmi.2024.02.003] [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: 10/23/2023] [Revised: 01/26/2024] [Accepted: 02/04/2024] [Indexed: 02/13/2024]
Abstract
The WHO Model List of Essential Medicines (EML) prioritizes medicines that have significant global public health value. The EML can also deliver important messages on appropriate medicine use. Since 2017, in response to the growing challenge of antimicrobial resistance, antibiotics on the EML have been reviewed and categorized into three groups: Access, Watch, and Reserve, leading to a new categorization called AWaRe. These categories were developed taking into account the impact of different antibiotics and classes on antimicrobial resistance and the implications for their appropriate use. The 2023 AWaRe classification provides empirical guidance on 41 essential antibiotics for over 30 clinical infections targeting both the primary health care and hospital facility setting. A further 257 antibiotics not included on the EML have been allocated an AWaRe group for stewardship and monitoring purposes. This article describes the development of AWaRe, focussing on the clinical evidence base that guided the selection of Access, Watch, or Reserve antibiotics as first and second choices for each infection. The overarching objective was to offer a tool for optimizing the quality of global antibiotic prescribing and reduce inappropriate use by encouraging the use of Access antibiotics (or no antibiotics) where appropriate. This clinical evidence evaluation and subsequent EML recommendations are the basis for the AWaRe antibiotic book and related smartphone applications. By providing guidance on antibiotic prioritization, AWaRe aims to facilitate the revision of national lists of essential medicines, update national prescribing guidelines, and supervise antibiotic use. Adherence to AWaRe would extend the effectiveness of current antibiotics while helping countries expand access to these life-saving medicines for the benefit of current and future patients, health professionals, and the environment.
Collapse
Affiliation(s)
- Lorenzo Moja
- Health Products Policy and Standards, World Health Organization, Geneva, Switzerland.
| | - Veronica Zanichelli
- Health Products Policy and Standards, World Health Organization, Geneva, Switzerland
| | - Dominik Mertz
- Department of Medicine, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Canada
| | - Sumanth Gandra
- Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine in St. Louis, Missouri, United States
| | - Bernadette Cappello
- Health Products Policy and Standards, World Health Organization, Geneva, Switzerland
| | - Graham S Cooke
- Department of Infectious Diseases, Imperial College London, London, UK
| | - Pem Chuki
- Antimicrobial Stewardship Unit, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Stephan Harbarth
- Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; World Health Organization Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance, Geneva, Switzerland
| | - Celine Pulcini
- APEMAC, and Centre régional en antibiothérapie du Grand Est AntibioEst, Université de Lorraine, CHRU-Nancy, Nancy, France
| | - Marc Mendelson
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Evelina Tacconelli
- Infectious Diseases Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Loice Achieng Ombajo
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya; Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Ronald Chitatanga
- Antimicrobial Resistance National Coordinating Centre, Public Health Institute of Malawi, Blantyre, Malawi
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | | | - Christelle Elias
- Service Hygiène et Epidémiologie, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Per Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | | | - Sarah Paulin
- Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland
| | - Arno Muller
- Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland
| | | | - Teodora Elvira Wi
- Department of Global HIV, Hepatitis and STIs Programme, World Health Organization, Geneva, Switzerland
| | - Wilson Milton Were
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Elizabeth Tayler
- WHO Regional Office for the Eastern Mediterranean (EMRO), World Health Organisation, Cairo, Egypt
| | | | - Carmem Pessoa Da Silva
- Antimicrobial Resistance Division, World Health Organization, Geneva, Switzerland; Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Nicola Magrini
- NHS Clinical Governance, Romagna Health Authority, Ravenna, Italy; World Health Organization Collaborating Centre for Evidence Synthesis and Guideline Development, Bologna, Italy
| | - Mike Sharland
- Centre for Neonatal and Paediatric Infections, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Benedikt Huttner
- Health Products Policy and Standards, World Health Organization, Geneva, Switzerland
| | - Mark Loeb
- Department of Medicine, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; World Health Organization Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, McMaster University, Hamilton, Canada
| |
Collapse
|
6
|
Xu X, Lu H, Huo P, Jin D, Zhu Y, Meng H. Effects of amoxicillin and metronidazole as an adjunct to scaling and root planing on glycemic control in patients with periodontitis and type 2 diabetes: A short-term randomized controlled trial. J Periodontal Res 2024; 59:249-258. [PMID: 38115631 DOI: 10.1111/jre.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To assess the effects of amoxicillin and metronidazole with scaling and root planing (SRP) on periodontal parameters and glycemic control in patients with severe periodontitis and diabetes mellitus. BACKGROUND Adjunctive antibiotics use is advantageous for treating periodontitis in patients with severe periodontitis and diabetes. However, the effects of adjunctive antibiotic use on hemoglobin A1c (HbA1c) levels remain unclear. METHODS This short-term, randomized controlled trial enrolled patients with severe periodontitis and type 2 diabetes. The patients were randomly allocated to SPR only (i.e., control) or SPR + antibiotics (500 mg of amoxicillin and 200 mg of metronidazole, three times daily for 7 days) groups. Periodontal and hematological parameters were assessed at baseline and 3 months after treatment. Inter- and intra-group analyses were performed using Student's t-tests, Mann-Whitney U tests, and the binary logistic regression models. p-values of <.05 were considered statistically significant. RESULTS This study enrolled 49 patients, with 23 and 26 patients in the SRP-only and SRP + antibiotics groups, respectively. The periodontal parameters improved significantly and similarly in both groups after treatment (p < .05). The SRP + antibiotics group had more sites of improvement than the SRP-only group when the initial probing depth was >6 mm. (698 [78.96%] vs. 545 [73.35%], p = .008). The HbA1c levels decreased in the SRP-only and SRP + antibiotics groups after treatment (0.39% and 0.53%, respectively). The multivariable binary logistic regression model demonstrated that antibiotics administration and a high baseline HbA1c level were associated with a greater reduction in the HbA1c level (odds ratio = 4.551, 95% confidence interval: 1.012-20.463; odds ratio = 7.162, 95% confidence interval: 1.359-37.753, respectively). CONCLUSIONS SRP and SRP plus systemic antibiotics were beneficial for glycemic control. Adjunctive antibiotic use slightly improved the outcome for patients with severe periodontitis and poorly controlled diabetes.
Collapse
Affiliation(s)
- Xinran Xu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - He Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Pengcheng Huo
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Dongsiqi Jin
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yunxuan Zhu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| |
Collapse
|
7
|
Anwar SK, Hafez AM, Roshdy YS. Clinical and microbiological efficacy of intra-pocket application of diode laser in grade C periodontitis: a randomized controlled clinical trial. BMC Oral Health 2024; 24:270. [PMID: 38395824 PMCID: PMC10893689 DOI: 10.1186/s12903-024-04031-0] [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: 08/20/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Periodontitis is a microbially induced disease destroying structures anchoring teeth to jaw bones. Although metronidazole in combination with spiramycin is the effective conventional treatment of stage III grade C periodontitis, it has several systemic side effects. Laser therapy is widely used nowadays as an adjunct to scaling and root planing (SRP) to modulate inflammatory host response and eradicate microbes, due to bactericidal and detoxifying effects. Since microbiological analysis is one of the diagnostic methods identifying periodontal risk; our research aimed to investigate the efficacy of intra-pocket application of diode laser (980 nm) versus antibiotic therapy in enhancing clinical and microbiological parameters in stage III grade C periodontitis. METHODS A randomized controlled clinical trial was conducted on fifty patients with stage III grade C periodontitis, divided equally into two groups. We managed test group by SRP with intra-pocket application of diode laser (980 nm) and the control group by SRP with systemic antibiotic administration (spiramycin and metronidazole). Then, we measured periodontal pocket depth (PPD) and clinical attachment loss (CAL) for both groups, before treatment (baseline), four and twelve weeks after. Moreover, we collected gingival crevicular fluid from both groups at baseline, four and twelve weeks after treatment and analyzed by real-time polymerase chain reaction to detect the relative count of Aggregatibacter actinomycetemcomitans and Porhyromonas gingivalis. RESULTS Compared to baseline, all assessed clinical and microbiological parameters attested improvement at the end of the study period in each group individually with no significant difference between the two studied groups. Although, at twelve weeks, flare up of bacterial levels was detected with systemic antibiotic administration. CONCLUSION Laser therapy can be considered as an effective treatment modality in stage III grade C periodontitis, avoiding the systemic antibiotic side effects and solving the recurrence problems due to bacterial resistance by long term usage. TRIAL REGISTRATION NCT05222737 retrospectively on 03/02/2022, Clinicaltrial.gov.
Collapse
Affiliation(s)
- Souzy Kamal Anwar
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt.
| | - Amira Mohamed Hafez
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
| | - Yara Safwat Roshdy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
| |
Collapse
|
8
|
Pamuk F, Lütfioğlu M, Paksoy T, Koyuncuoglu CZ, Polat NG, Cifcibasi E, Yildirim S, Kantarci A. Impact of low-level laser therapy as an adjunct to non-surgical periodontal treatment on the levels of tissue plasminogen activator and plasminogen activator inhibitor 1 in Stage 3-4, Grade C periodontitis patients: a split-mouth, randomized control study. Clin Oral Investig 2023; 27:6439-6449. [PMID: 37709984 DOI: 10.1007/s00784-023-05248-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
AIM To investigate the effects of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal treatment (NSPT) on the plasminogen-activating system. MATERIALS AND METHODS Stage 3-4 Grade C periodontitis and age-gender-matched healthy individuals participated in the split-mouth study (ClinicalTrials.gov identifier, NCT05233501). The study groups were Periodontitis/NSPT (Sham); Periodontitis/NSPT + LLLT (LLLT); Healthy (Control). Following NSPT, LLLT was applied on Days 0, 2 and 7. Clinical parameters were recorded at baseline and on Day 30. Gingival crevicular fluid (GCF) was collected at baseline, on days 7, 14, and 30; tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels were measured with ELISA. RESULTS Clinical parameters, total GCF tPA (tPAt) and PAI-1 (PAI-1t) levels significantly reduced in LLLT and Sham groups (< 0.001). GCF tPAt levels in LLLT were significantly lower (< 0.05) than Sham on Day 7. GCF tPAt levels in periodontitis groups were significantly higher than the Control at baseline, on Days 7 and 14 (< 0.01). By Day 30, both groups decreased to control levels (> 0.05). GCF PAI-1t levels were significantly lower in LLLT than the Sham on day 30 (< 0.01), comparable to healthy controls (> 0.05). CONCLUSION Adjunctive LLLT modulates the plasminogen activating system in severe periodontitis by altering GCF tPA and PAI-1 levels. CLINICAL RELEVANCE LLLT as an adjunct to non-surgical periodontal treatment in patients with Stage 3-4 Grade C leads to reduced plasminogen activation.
Collapse
Affiliation(s)
- F Pamuk
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.
- Faculty of Dentistry, Department of Periodontology, Beykent University, Istanbul, Turkey.
| | - M Lütfioğlu
- Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey
| | - T Paksoy
- Hamidiye Faculty of Dentistry, Department of Periodontology, University of Health Sciences, Istanbul, Turkey
| | - C Z Koyuncuoglu
- Faculty of Dentistry, Department of Periodontology, Istanbul Aydin University, Istanbul, Turkey
| | - N G Polat
- Clinical Laboratory, Unit of Immunology and Allergy, Koç University Hospital, Istanbul, Turkey
| | - E Cifcibasi
- Faculty of Dentistry, Department of Periodontology, Istanbul University, Istanbul, Turkey
| | - S Yildirim
- Faculty of Dentistry, Department of Periodontology, Ondokuz Mayis University, Samsun, Turkey
| | - A Kantarci
- Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
| |
Collapse
|
9
|
Li Z, Baidoun R, Brown AC. Toxin-Triggered Liposomes for the Controlled Release of Antibiotics to Treat Infections Associated with Gram-Negative Bacteria. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.28.559931. [PMID: 37808632 PMCID: PMC10557637 DOI: 10.1101/2023.09.28.559931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Antibiotic resistance has become an urgent threat to health care in recent years. The use of drug delivery systems provides advantages over conventional administration of antibiotics and can slow the development of antibiotic resistance. In the current study, we developed a toxin-triggered liposomal antibiotic delivery system, in which the drug release is enabled by the leukotoxin (LtxA) produced by the Gram-negative pathogen, Aggregatibacter actinomycetemcomitans. LtxA has previously been shown to mediate membrane disruption by promoting a lipid phase change in nonlamellar lipids, such as 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-N-methyl (N-methyl-DOPE). In addition, LtxA has been observed to bind strongly and nearly irreversibly to membranes containing large amounts of cholesterol. Here, we designed a liposomal delivery system composed of N-methyl-DOPE and cholesterol to take advantage of these interactions. Specifically, we hypothesized that liposomes composed of N-methyl-DOPE and cholesterol, encapsulating antibiotics, would be sensitive to LtxA, enabling controlled antibiotic release. We observed that liposomes composed of N-methyl-DOPE were sensitive to the presence of low concentrations of LtxA, and cholesterol increased the extent and kinetics of content release. The liposomes were stable under various storage conditions for at least 7 days. Finally, we showed that antibiotic release occurs selectively in the presence of an LtxA-producing strain of A. actinomycetemcomitans but not in the presence of a non-LtxA-expressing strain. Together, these results demonstrate that the designed liposomal vehicle enables toxin-triggered delivery of antibiotics to LtxA-producing strains of A. actinomycetemcomitans.
Collapse
Affiliation(s)
- Ziang Li
- Department of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, PA
| | - Rani Baidoun
- Department of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, PA
- Current Affiliation: Department of Chemical and Biomolecular Engineering, University of Pennsylvania, Philadelphia, PA
| | - Angela C. Brown
- Department of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, PA
| |
Collapse
|
10
|
Guha Biswas P, Mohan A, Kandaswamy E. Treatment of Periodontitis Affecting Human Primary Teeth-A Systematic Review. Dent J (Basel) 2023; 11:171. [PMID: 37504237 PMCID: PMC10378644 DOI: 10.3390/dj11070171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
The aim of this systematic review is to report the treatment options (Intervention) and outcomes (O) for primary teeth affected by periodontitis (Population) and if the treatment of primary teeth can prevent the spread of periodontitis to permanent teeth (Outcomes). The following databases were searched for papers published before December 2022: PubMed, Embase, Web of Science, and Ebscohost. Studies on children affected by periodontitis involving the primary teeth were included and those on children who presented with periodontitis as a manifestation of systemic disease were excluded. Narrative synthesis and methodological quality assessments were performed for the included studies. Three interventional studies (without a control group) that evaluated treatments involving scaling and root planing (SRP with antibiotics) and extraction were included (total n = 60 patients). Additionally, twelve case reports/case series articles (n = 19 patients) were identified. The diagnoses ranged from aggressive periodontitis to juvenile periodontitis and pre-pubertal periodontitis. Based on a limited number of published studies, it was found that the early treatment of periodontitis affecting the primary teeth using SRP and systemic antibiotics resulted in favorable improvements in PD and CAL. Limited evidence suggests that SRP and the extraction of the primary teeth involved have the potential to prevent periodontitis affecting permanent teeth. Future trials are required to standardize the treatment protocols and to confirm these findings.
Collapse
Affiliation(s)
- Protyusha Guha Biswas
- Department of Oral Pathology and Microbiology, Meenakshi Ammal Dental College and Hospital, Chennai 600095, India
| | | | - Eswar Kandaswamy
- Department of Periodontics, Louisiana State University Health Sciences Center, School of Dentistry, New Orleans, LA 70119, USA
| |
Collapse
|
11
|
Montagner AF, Angst PDM, Raggio DP, VAN DE Sande FH, Tedesco TK. Methodological quality of network meta-analysis in dentistry: a meta-research. Braz Oral Res 2023; 37:e062. [PMID: 37436290 DOI: 10.1590/1807-3107bor-2023.vol37.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/27/2023] [Indexed: 07/13/2023] Open
Abstract
This meta-research aimed to provide an overview of the methodological quality and risk of bias of network meta-analyses (NMA) in dentistry. Searches for NMA of randomized clinical trials with clinical outcomes in dentistry were performed in databases up to January 2022. Two reviewers independently screened titles/abstracts, selected full texts, and extracted the data. The adherence to PRISMA-NMA reporting guideline, the AMSTAR-2 methodological quality tool, and the ROBIS risk of bias tool were assessed in the studies. Correlation between the PRISMA-NMA adherence and the AMSTAR-2 and ROBIS results was also investigated. Sixty-two NMA studies were included and presented varied methodological quality. According to AMSTAR-2, half of the NMA presented moderate quality (n = 32; 51.6%). The adherence to PRISMA-NMA also varied. Only 36 studies (58.1%) prospectively registered the protocol. Other issues lacking of reporting were data related were data related to the NMA geometry and the assessment of results consistency, and the evaluation of risk of bias across the studies. ROBIS assessment showed a high risk of bias mainly for domains 1 (study eligibility criteria) and 2 (identification and selection of studies). Correlation coefficients between the PRISMA-NMA adherence and the AMSTAR-2 and ROBIS results showed moderate correlation (rho < 0.6). Overall, NMA studies in dentistry were of moderate quality and at high risk of bias in several domains, especially study selection. Future reviews should be better planned and conducted and have higher compliance with reporting and quality assessment tools.
Collapse
Affiliation(s)
| | | | | | | | - Tamara Kerber Tedesco
- Univesidade Cruzeiro do Sul - Unicsul, Graduate Program in Dentistry, São Paulo, SP, Brazil
| |
Collapse
|
12
|
Mendes SDNC, Esteves CM, Mendes JAV, Feres M, Figueiredo N, de Miranda TS, Shibli JA, Figueiredo LC. Systemic Antibiotics and Chlorhexidine Associated with Periodontal Therapy: Microbiological Effect on Intraoral Surfaces and Saliva. Antibiotics (Basel) 2023; 12:antibiotics12050847. [PMID: 37237750 DOI: 10.3390/antibiotics12050847] [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: 03/14/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
The effect of systemic antibiotics on the microbial profile of extracrevicular sites after periodontal treatment is currently the subject of research. This study evaluated the microbiological effects on different oral cavity sites of scaling and root planing (SRP) combined with antimicrobial chemical control in the treatment of periodontitis. Sixty subjects were randomly assigned to receive SRP alone or combined with metronidazole (MTZ) + amoxicillin (AMX) for 14 days, with or without chlorhexidine mouth rinse (CHX) for 60 days. Microbiological samples were evaluated by checkerboard DNA-DNA hybridization until 180 days post therapy. The adjunctive use of antibiotics plus CHX significantly reduced the mean proportions of red complex species from subgingival biofilm and saliva (p < 0.05). Furthermore, the analysis of all intraoral niches showed a significantly lower mean proportion of the red complex species in the same group. In conclusion, the concomitant use of antimicrobial chemical control (systemic and local) demonstrated a beneficial effect on the composition of the oral microbiota.
Collapse
Affiliation(s)
- Stella de Noronha Campos Mendes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07090-023, SP, Brazil
- Department of Dentistry, Federal University of Piaui, Teresina 64049-550, PI, Brazil
| | - Camila Machado Esteves
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07090-023, SP, Brazil
| | | | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07090-023, SP, Brazil
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Nathalia Figueiredo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07090-023, SP, Brazil
| | | | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07090-023, SP, Brazil
| | - Luciene Cristina Figueiredo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07090-023, SP, Brazil
| |
Collapse
|
13
|
Branco-de-Almeida L, Velsko I, de Oliveira I, de Oliveira R, Shaddox L. Impact of Treatment on Host Responses in Young Individuals with Periodontitis. J Dent Res 2023; 102:473-488. [PMID: 36803061 PMCID: PMC10150440 DOI: 10.1177/00220345221148161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Grade C periodontitis in young individuals is characterized by severe/rapid periodontal destruction, usually early onset, in systemically healthy individuals. An individual's host response, triggered by a dysbiotic subgingival biofilm, has been reported as a contributor to the tissue destruction, although mechanisms of this response and contributions to such disease remain poorly understood. Nonsurgical treatment has resulted in positive clinical responses for both localized (now molar-incisor pattern) and generalized forms of grade C periodontitis, especially when adjunctive systemic antibiotics are used. Nonsurgical treatment may also affect host responses, although mechanisms leading to significant changes in this response remain unclear. Significant effects on inflammatory response to antigens/bacteria have been described posttreatment, but evidence for long-term effects remains limited. Nonsurgical treatment in these individuals may also modulate a variety of host markers in serum/plasma and gingival crevicular fluid along with clinical parameter improvements. The impact of other adjuncts to nonsurgical treatment focusing on controlling exacerbated immunoinflammatory responses needs to be further explored in grade C periodontitis in young individuals. Recent evidence suggests that nonsurgical treatment with adjunctive laser therapy may modulate host and microbial responses in those subjects, at least in the short term. Available evidence, while very heterogeneous (including variations in disease definition and study designs), does not provide clear conclusions on this topic yet provides important insights for future studies. In this review, studies within the past decade evaluating the impact of nonsurgical treatment on systemic/local host responses in young individuals with grade C periodontitis, as well as long-term clinical responses posttreatment, will be critically appraised and discussed.
Collapse
Affiliation(s)
- L.S. Branco-de-Almeida
- Post Graduate Program in Dentistry,
School of Dentistry, Federal University of Maranhão, São Luís, Maranhão,
Brazil
| | - I.M. Velsko
- Department of Archaeogenetics, Max
Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - I.C.V. de Oliveira
- Post Graduate Program in Dentistry,
School of Dentistry, Federal University of Maranhão, São Luís, Maranhão,
Brazil
| | - R.C.G. de Oliveira
- Division of Periodontology, Center for
Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY,
USA
| | - L.M. Shaddox
- Division of Periodontology, Center for
Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY,
USA
| |
Collapse
|
14
|
Kherul Anuwar AH, Saub R, Safii SH, Ab-Murat N, Mohd Taib MS, Mamikutty R, Ng CW. Systemic Antibiotics as an Adjunct to Subgingival Debridement: A Network Meta-Analysis. Antibiotics (Basel) 2022; 11:antibiotics11121716. [PMID: 36551373 PMCID: PMC9774554 DOI: 10.3390/antibiotics11121716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
This review aimed to evaluate the effectiveness of systemic antibiotics as adjunctive treatment to subgingival debridement in patients with periodontitis. Randomized controlled trials were included that assessed the effectiveness of systemic antibiotics in improving periodontal status, indicated by clinical attachment gain level, probable pocket depth reduction, and bleeding on probing reduction of patients with any form of periodontitis at any follow-up time. Network meta-analyses with a frequentist model using random effects was employed to synthesize the data. The relative effects were reported as mean difference with a 95% confidence interval. Subsequently, all treatments were ranked based on their P-scores. A total of 30 randomized controlled trials were included in this network meta-analyses. Minimally important clinical differences were observed following the adjunctive use of satranidazole, metronidazole, and clindamycin for clinical attachment gain level and probable pocket depth reduction. For bleeding on probing reduction, minimally important clinical differences were observed following the adjunctive use of metronidazole and a combination of amoxycillin and metronidazole. However, the network estimates were supported by evidence with certainty ranging from very low to high. Therefore, the findings of this network meta-analyses should be interpreted with caution. Moreover, the use of these antibiotics adjunct to subgingival debridement should be weighed against possible harm to avoid overuse and inappropriate use of these antibiotics in patients with periodontitis.
Collapse
Affiliation(s)
- Ainol Haniza Kherul Anuwar
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Roslan Saub
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence:
| | - Norintan Ab-Murat
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Mohd Syukri Mohd Taib
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | | | - Chiu Wan Ng
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| |
Collapse
|
15
|
Faveri M, Retamal-Valdes B, Mestnik MJ, de Figueiredo LC, Barão VAR, Souza JGS, Duarte PM, Feres M. Microbiological effects of amoxicillin plus metronidazole in the treatment of young patients with Stages III and IV periodontitis: A secondary analysis from a 1-year double-blinded placebo-controlled randomized clinical trial. J Periodontol 2022; 94:498-508. [PMID: 35869939 DOI: 10.1002/jper.21-0171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite the body of evidence supporting the clinical benefits of metronidazole (MTZ) and amoxicillin (AMX) in the treatment of young patients with periodontitis, the microbiological outcomes of this antibiotic protocol have been less explored. This study evaluated the microbiological effects of adjunctive MTZ+AMX in the treatment of young patients with periodontitis. METHODS Subjects with periodontitis Stages III or IV and ≤30 years old were randomly allocated to receive scaling and root planing (SRP) with placebo (n = 15) or with MTZ (400 mg) and AMX (500 mg) three times a day for 14 days (n = 15). Nine subgingival biofilm samples per subject (three samples from each probing depth (PD) category: ≤3, 4-6, and ≥7 mm) were collected at baseline and 3-, 6-, and 12-months post-treatment and individually analyzed for 40 bacterial species by checkerboard DNA-DNA hybridization. RESULTS Thirty subjects (15/group) with mean ages 27.6 ± 3.5 (control) and 26.8 ± 3.9 (test) were included. At 12 months post-therapy, the antibiotic group harbored lower proportions of red complex (1.3%) than the placebo group (12.5%) (p < 0.05). SRP + MTZ+AMX was more effective than mechanical treatment in reducing levels/proportions of several pathogens and increasing proportions of Actinomyces species (p < 0.05). Levels/proportions of Aggregatibacter actinomycetemcomitans were only reduced in the antibiotic group (p < 0.05). This group also exhibited greater reduction in the number of sites with PD ≥5 mm and higher percentage of subjects reaching the clinical end point for treatment (≤4 sites with PD ≥5 mm) than the control group (p < 0.05). CONCLUSION SRP+MTZ+AMX allowed for establishing a long-term healthier subgingival biofilm community and periodontal clinical condition, than SRP only.
Collapse
Affiliation(s)
- Marcelo Faveri
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Belen Retamal-Valdes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Maria Josefa Mestnik
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | | | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - João Gabriel Silva Souza
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.,Dental Science School (Faculdade de Ciências Odontológicas-FCO), Montes, Claros, Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.,Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.,The Forsyth Institute, Cambridge, Massachusetts, USA
| |
Collapse
|
16
|
Cosgarea R, Jepsen S, Heumann C, Batori-Andronescu I, Rosu A, Bora R, Arweiler NB, Eick S, Sculean A. Clinical, microbiological and immunological effects of 3- or 7-day systemic antibiotics adjunctive to subgingival instrumentation in patients with aggressive (stage III/IV grade C) periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol 2022; 49:1106-1120. [PMID: 35781888 DOI: 10.1111/jcpe.13676] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/08/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the clinical non-inferiority of a 3-day-protocol of systemic antibiotics adjunctive to subgingival instrumentation (SI) compared to a 7-day-protocol in patients with stage III/IV grade C periodontitis. METHODS 50 systemically healthy patients (32.7±4.3 years) with aggressive periodontitis (stage III/IV grade C periodontitis) were treated by SI and adjunctive amoxicillin and metronidazole randomly assigned to group A: (n=25) 500mg antibiotics 3-times-daily for 3 days, followed by placebo 3-times-daily for 4 days, or group B: (n=25) 500mg AB 3-times-daily for 7 days. Clinical, microbial and immunological parameters were assessed at baseline, 3 and 6 months, and patient-related outcomes after 2 weeks. The primary outcome variable was the number of residual sites with PD≥6mm at 6 months. RESULTS For the primary outcome variable (the number of residual sites with PD≥6mm at 6 months), the null hypothesis was rejected and demonstrated the non-inferiority of the 3d AB protocol compared to 7d AB (the upper limits of the 95%CI for ITT: [-2.572; 1.050] and PP: [-2.523; 1.318] were lower than the assumed margin of Δ=3.1). Comparable clinical improvements were obtained for all parameters with both antibiotic protocols (p>0.05). All investigated periodontopathogens and pro-inflammatory host-derived markers were statistically significantly reduced, without differences between the treatments (p>0.05). CONCLUSION These findings indicate that in patients with aggressive periodontitis (stage III/IV grade C periodontitis), a 3-day systemic administration of amoxicillin and metronidazole adjunctive to SI may lead to non-inferior clinical outcomes after 6-months with fewer adverse events compared to a 7-day-protocol.
Collapse
Affiliation(s)
- Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany.,Department of Periodontology and Peri-implant Diseases, Philips University Marburg, Marburg, Germany.,Clinic for Prosthetic Dentistry, University Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | | | - Ionela Batori-Andronescu
- Periodontal private practice Cosmedica, Cluj-Napoca, Romania.,Department of Periodontology, University Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Alexandra Rosu
- Periodontal private practice Cosmedica, Cluj-Napoca, Romania
| | - Raluca Bora
- Periodontal private practice Cosmedica, Cluj-Napoca, Romania
| | - Nicole B Arweiler
- Department of Periodontology and Peri-implant Diseases, Philips University Marburg, Marburg, Germany
| | - Sigrun Eick
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| |
Collapse
|
17
|
Zhang Z, Yu Y, Zhu G, Zeng L, Xu S, Cheng H, Ouyang Z, Chen J, Pathak JL, Wu L, Yu L. The Emerging Role of Plant-Derived Exosomes-Like Nanoparticles in Immune Regulation and Periodontitis Treatment. Front Immunol 2022; 13:896745. [PMID: 35757759 PMCID: PMC9231591 DOI: 10.3389/fimmu.2022.896745] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/16/2022] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is an infectious oral disease, which leads to the destruction of periodontal tissues and tooth loss. Although the treatment of periodontitis has improved recently, the effective treatment of periodontitis and the periodontitis-affected periodontal tissues is still a challenge. Therefore, it is urgent to explore new therapeutic strategies for periodontitis. Natural products show anti-microbial, anti-inflammatory, anti-oxidant and bone protective effects to periodontitis and most of these natural products are safe and cost-effective. Among these, the plant-derived exosome-like nanoparticles (PELNs), a type of natural nanocarriers repleted with lipids, proteins, RNAs, and other active molecules, show the ability to enter mammalian cells and regulate cellular activities. Reports from the literature indicate the great potential of PELNs in the regulation of immune functions, inflammation, microbiome, and tissue regeneration. Moreover, PELNs can also be used as drug carriers to enhance drug stability and cellular uptake in vivo. Since regulation of immune function, inflammation, microbiome, and tissue regeneration are the key phenomena usually targeted during periodontitis treatment, the PELNs hold the promising potential for periodontitis treatment. This review summarizes the recent advances in PELNs-related research that are related to the treatment of periodontitis and regeneration of periodontitis-destructed tissues and the underlying mechanisms. We also discuss the existing challenges and prospects of the application of PELNs-based therapeutic approaches for periodontitis treatment.
Collapse
Affiliation(s)
- Zeyu Zhang
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Yang Yu
- Department of Sports and Health, Guangzhou Sport University, Guangzhou, China
| | - Guanxiong Zhu
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Liting Zeng
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Shaofen Xu
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Haoyu Cheng
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Zhaoguang Ouyang
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Jianwei Chen
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Janak L Pathak
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China
| | - Lihong Wu
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Lina Yu
- Department of Preventive Dentistry, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.,School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
18
|
Setiawatie EM, Gani MA, Rahayu RP, Ulfah N, Kurnia S, Augustina EF, Sari DS. Nigella sativa toothpaste promotes anti-inflammatory and anti-destructive effects in a rat model of periodontitis. Arch Oral Biol 2022; 137:105396. [DOI: 10.1016/j.archoralbio.2022.105396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 02/03/2022] [Accepted: 03/06/2022] [Indexed: 11/02/2022]
|
19
|
Wang C, Gong J, Li D, Xing X. circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis. Open Med (Wars) 2022; 17:638-647. [PMID: 35480399 PMCID: PMC8994215 DOI: 10.1515/med-2022-0442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 11/21/2022] Open
Abstract
CircularRNAs (circRNAs) are collectively involved in periodontitis. The aim of this study was to explore the roles of circ_0062491 in osteogenic differentiation of PDLSCs and provide a novel method for periodontitis treatment. mRNA and protein expression levels were measured by qRT-PCR and western blotting. Alkaline phosphatase (ALP) and alizarin red S (ARS) staining were used to detect the activity of osteogenesis. Furthermore, the interactions between miR-142-5p and circ_0062491/IGF1 were verified by a luciferase reporter assay. circ_0062491 was suppressed in PDL tissues of periodontitis patients and overexpressed in osteogenesis-induced PDLSCs. Upregulated circ_0062491 promoted osteogenic differentiation of PDLSCs. miR-142-5p was verified to be a target of circ_0062491, and the overexpression of miR-142-5p suppressed the osteogenic differentiation of PDLSCs induced by circ_0062491 Additionally, miR-142-5p targeted IGF1, and silenced IGF1 abrogated the effects of suppressed miR-142-5p on osteogenic differentiation of PDLSCs. In conclusion, circ_0062491 acted as a competing endogenous RNA to regulate osteogenic differentiation of PDLSCs via the miR-142-5p/IGF1 axis.
Collapse
Affiliation(s)
- Chunlin Wang
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Xuanwu District, Nanjing, Jiangsu 210000, China
| | - Junxia Gong
- Department of First Outpatient, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dai Li
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Xuanwu District, Nanjing, Jiangsu 210000, China
| | - Xianghui Xing
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Xuanwu District, Nanjing, Jiangsu 210000, China
| |
Collapse
|
20
|
Jones OP, Hoyle PJ. Azithromycin as an adjunct to subgingival professional mechanical plaque removal in the treatment of grade C periodontitis: a systematic review and meta-analysis. J Periodontal Implant Sci 2022; 52:352-369. [PMID: 36302643 PMCID: PMC9614177 DOI: 10.5051/jpis.2200340017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/22/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of this systematic review was to evaluate clinical and microbiological outcomes with the use of azithromycin as an adjunct to non-surgical subgingival professional mechanical plaque removal (PMPR) in the treatment of grade C periodontitis. Online database searches using high-level MeSH terms in a PICO structure were conducted along with hand-searching of relevant periodontal journals. Titles and abstracts of identified studies were independently reviewed by both authors and the full texts of studies meeting the inclusion criteria were independently reviewed. In total, 122 studies were identified through searches, of which 6 were included in the qualitative analysis and 4 in the meta-analysis. Three studies included in the meta-analysis were deemed at low risk of bias and 1 at serious risk. There were conflicting results on whether azithromycin reduced the number of subgingival pathogens or detectable subgingival Aggregatibacter actinomycetemcomitans between the included studies. The meta-analysis revealed a statistically significant probing depth reduction difference in favour of azithromycin compared to the control at 3 months (weighted mean difference [WMD]=−0.39 mm; 95% confidence interval [CI], −0.66 to −0.13 mm; I2=0%) and 12 months (WMD=−1.32 mm; 95% CI, −1.71 to −0.93 mm; I2=0%). The clinical attachment level change was also statistically significant in favour of azithromycin compared to the control at 3 months (WMD=−0.61 mm; 95% CI, −1.13 to −0.10 mm; I2=71%) and 12 months (WMD=−0.88 mm; 95% CI, −1.32 to −0.44 mm; I2=0%). Based upon these results, azithromycin offers additional improvements in some clinical parameters when used in conjunction with subgingival PMPR in patients with aggressive periodontitis over control groups. These improvements appear to be maintained for up to 12 months after treatment completion. However, due to a lack of well-designed studies, the conclusions that can be drawn from the available evidence are limited.
Collapse
Affiliation(s)
- Oliver P Jones
- Charles Clifford Dental Hospital, Sheffield, United Kingdom
| | | |
Collapse
|
21
|
Abdulkareem A, Abdulbaqi H, Gul S, Milward M, Chasib N, Alhashimi R. Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview. Antibiotics (Basel) 2021; 11:antibiotics11010009. [PMID: 35052887 PMCID: PMC8773342 DOI: 10.3390/antibiotics11010009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Periodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. However, in view of the growing concern about bacterial resistance, alternative approaches have been investigated. Currently, a range of antimicrobial agents and protocols have been used in clinical management, but these remain largely non-validated. This review aimed to evaluate the efficacy of adjunctive antibiotic use in periodontal management and to compare them to recently suggested alternatives. Evidence from in vitro, observational and clinical trial studies suggests efficacy in the use of adjunctive antimicrobials in patients with grade C periodontitis of young age or where the associated risk factors are inconsistent with the amount of bone loss present. Meanwhile, alternative approaches such as photodynamic therapy, bacteriophage therapy and probiotics showed limited supportive evidence, and more studies are warranted to validate their efficiency.
Collapse
Affiliation(s)
- Ali Abdulkareem
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
- Correspondence:
| | - Hayder Abdulbaqi
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
| | - Sarhang Gul
- College of Dentistry, University of Sulaimani, Sulaymaniyah 40062, Iraq;
| | - Mike Milward
- College of Dentistry, University of Birmingham, Birmingham B5 7EG, UK;
| | - Nibras Chasib
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
| | - Raghad Alhashimi
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
| |
Collapse
|
22
|
Luo J, Xu L, Li L, Zhang J, Zhang M, Xu M. Comparison of treatments for hepatocellular carcinoma patients with portal vein thrombosis: a systematic review and network meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1450. [PMID: 34734002 PMCID: PMC8506756 DOI: 10.21037/atm-21-3937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/26/2021] [Indexed: 02/05/2023]
Abstract
Background Sorafenib, hepatectomy, and transarterial chemoembolization (TACE) are the recommended treatment for portal vein tumor thrombosis (PVTT) patients. Therefore, the aim of the present study was to conduct a multi-treatment meta-analysis. The aim of the present study was to analyze the survival benefit of different treatments options on PVTT patients. Methods We systematically analyzed 12 randomized controlled trials (4,265 participants) from 2012 to 2019, which compared any of the following treatment options on PVTT patients: TACE, sorafenib, hepatectomy, sorafenib + TACE, hepatectomy + TACE, and sorafenib + hepatectomy. The main outcome was the 1-year survival rate of patients. Results The results of the rank probability of effectiveness showed that sorafenib + TACE was more likely to be the most effective treatment, sorafenib + TACE group was ranged rank 1 when compared with the others [hepatectomy group: odds ratio (OR): 0.79, 95% confidence interval (CI): 0.03–18.26; hepatectomy + TACE group: OR: 0.51, 95% CI: 0.01–13.59; sorafenib group: OR: 0.14, 95% CI 0.01–2.29, sorafenib + hepatectomy group: OR: 0.15, 95% CI: 0.00–24.88; and TACE group: OR: 0.51, 95% CI: 0.02–9.88]. The second most effect treatment option was hepatectomy alone. Discussion Sorafenib + TACE is more likely to be the most effective treatment option, while hepatectomy alone is the second effective treatment option.
Collapse
Affiliation(s)
- Jianchen Luo
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Liangliang Xu
- Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lian Li
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jingfu Zhang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Zhang
- Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Mingqing Xu
- Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
23
|
Paz HES, Monteiro MF, Stolf CS, Altabtbaei K, Casati MZ, Casarin RCV, Kumar PS. Predicted functional and taxonomic analysis of subgingival biofilm of grade C periodontitis in young patients under maintenance therapy. J Periodontol 2021; 93:1119-1130. [PMID: 34727386 DOI: 10.1002/jper.21-0411] [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: 07/14/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND In Grade C periodontitis in young patients (PerioC-Y), the functional roles of the subgingival community after years of periodontal treatment are still underexplored. This study evaluated the taxonomic and predicted functional content of the subgingival microbiome of PerioC-Y patients under supportive periodontal therapy (SPT). METHODS Clinical and microbiological data from subgingival biofilm were assessed from 10 PerioC-Y patients at two time points: at baseline and after 5.7±1.3 years of SPT. This was compared to 15 patients without a history of periodontitis. The V1-V3 and V4-V5 regions of the 16S rRNA were sequenced using the Illumina Miseq. Microbial composition was evaluated by the core microbiome, and alpha- and beta-diversity. The microbiome functional content was predicted using Picrust2, and the gene differential abundance was analyzed with DESeq2. RESULTS Clinical improvements were seen in PerioC-Y-SPT. Differences in β-diversity between PerioC-Y and Health were observed (Health x PerioC-Y-baseline, p = 0.02; Health x PerioC-Y-SPT, p = 0.05). Moreover, although β-diversity did not statistically change between baseline and SPT in PerioC-Y, the microbial correlation evidenced increased Streptococcus and decreased Treponema network contributions during SPT. Based on predicted functional data, treatment induced a reduction in genes related to flagellar protein and signal transduction in PerioC-Y. However, compared to healthy individuals, some genes remained more highly abundant in PerioC-Y-SPT, such as quorum sensing and efflux pump transporters. CONCLUSION Despite clinical improvements and a shift in taxonomic composition, the PerioC-Y patients' periodontal treatment was not enough to reach a similar microbiome to patients without disease experience. Some functional content in this biofilm remained altered in PerioC-Y regardless of disease control. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Hélvis E S Paz
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Mabelle F Monteiro
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Camila S Stolf
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Khaled Altabtbaei
- Department of Periodontology, School of Dentistry, University of Alberta, Edmonton, Canada
| | - Márcio Z Casati
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Renato C V Casarin
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Purnima S Kumar
- Department of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
24
|
Wang Z, Wang D, Guo S, Zhuo Q, Jiang D, Yu Z. Long noncoding RNA distal-less homeobox 2 antisense 1 restrains inflammatory response and apoptosis of periodontal ligament cells by binding with microRNA-330-3p to regulate Ro60, Y RNA binding protein. Arch Oral Biol 2021; 133:105298. [PMID: 34752991 DOI: 10.1016/j.archoralbio.2021.105298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aims to investigate the role of long noncoding RNA distal-less homeobox 2 antisense 1 (DLX2-AS1) in lipopolysaccharide-induced inflammatory response and apoptosis of periodontal ligament cells (PDLCs). DESIGN Lipopolysaccharide was used to induce inflammation response of PDLCs. The expression of DLX2-AS1, microRNA-330-3p and Ro60, Y RNA binding protein (RO60) in lipopolysaccharide-treated PDLCs was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR). Enzyme linked immunosorbent assay (ELISA) was performed to evaluate the concentration of inflammatory cytokines in PDLCs after DLX2-AS1 overexpression or RO60 downregulation. The apoptosis of PDLCs after lipopolysaccharide treatment or indicated transfection was analyzed by flow cytometry analysis. The level of apoptosis-related proteins, Bax and Bcl-2, were examined by western blotting. The binding capacity between microRNA-330-3p and DLX2-AS1 (or RO60) was verified by luciferase reporter assays. RESULTS DLX2-AS1 was downregulated in PDLCs after lipopolysaccharide treatment. DLX2-AS1 overexpression decreased the production of inflammatory cytokines and inhibited cell apoptosis. microRNA-330-3p bound with DLX2-AS1 and displayed high expression in lipopolysaccharide-induced PDLCs. In addition, the downregulation of RO60, a target gene of microRNA-330-3p, reversed the suppressive influence of DLX2-AS1 overexpression on the inflammatory response and apoptosis of PDLCs. CONCLUSIONS DLX2-AS1 restrains inflammatory response and apoptosis of PDLCs via the microRNA-330-3p/RO60 axis.
Collapse
Affiliation(s)
- Zhihua Wang
- Department of Stomatology, Huaian Maternal and Child Health Hospital, Huaian 223300, Jiangsu, China
| | - Dazhao Wang
- Department of Stomatology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian 223300, Jiangsu, China
| | - Song Guo
- Department of Stomatology, Huaian Maternal and Child Health Hospital, Huaian 223300, Jiangsu, China
| | - Qibao Zhuo
- Department of Stomatology, Huaian Maternal and Child Health Hospital, Huaian 223300, Jiangsu, China
| | - Dongting Jiang
- Department of Stomatology, Huaian Maternal and Child Health Hospital, Huaian 223300, Jiangsu, China
| | - Zhifen Yu
- Department of Stomatology, Huaian Maternal and Child Health Hospital, Huaian 223300, Jiangsu, China.
| |
Collapse
|
25
|
Lu H, He L, Jin D, Zhu Y, Meng H. The effect of adjunctive systemic antibiotics on microbial populations compared to scaling and root planing alone for the treatment of periodontitis: A pilot randomized clinical trial. J Periodontol 2021; 93:570-583. [PMID: 34374434 DOI: 10.1002/jper.20-0764] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 11/10/2022]
Abstract
AIM To investigate the microbial shift after periodontitis being treated by scaling and root planing (SRP) with or without adjunctive antibiotics, and to assess the relationship between oral microbiota and systemic factors. METHODS A 6-month pilot randomized controlled trial recruited 14 subjects with severe periodontitis, divided into test group and control group to receive full-mouth SRP with or without amoxicillin (500mg) and metronidazole (200mg) (t.i.d. 7d). Clinical examination, collection of subgingival plaque and saliva, and blood tests were performed at baseline pre-treatment, three months, and six months post-treatment. The V3V4 region of 16S DNA was sequenced; taxonomic assignment was based on the Human Oral Microbiome Database. RESULTS The periodontal condition significantly improved in both groups; the test group showed a greater improvement in plaque index, probing depth, and bleeding index than the control group. The test group demonstrated significantly lower microbial richness and diversity, and less abundant Porphyromonas than the control group in at three months for both subgingival microbiome and salivary microbiome. However, the microbial differences narrowed within six months. The subgingival and salivary microbiota shifted synergistically. Glucose was positively related to subgingival Porphyromonas; mean platelet volume was positively related to subgingival Leptotrichia. CONCLUSIONS Systemic administration of amoxicillin and metronidazole along with SRP had an advantage over SRP alone in clinical improvement and infection control in both the subgingival region and saliva three months post-treatment. Microbial advantage nearly disappeared at six months; however, the clinical advantage lasted longer. The use of antibiotics also has potential benefits for systemic inflammation and glucose. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Hongye Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China.,Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Lu He
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Dongsiqi Jin
- The Third Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yunxuan Zhu
- The Second Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| |
Collapse
|
26
|
Luchian I, Goriuc A, Martu MA, Covasa M. Clindamycin as an Alternative Option in Optimizing Periodontal Therapy. Antibiotics (Basel) 2021; 10:antibiotics10070814. [PMID: 34356735 PMCID: PMC8300806 DOI: 10.3390/antibiotics10070814] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/24/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022] Open
Abstract
Periodontal disease is an oral infectious and inflammatory disease caused by microorganisms that determine the host-mediated destruction of soft and hard periodontal tissues, which ultimately leads to tooth loss. Periodontitis affects a large part of the population, with various degrees of severity. Treatment consists of etiologic therapy: the removal of biofilm through mechanical debridement plus microbial elimination by supplementary measures. Antibiotic administration, either systemically or through local delivery, has been shown to improve clinical outcomes after mechanical periodontal treatment. Clindamycin is a lincosamide with a broad spectrum, being active against aerobic, anaerobic, and β-lactamase-producing bacteria. This antibiotic offers several advantages and some disadvantages and has been used in periodontal treatment both systemically and locally with various degrees of success. Among the properties that recommend it for periodontal treatment is the bacteriostatic effect, the inhibition of bacterial proteins synthesis, the enhancement of neutrophil chemotaxis, phagocytosis and the oxidative burst–oxidative stress storm. Furthermore, it is easily absorbed at the level of oral tissues in a considerable amount. This substantial tissue penetration, especially inside the bone, is synergistic with a stimulating effect on the host immune system. The aim of this review is to explore the applicability of this antibiotic agent and to evaluate its antimicrobial potential and limitations at the level of the oral biofilm associated with periodontal disease.
Collapse
Affiliation(s)
- Ionut Luchian
- Department of Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania;
| | - Ancuta Goriuc
- Department of Biochemistry, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
- Correspondence: (A.G.); (M.A.M.); Tel.: +40-723-438-089 (A.G.); +40-742-189-178 (M.A.M.)
| | - Maria Alexandra Martu
- Department of Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania;
- Correspondence: (A.G.); (M.A.M.); Tel.: +40-723-438-089 (A.G.); +40-742-189-178 (M.A.M.)
| | - Mihai Covasa
- Department of Health and Human Development, University “Stefan cel Mare” Suceava, 13 Universității Street, 720229 Suceava, Romania;
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, 309E Second Street, Pomona, CA 91766, USA
| |
Collapse
|
27
|
Plemmenos G, Evangeliou E, Polizogopoulos N, Chalazias A, Deligianni M, Piperi C. Central Regulatory Role of Cytokines in Periodontitis and Targeting Options. Curr Med Chem 2021; 28:3032-3058. [PMID: 32838709 DOI: 10.2174/0929867327666200824112732] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Periodontitis is an immune-inflammatory disease that leads to the progressive destruction of bone and connective tissue in the periodontal area. The cytokine network plays a primary role in tissue homeostasis, the recruitment of immune cells to control the pathogenic impact and the regulation of osteoclastic function, thus modulating the intensity and duration of the immune response. This review provides an update on the main cytokines implicated in the pathogenesis and progression of periodontitis and their targeting potential in order to enrich current treatment options. METHODS A structured search of bibliographic databases (PubMed, MEDLINE, Scopus) was performed for peer-reviewed cytokine studies focused on periodontitis the last ten years. A qualitative content analysis was performed in screened papers and a critical discussion of main findings is provided. RESULTS An altered cytokine profile has been detected in periodontitis patients and the interplay of pro-inflammatory and/or anti-inflammatory cytokines has been associated with disease pathogenesis. Among the most prominent pro-inflammatory cytokines, TNF-α, IL-1β, IL-17, IL-6 and the chemokines CXCL-6, CXCL-8 are overexpressed in periodontitis patients and correlate with disease progression. On the other hand, the anti-inflammatory IL-4 and IL- 11 levels are reduced while IL-12 and IFN-γ expression play a dual role in periodontal disease. Current periodontitis treatment strategies include selective antibiotics, antimicrobial photodynamic therapy and probiotics, which can modulate the cytokine network and when applied in combination with specific anti-cytokine agents can exert additional beneficial effects. CONCLUSION It is evident that cytokines play a central regulatory role in the inflammatory process and immune cell response that underlies bone destruction in periodontitis. Specific cytokine targeting should be considered as a complementary therapeutic scheme to current periodontal management.
Collapse
Affiliation(s)
- Grigorios Plemmenos
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Evangelos Evangeliou
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Nikolaos Polizogopoulos
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Andreas Chalazias
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Marianthi Deligianni
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| | - Christina Piperi
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Goudi, 115 27 Athens, Greece
| |
Collapse
|
28
|
Buonavoglia A, Leone P, Solimando AG, Fasano R, Malerba E, Prete M, Corrente M, Prati C, Vacca A, Racanelli V. Antibiotics or No Antibiotics, That Is the Question: An Update on Efficient and Effective Use of Antibiotics in Dental Practice. Antibiotics (Basel) 2021; 10:550. [PMID: 34065113 PMCID: PMC8151289 DOI: 10.3390/antibiotics10050550] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 12/17/2022] Open
Abstract
The antimicrobial resistance (AMR) phenomenon is an emerging global problem and is induced by overuse and misuse of antibiotics in medical practice. In total, 10% of antibiotic prescriptions are from dentists, usually to manage oro-dental pains and avoid postsurgical complications. Recent research and clinical evaluations highlight new therapeutical approaches with a reduction in dosages and number of antibiotic prescriptions and recommend focusing on an accurate diagnosis and improvement of oral health before dental treatments and in patients' daily lives. In this article, the most common clinical and operative situations in dental practice, such as endodontics, management of acute alveolar abscesses, extractive oral surgery, parodontology and implantology, are recognized and summarized, suggesting possible guidelines to reduce antibiotic prescription and consumption, maintaining high success rates and low complications rates. Additionally, the categories of patients requiring antibiotic administration for pre-existing conditions are recapitulated. To reduce AMR threat, it is important to establish protocols for treatment with antibiotics, to be used only in specific situations. Recent reviews demonstrate that, in dentistry, it is possible to minimize the use of antibiotics, thoroughly assessing patient's conditions and type of intervention, thus improving their efficacy and reducing the adverse effects and enhancing the modern concept of personalized medicine.
Collapse
Affiliation(s)
- Alessio Buonavoglia
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Patrizia Leone
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Antonio Giovanni Solimando
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Rossella Fasano
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Eleonora Malerba
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Marcella Prete
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | | | - Carlo Prati
- Endodontic Clinical Section, Department of Biomedical and NeuroMotor Sciences, Dental School, University of Bologna, 40125 Bologna, Italy;
| | - Angelo Vacca
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Vito Racanelli
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| |
Collapse
|
29
|
Dalvi S, Benedicenti S, Hanna R. Is antimicrobial photodynamic therapy an effective treatment modality for aggressive periodontitis? A systematic review of in vivo human randomized controlled clinical trials. Photodiagnosis Photodyn Ther 2021; 34:102314. [PMID: 33932563 DOI: 10.1016/j.pdpdt.2021.102314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/11/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Limitations of scaling and root planing (SRP) have directed research to utilize additional therapies to enhance conventional techniques. The present systematic review was conducted to evaluate and present a comprehensive overview on effectiveness of antimicrobial photodynamic therapy (aPDT) in the management of aggressive periodontitis (AgP). METHODOLOGY The PRISMA statement guidelines and Cochrane Collaboration recommendations were followed to conduct this systematic review. The review protocol is registered in PROSPERO (CRD 42019143316). A structured electronic and manual search strategy was implied to gather the relevant published data on in vivo human RCTs from their earliest records until 31st October 2019. Relevant data was extracted from the eligible studies, analysed and impartially appraised for its quality. RESULTS Eleven papers met the eligibility criteria and included in this review. The data on standardized study protocol, ideal photosensitizer (PS) dye-wavelength combination, optimal parameters was inconclusive and a high risk of bias in majority of the studies noted, which are fundamental in establishing a standardized and replicable protocol. CONCLUSION Ultimately researchers should conduct well-designed and robust RCTs performed by trained clinicians in order to determine the effectiveness of aPDT, if any, after acknowledging the drawbacks highlighted in this systematic review.
Collapse
Affiliation(s)
- Snehal Dalvi
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy; Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India.
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy; Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK.
| |
Collapse
|
30
|
Retamal-Valdes B, Teughels W, Oliveira LM, da Silva RN, Fritoli A, Gomes P, Soares GMS, Temporão N, Furquim CP, Duarte PM, Doyle H, Faveri M, Figueiredo LC, Feres M. Clinical, microbiological, and immunological effects of systemic probiotics in periodontal treatment: study protocol for a randomized controlled trial. Trials 2021; 22:283. [PMID: 33858486 PMCID: PMC8048221 DOI: 10.1186/s13063-021-05246-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association of scaling and root planing (SRP) with systemic metronidazole (MTZ) plus amoxicillin (AMX) has shown to be an effective treatment protocol, particularly for periodontitis stages III and IV, generalized. More recently, probiotics have also been suggested as a promising adjunctive treatment for periodontal diseases due to their antimicrobial and anti-inflammatory properties. Therefore, the aim of this randomized clinical trial (RCT) is to evaluate the clinical, microbiological, and immunological effects of probiotics as adjuncts to SRP alone or with MTZ+AMX in the treatment of periodontitis. METHODS Subjects with periodontitis are being randomly assigned to receive (i) SRP alone, or with (ii) two probiotic lozenges/day for 90 days (Prob), (iii) MTZ (400 mg) and AMX (500 mg) thrice a day (TID) for 14 days (MTZ+AMX), or (iv) Prob and MTZ+AMX. Subjects are being monitored for up to 12 months post-treatment. Nine subgingival plaque samples per patient are being collected at baseline and at 3, 6, and 12 months post-therapy and analyzed by checkerboard DNA-DNA hybridization for 40 bacterial species. Peripheral blood and gingival crevicular fluid (GCF) of four randomly selected periodontal sites will be analyzed by means of a multiplex fluorescent bead-based immunoassay for 17 cyto/chemokines. STATISTICAL ANALYSES The significance of differences in each group (over the course of the study) will be sought using repeated measures ANOVA or Friedman tests and among groups (at each time point) using either ANOVA/ANCOVA or Kruskal-Wallis tests, depending on normality of the data. The chi-square test will be used to compare differences in the frequency of subjects achieving the clinical endpoint for treatment (≤ 4 sites with PD ≥ 5 mm) at 1 year and of self-perceived adverse effects. A stepwise forward logistic regression analysis will be performed in order to investigate the impact of different predictor variables on the percentage of patients achieving the clinical endpoint for treatment. The Number Needed to Treat (NNT) with different treatment protocols will be also calculated. Statistical significance will be set at 5%. TRIAL REGISTRATION ClinicalTrials.gov NCT03733379. Registered on November 7, 2018.
Collapse
Affiliation(s)
- Belen Retamal-Valdes
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, Katholieke Universiteit Leuven (KULeuven), Leuven, Belgium
| | - Laryssa Macedo Oliveira
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Rebeca Nascimento da Silva
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Aretuza Fritoli
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Patricia Gomes
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | | | - Natalie Temporão
- Department of Stomatology, Federal University of Parana, Curitiba, Parana, Brazil
| | - Camila Pinheiro Furquim
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil.,Department of Stomatology, Federal University of Parana, Curitiba, Parana, Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil.,Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Helio Doyle
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Marcelo Faveri
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Luciene Cristina Figueiredo
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil.
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| |
Collapse
|
31
|
Agossa K, Sy K, Mainville T, Gosset M, Jeanne S, Grosgogeat B, Siepmann F, Loingeville F, Dubar M. Antibiotic Use in Periodontal Therapy among French Dentists and Factors Which Influence Prescribing Practices. Antibiotics (Basel) 2021; 10:303. [PMID: 33804145 PMCID: PMC8001084 DOI: 10.3390/antibiotics10030303] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 01/21/2023] Open
Abstract
The aim of the present survey is to investigate the use of antibiotics during periodontal therapy among French dentists with a focus on exploring potential differences between various groups of practitioners. A self-administered questionnaire was distributed to different groups of practitioners including members of (i) the French Society of Periodontology and Implantology; (ii) the College of University Teachers in Periodontology and, (iii) private practitioners participating in the French general dental practice-based research network. 272 questionnaires were included in the analysis. Prescription patterns were globally in line with the current recommendations. Systemic antibiotics are most frequently used as a first-line therapy in necrotizing periodontitis (92%) and aggressive periodontitis (53.3% to 66.1%). However, malpractice still exists, including in the management of periodontal abscesses. Antibiotics are prescribed (i) less frequently for periodontal abscesses and (ii) more frequently for generalized aggressive periodontitis by members of the periodontal society and University college (p < 0.05). Amoxicillin (59.9%) and the amoxicillin + metronidazole (59.6%) combination were the most frequently prescribed molecules. Providing a high number of periodontal treatments per week, being more recently graduated, having a post-graduate certificate in periodontology and holding or having held an academic position/hospital practice were all factors associated with a better knowledge of and/or more adequate antibiotic use.
Collapse
Affiliation(s)
- Kevimy Agossa
- University of Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France; (K.S.); (F.S.)
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, 59000 Lille, France; (T.M.); (M.D.)
| | - Kadiatou Sy
- University of Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France; (K.S.); (F.S.)
- Faculté d’Odontologie, Université de Lyon, Université Claude Bernard Lyon 1, 69008 Lyon, France;
- Hospices Civils de Lyon, Service d’Odontologie, 69007 Lyon, France
| | - Théo Mainville
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, 59000 Lille, France; (T.M.); (M.D.)
| | - Marjolaine Gosset
- Laboratory Orofacial Pathologies, Imaging and Biotherapies URP2496, Université de Paris, F-92120 Montrouge, France;
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, F-94200 Ivry-sur-Seine, France
- SFPIO—French Society of Periodontology and Oral Implantology, 44000 Nantes, France
| | - Sylvie Jeanne
- UFR d’Odontologie de Rennes, Bâtiment 15, 2 Avenue du Professeur Léon Bernard, Campus Santé, 35043 Rennes, France;
- Pôle Odontologie, CHU Rennes, 2 Rue Henri Le Guilloux, 35000 Rennes, France
- CNEP—French College of Teachers in Periodontology, 35000 Rennes, France
| | - Brigitte Grosgogeat
- Faculté d’Odontologie, Université de Lyon, Université Claude Bernard Lyon 1, 69008 Lyon, France;
- Hospices Civils de Lyon, Service d’Odontologie, 69007 Lyon, France
- Laboratoire des Multimatériaux et Interfaces, Université de Lyon—Claude Bernard Lyon 1, UMR CNRS 5615, F-69622 Villeurbanne, France
- ReCOL—French Private Dental Practice-Based Research Network, 69007 Lyon, France
| | - Florence Siepmann
- University of Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France; (K.S.); (F.S.)
| | - Florence Loingeville
- University of Lille, CHU Lille, ULR 2694—METRICS: Evaluation of Health Technologies and Medical Practices, F-59000 Lille, France;
| | - Marie Dubar
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, 59000 Lille, France; (T.M.); (M.D.)
- University of Lille, Inserm, CHU Lille, UMR-S 1172 JPArc, F-59000 Lille, France
| |
Collapse
|
32
|
Bashir NZ, Krstic M. Boric acid as an adjunct to periodontal therapy: A systematic review and meta-analysis. Int J Dent Hyg 2021; 19:139-152. [PMID: 33513275 DOI: 10.1111/idh.12487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/17/2020] [Accepted: 01/24/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate the efficacy of boric acid as an adjunct to non-surgical periodontal therapy, in comparison with a placebo adjunct, in terms of changes in probing pocket depth (PPD) and clinical attachment level (CAL), in patients with periodontitis. METHODS Four electronic databases were searched from inception to May 2020 (PubMed, Cochrane CENTRAL, EMBASE via OVID and Web of Science). Clinical outcomes were extracted, pooled and meta-analyses conducted using mean difference with standard deviations. RESULTS For PPD, a mean additional reduction of 0.58 mm (95% CI: -0.03-1.19 mm, p = 0.06) was observed at 3 months and a mean additional reduction of 1.18 mm (95% CI: 0.97-1.40 mm, p < 0.05) at 6 months, compared with placebo. For CAL, a mean additional gain of 0.62 mm (95% CI: -0.07-1.32 mm, p = 0.08) was observed at 3 months and a mean additional gain of 1.24 mm (95% CI: 0.89-1.58 mm, p < 0.05) at 6 months, compared with placebo. No adverse events were reported in any studies. CONCLUSIONS The adjunctive use of boric acid in non-surgical periodontal therapy results in improved treatment outcomes at 3 and 6 months, with no adverse events reported.
Collapse
Affiliation(s)
| | - Milan Krstic
- School of Dentistry, University of Birmingham, Birmingham, UK
| |
Collapse
|
33
|
Branco-de-Almeida LS, Cruz-Almeida Y, Gonzalez-Marrero Y, Kudsi R, de Oliveira ICV, Dolia B, Huang H, Aukhil I, Harrison P, Shaddox LM. Treatment of localized aggressive periodontitis alters local host immunoinflammatory profiles: A long-term evaluation. J Clin Periodontol 2020; 48:237-248. [PMID: 33205510 DOI: 10.1111/jcpe.13404] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the local immunoinflammatory profiles in localized aggressive periodontitis patients (LAP) before and after periodontal treatment and maintenance. METHODS Sixty-six African-Americans with LAP (7-21 years old) were included. After periodontal examination, all patients received periodontal treatment with mechanical debridement plus systemic amoxicillin/metronidazole for 7 days. Gingival crevicular fluid was collected from diseased and healthy sites at baseline and 3, 6, 12, and 24 months following treatment. Levels of 16 inflammatory/bone resorption markers were determined using Milliplex® . Univariate and correlation analyses were performed among all parameters/biomarkers. Discriminant analyses (DA) evaluated profile differences between LAP diseased and healthy sites at each time point as compared to the baseline. RESULTS Reductions in the clinical parameters (except for visible plaque) were observed at all time points compared to the baseline. Levels of IL-12p70, IL-2, IL-6, MIP-1α, RANKL, and OPG were reduced after treatment, and several cytokines/chemokines were correlated with clinical parameters reductions. DA showed that differences in the immunoinflammatory profiles between LAP diseased and healthy sites decreased after periodontal treatment compared to the baseline. CONCLUSIONS Periodontal treatment modified the local immunoinflammatory profile of LAP sites in the long term, as suggested by changes in biomarkers from baseline, along with clinical stability of the disease. (Clinicaltrials.gov number, NCT01330719).
Collapse
Affiliation(s)
- Luciana S Branco-de-Almeida
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA.,Post Graduate Program in Dentistry, School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | - Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida, USA
| | - Yandy Gonzalez-Marrero
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Rachad Kudsi
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Izabel C V de Oliveira
- Post Graduate Program in Dentistry, School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | - Bogdan Dolia
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Hong Huang
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Ikramuddin Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Peter Harrison
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA.,Department of Periodontology, Trinity College School of Dental Sciences, Dublin, Ireland
| | - Luciana M Shaddox
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA.,Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
34
|
Sgolastra F, Petrucci A, Ciarrocchi I, Masci C, Spadaro A. Adjunctive systemic antimicrobials in the treatment of chronic periodontitis: A systematic review and network meta-analysis. J Periodontal Res 2020; 56:236-248. [PMID: 33314159 DOI: 10.1111/jre.12821] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 10/31/2020] [Accepted: 11/12/2020] [Indexed: 12/28/2022]
Abstract
The aim of this systematic review and network meta-analysis was to assess the efficacy of antimicrobials adjunctive to scaling and root planing (SRP) in the treatment of chronic periodontitis. The study was conducted according to the PRISMA statement. The protocol (CRD42020178621) was registered on the International Prospective Register of Systematic Reviews (PROSPERO). The MEDLINE, EMBASE, and CENTRAL databases were searched up to March 2020; furthermore, a manual search of relevant periodontal journals was conducted. Mean differences (MD) and standard deviations were calculated for clinical attachment level (CAL) gain and probing depth (PD) reduction at 6 and 12 months. A network meta-analysis was performed to assess direct and indirect comparisons and to establish a ranking of treatments. A total of 21 randomized clinical trials (RCTs) were included in the systematic review. Network meta-analysis showed that SRP + amoxicillin (AMX) + metronidazole (MTZ), as compared to SRP, reached the highest PD reduction at 6 [MD = 0.47; 95% CI (0.3; 0.64)] and 12 months [MD = 0.51; 95% CI (0.25; 0.78)], and CAL gain at 6 [MD = 0.54; 95% CI (0.27; 0.8)] and 12 months [MD = 0.37; 95% CI (0.05; 0.69)]. Network meta-analysis indicated that AMX + MTZ adjunctive to SRP provided the best improvement in clinical parameters, followed by SRP + MTZ.
Collapse
|
35
|
Khattri S, Kumbargere Nagraj S, Arora A, Eachempati P, Kusum CK, Bhat KG, Johnson TM, Lodi G. Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis. Cochrane Database Syst Rev 2020; 11:CD012568. [PMID: 33197289 PMCID: PMC9166531 DOI: 10.1002/14651858.cd012568.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Systemic antimicrobials can be used as an adjunct to mechanical debridement (scaling and root planing (SRP)) as a non-surgical treatment approach to manage periodontitis. A range of antibiotics with different dosage and combinations are documented in the literature. The review follows the previous classification of periodontitis as all included studies used this classification. OBJECTIVES To assess the effects of systemic antimicrobials as an adjunct to SRP for the non-surgical treatment of patients with periodontitis. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases to 9 March 2020: Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, and Embase. The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. SELECTION CRITERIA We included randomized controlled trials (RCTs) which involved individuals with clinically diagnosed untreated periodontitis. Trials compared SRP with systemic antibiotics versus SRP alone/placebo, or with other systemic antibiotics. DATA COLLECTION AND ANALYSIS We selected trials, extracted data, and assessed risk of bias in duplicate. We estimated mean differences (MDs) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using GRADE. MAIN RESULTS We included 45 trials conducted worldwide involving 2664 adult participants. 14 studies were at low, 8 at high, and the remaining 23 at unclear overall risk of bias. Seven trials did not contribute data to the analysis. We assessed the certainty of the evidence for the 10 comparisons which reported long-term follow-up (≥ 1 year). None of the studies reported data on antimicrobial resistance and patient-reported quality of life changes. Amoxicillin + metronidazole + SRP versus SRP in chronic/aggressive periodontitis: the evidence for percentage of closed pockets (MD -16.20%, 95% CI -25.87 to -6.53; 1 study, 44 participants); clinical attachment level (CAL) (MD -0.47 mm, 95% CI -0.90 to -0.05; 2 studies, 389 participants); probing pocket depth (PD) (MD -0.30 mm, 95% CI -0.42 to -0.18; 2 studies, 389 participants); and percentage of bleeding on probing (BOP) (MD -8.06%, 95% CI -14.26 to -1.85; 2 studies, 389 participants) was of very low certainty. Only the results for closed pockets and BOP showed a minimally important clinical difference (MICD) favouring amoxicillin + metronidazole + SRP. Metronidazole + SRP versus SRP in chronic/aggressive periodontitis: the evidence for percentage of closed pockets (MD -12.20%, 95% CI -29.23 to 4.83; 1 study, 22 participants); CAL (MD -1.12 mm, 95% CI -2.24 to 0; 3 studies, 71 participants); PD (MD -1.11 mm, 95% CI -2.84 to 0.61; 2 studies, 47 participants); and percentage of BOP (MD -6.90%, 95% CI -22.10 to 8.30; 1 study, 22 participants) was of very low certainty. Only the results for CAL and PD showed an MICD favouring the MTZ + SRP group. Azithromycin + SRP versus SRP for chronic/aggressive periodontitis: we found no evidence of a difference in percentage of closed pockets (MD 2.50%, 95% CI -10.19 to 15.19; 1 study, 40 participants); CAL (MD -0.59 mm, 95% CI -1.27 to 0.08; 2 studies, 110 participants); PD (MD -0.77 mm, 95% CI -2.33 to 0.79; 2 studies, 110 participants); and percentage of BOP (MD -1.28%, 95% CI -4.32 to 1.76; 2 studies, 110 participants) (very low-certainty evidence for all outcomes). Amoxicillin + clavulanate + SRP versus SRP for chronic periodontitis: the evidence from 1 study, 21 participants for CAL (MD 0.10 mm, 95% CI -0.51 to 0.71); PD (MD 0.10 mm, 95% CI -0.17 to 0.37); and BOP (MD 0%, 95% CI -0.09 to 0.09) was of very low certainty and did not show a difference between the groups. Doxycycline + SRP versus SRP in aggressive periodontitis: the evidence from 1 study, 22 participants for CAL (MD -0.80 mm, 95% CI -1.49 to -0.11); and PD (MD -1.00 mm, 95% CI -1.78 to -0.22) was of very low certainty, with the doxycycline + SRP group showing an MICD in PD only. Tetracycline + SRP versus SRP for aggressive periodontitis: we found very low-certainty evidence of a difference in long-term improvement in CAL for the tetracycline group (MD -2.30 mm, 95% CI -2.50 to -2.10; 1 study, 26 participants). Clindamycin + SRP versus SRP in aggressive periodontitis: we found very low-certainty evidence from 1 study, 21 participants of a difference in long-term improvement in CAL (MD -1.70 mm, 95% CI -2.40 to -1.00); and PD (MD -1.80 mm, 95% CI -2.47 to -1.13) favouring clindamycin + SRP. Doxycycline + SRP versus metronidazole + SRP for aggressive periodontitis: there was very low-certainty evidence from 1 study, 27 participants of a difference in long-term CAL (MD 1.10 mm, 95% CI 0.36 to 1.84); and PD (MD 1.00 mm, 95% CI 0.30 to 1.70) favouring metronidazole + SRP. Clindamycin + SRP versus metronidazole + SRP for aggressive periodontitis: the evidence from 1 study, 26 participants for CAL (MD 0.20 mm, 95% CI -0.55 to 0.95); and PD (MD 0.20 mm, 95% CI -0.38 to 0.78) was of very low certainty and did not show a difference between the groups. Clindamycin + SRP versus doxycycline + SRP for aggressive periodontitis: the evidence from 1 study, 23 participants for CAL (MD -0.90 mm, 95% CI -1.62 to -0.18); and PD (MD -0.80 mm, 95% CI -1.58 to -0.02) was of very low certainty and did not show a difference between the groups. Most trials testing amoxicillin, metronidazole, and azithromycin reported adverse events such as nausea, vomiting, diarrhoea, mild gastrointestinal disturbances, and metallic taste. No serious adverse events were reported. AUTHORS' CONCLUSIONS There is very low-certainty evidence (for long-term follow-up) to inform clinicians and patients if adjunctive systemic antimicrobials are of any help for the non-surgical treatment of periodontitis. There is insufficient evidence to decide whether some antibiotics are better than others when used alongside SRP. None of the trials reported serious adverse events but patients should be made aware of the common adverse events related to these drugs. Well-planned RCTs need to be conducted clearly defining the minimally important clinical difference for the outcomes closed pockets, CAL, PD, and BOP.
Collapse
Affiliation(s)
- Shivi Khattri
- Department of Periodontics, Subharti Dental College and Hospital, Meerut, India
| | - Sumanth Kumbargere Nagraj
- Department of Oral Medicine and Oral Radiology, Faculty of Dentistry, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - Ankita Arora
- Department of Pedodontics and Preventive Dentistry, Faculty of Dentistry, Melaka-Manipal Medical College, Melaka, Malaysia
| | - Prashanti Eachempati
- Department of Prosthodontics, Faculty of Dentistry, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - Chandan Kumar Kusum
- Department of Prosthodontics, Subharti Dental College and Hospital, Meerut, India
| | - Kishore G Bhat
- Department of Molecular Biology and Immunology, Maratha Mandal's NGH Institute of Dental Sciences and Research Centre, Belgaum, India
| | - Trevor M Johnson
- Faculty of General Dental Practice (UK), RCS England, London, UK
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| |
Collapse
|
36
|
Bolstad AI, Saetre MM, Aasgaard AS, Bunaes DF. Shift in antibiotic prescription at a University Dental Clinic in Norway 2013-2017. Eur J Oral Sci 2020; 128:518-525. [PMID: 33084160 DOI: 10.1111/eos.12741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 01/03/2023]
Abstract
A considerable number of prescriptions for antibiotics are issued by dentists. Educational institutions have a special responsibility to promote informed attitudes among dental students towards prescribing antibiotics. The purpose of this study was to analyze the antibiotic prescriptions issued during a 5-year period (2013-2017) at a University Dental Clinic (UDC) in Norway. All patient records containing prescriptions for patients ≥18 yr of age as of 2013-2017 were identified through an electronic search. In total, 6,014 patient record lines containing prescriptions were obtained, 1,047 (17.4%) of which were prescriptions for systemic antibiotics. These patient record lines were analysed to identify the specific antibiotic prescribed, the indication or diagnosis for which it was prescribed, and whether microbiological testing (to determine antibiotic sensitivity) had been carried out. Acute infections were the most common context for prescribing antibiotics. Surprisingly, prophylaxis was the second most frequent reason stated. Disease related to pulp necrosis (43%) and postoperative infections (26%) was the most common diagnosis for therapeutic antibiotic prescriptions. Antibiotic therapy was more commonly used to treat peri-implantitis than to treat periodontitis. Only 60% of the clindamycin prescriptions were issued to patients with penicillin allergy. Further studies are warranted concerning antibiotic use at UDC because this can probably be more restrictive, in particular concerning usage related to antibiotic prophylaxis. Microbiological testing should be performed before administration of antibiotic therapy for periodontitis and peri-implantitis. The reason for prescribing antibiotics should always be stated in the patient's record lines.
Collapse
Affiliation(s)
- Anne I Bolstad
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Malene M Saetre
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Anette S Aasgaard
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Dagmar F Bunaes
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| |
Collapse
|
37
|
Feres M, Retamal-Valdes B, Fermiano D, Faveri M, Figueiredo LC, Mayer MPA, Lee JJ, Bittinger K, Teles F. Microbiome changes in young periodontitis patients treated with adjunctive metronidazole and amoxicillin. J Periodontol 2020; 92:467-478. [PMID: 32844406 DOI: 10.1002/jper.20-0128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/18/2020] [Accepted: 07/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND To our knowledge, to date, no studies have comprehensively assessed the changes occurring in the subgingival microbiome of young patients with periodontitis treated by means of mechanical and antibiotic therapy. Thus, this study aimed to use next-generation sequencing to evaluate the subgingival microbial composition of young patients with severe periodontitis treated with scaling and root planing and systemic metronidazole and amoxicillin. METHODS Subgingival samples from healthy individuals and shallow and deep sites from periodontitis patients were individually collected at baseline and 90 days post-treatment. The samples were analyzed using 16S rRNA-gene sequencing (MiSeq-Illumina) and QIIME pipeline. Differences between groups for the microbiological data were determined using principal coordinate analysis (PCoA), linear mixed models, and the PERMANOVA test. RESULTS One hundred samples were collected from 10 periodontitis patients and seven healthy individuals. PCoA analysis revealed significant partitioning between pre-and post-treatment samples. No major differences in the composition of the subgingival microbiota were observed between shallow and deep sites, at baseline or at 90-days post-treatment, and the microbiome of both site categories after treatment moved closer in similarity to that observed in periodontal health. Treatment significantly improved all clinical parameters and reduced the relative abundance of classical periodontal pathogens and of Fretibacterium fastidiosum, Eubacterium saphenum, Porphyromonas endodontalis, Treponema medium, Synergistetes, TM7, and Treponema spp, and increased that of Actinomyces, Rothia, Haemophilus, Corynebacterium, and Streptococci spp. CONCLUSION Mechanical treatment associated with metronidazole and amoxicillin promoted a beneficial change in the microbiome of young individuals with severe periodontitis.
Collapse
Affiliation(s)
- Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Belén Retamal-Valdes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Daiane Fermiano
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Marcelo Faveri
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | | | - Marcia P A Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Jung-Jin Lee
- Microbiome Center at the Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kyle Bittinger
- Microbiome Center at the Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Flavia Teles
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
38
|
Derikvand N, Ghasemi SS, Safiaghdam H, Piriaei H, Chiniforush N. Antimicrobial Photodynamic Therapy with Diode laser and Methylene blue as an adjunct to scaling and root planning: A clinical trial. Photodiagnosis Photodyn Ther 2020; 31:101818. [DOI: 10.1016/j.pdpdt.2020.101818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/17/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
|
39
|
Xu T, Wu X, Zhou Z, Ye Y, Yan C, Zhuge N, Yu J. Hyperoside ameliorates periodontitis in rats by promoting osteogenic differentiation of BMSCs via activation of the NF-κB pathway. FEBS Open Bio 2020; 10:1843-1855. [PMID: 32687664 PMCID: PMC7459408 DOI: 10.1002/2211-5463.12937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/10/2020] [Accepted: 07/16/2020] [Indexed: 12/17/2022] Open
Abstract
Hyperoside, as an active compound, widely exists in a large number of Chinese herbal medicines and has been reported to possess anti‐inflammatory and diuretic properties. However, the effects and underlying mechanisms of hyperoside on periodontitis have not been previously reported. In this study, we found that hyperoside ameliorates symptoms of periodontitis in a rat model, with improvements in alveolar bone resorption, relief of inflammatory infiltration, increase in orderly arrangement of collagen fibers and increase of osteogenic differentiation. In addition, hyperoside promoted proliferation, up‐regulated EdU‐positive cells, decreased cell‐cycle distribution and increased the protein expression of Ki67 and PCNA in rat bone mesenchymal stem cells (rBMSCs), as revealed by Cell Counting Kit‐8, EdU, flow cytometry and western blot analysis. Moreover, hyperoside significantly promoted osteogenic differentiation, as shown by quantitative RT‐PCR, western blot and alizarin red staining assays. Furthermore, hyperoside activated the nuclear factor‐κB (NF‐κB) signaling pathway in rBMSCs, similar to the results observed in vivo. Finally, BMS345541, an inhibitor of the NF‐κB signaling pathway, could reverse the effects of hyperoside on the biological functions in rBMSCs. In conclusion, our results suggest that hyperoside has potential therapeutic properties against periodontitis via promotion of proliferation and osteogenic differentiation of rBMSCs via activation of the NF‐κB signaling pathway.
Collapse
Affiliation(s)
- Tao Xu
- Institute of Stomatology, Nanjing Medical University, Nanjing, China.,Department of Stomatology, Central Hospital of Nanjing, Nanjing, China
| | - Xiao Wu
- Institute of Stomatology, Nanjing Medical University, Nanjing, China.,Key Laboratory of Oral Diseases of Jiangsu Province, Stomatological Institute, Nanjing Medical University, Nanjing, China
| | - Zhou Zhou
- Institute of Stomatology, Nanjing Medical University, Nanjing, China.,Key Laboratory of Oral Diseases of Jiangsu Province, Stomatological Institute, Nanjing Medical University, Nanjing, China
| | - Yu Ye
- Institute of Stomatology, Nanjing Medical University, Nanjing, China.,Key Laboratory of Oral Diseases of Jiangsu Province, Stomatological Institute, Nanjing Medical University, Nanjing, China
| | - Chaoting Yan
- Institute of Stomatology, Nanjing Medical University, Nanjing, China.,Key Laboratory of Oral Diseases of Jiangsu Province, Stomatological Institute, Nanjing Medical University, Nanjing, China
| | | | - Jinhua Yu
- Institute of Stomatology, Nanjing Medical University, Nanjing, China.,Department of Endodontics, School of Stomatology, Nanjing Medical University, Nanjing, China
| |
Collapse
|
40
|
Teughels W, Feres M, Oud V, Martín C, Matesanz P, Herrera D. Adjunctive effect of systemic antimicrobials in periodontitis therapy: A systematic review and meta‐analysis. J Clin Periodontol 2020; 47 Suppl 22:257-281. [DOI: 10.1111/jcpe.13264] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Wim Teughels
- Department of Oral Health Sciences KU Leuven & Dentistry (Periodontology) University Hospitals Leuven Leuven Belgium
| | - Magda Feres
- Department of Periodontology Dental Research Division Guarulhos University Guarulhos Brazil
| | - Valerie Oud
- Department of Oral Health Sciences KU Leuven & Dentistry (Periodontology) University Hospitals Leuven Leuven Belgium
| | - Conchita Martín
- BIOCRAN (Craniofacial Biology) Research Group University Complutense Madrid Spain
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| |
Collapse
|
41
|
Arredondo A, Blanc V, Mor C, Nart J, León R. Resistance to β-lactams and distribution of β-lactam resistance genes in subgingival microbiota from Spanish patients with periodontitis. Clin Oral Investig 2020; 24:4639-4648. [PMID: 32495224 DOI: 10.1007/s00784-020-03333-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/08/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study was to analyze the distribution of β-lactamase genes and the multidrug resistance profiles in β-lactam-resistant subgingival bacteria from patients with periodontitis. MATERIALS AND METHODS Subgingival samples were obtained from 130 Spanish patients with generalized periodontitis stage III or IV. Samples were grown on agar plates with amoxicillin or cefotaxime and incubated in anaerobic and microaerophilic conditions. Isolates were identified to the species level by the sequencing of their 16S rRNA gene. A screening for the following β-lactamase genes was performed by the polymerase chain reaction (PCR) technique: blaTEM, blaSHV, blaCTX-M, blaCfxA, blaCepA, blaCblA, and blaampC. Additionally, multidrug resistance to tetracycline, chloramphenicol, streptomycin, erythromycin, and kanamycin was assessed, growing the isolates on agar plates with breakpoint concentrations of each antimicrobial. RESULTS β-lactam-resistant isolates were found in 83% of the patients. Seven hundred and thirty-seven isolates from 35 different genera were obtained, with Prevotella and Streptococcus being the most identified genera. blaCfxA was the gene most detected, being observed in 24.8% of the isolates, followed by blaTEM (12.9%). Most of the isolates (81.3%) were multidrug-resistant. CONCLUSIONS This study shows that β-lactam resistance is widespread among Spanish patients with periodontitis. Furthermore, it suggests that the subgingival commensal microbiota might be a reservoir of multidrug resistance and β-lactamase genes. CLINICAL RELEVANCE Most of the samples yielded β-lactam-resistant isolates, and 4 different groups of bla genes were detected among the isolates. Most of the isolates were also multidrug-resistant. The results show that, although β-lactams may still be effective, their future might be hindered by the presence of β-lactam-resistant bacteria and the presence of transferable bla genes.
Collapse
Affiliation(s)
- Alexandre Arredondo
- Department of Microbiology, Dentaid Research Center, Cerdanyola del Vallès, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Vanessa Blanc
- Department of Microbiology, Dentaid Research Center, Cerdanyola del Vallès, Spain
| | - Carolina Mor
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Rubén León
- Department of Microbiology, Dentaid Research Center, Cerdanyola del Vallès, Spain.
| |
Collapse
|
42
|
Afacan B, Keleş Yücel ZP, Paşali Ç, Atmaca İlhan H, Köse T, Emingil G. Effect of non-surgical periodontal treatment on gingival crevicular fluid hypoxia inducible factor-1 alpha, vascular endothelial growth factor and tumor necrosis factor-alpha levels in generalized aggressive periodontitis patients. J Periodontol 2020; 91:1495-1502. [PMID: 32246842 DOI: 10.1002/jper.19-0521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/04/2020] [Accepted: 03/10/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Hypoxia-inducible angiogenic pathway involving hypoxia inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF-α) may regulate several biological processes related to inflammation. The present study aimed to assess the effect of non-surgical periodontal treatment on gingival crevicular fluid (GCF) HIF-1α, VEGF, and TNF-α levels in generalized aggressive periodontitis (G-AgP). METHODS Twenty G-AgP patients and 20 periodontally healthy individuals were included. G-AgP patients received scaling and root planning (SRP), per quadrant at a 1-week-interval, performed with ultrasonic and periodontal hand instruments. GCF samples were collected and clinical periodontal parameters including probing depth, clinical attachment level, gingival index and plaque index were recorded at baseline, 1 and 3 months after treatment. Biomarker levels in GCF were analyzed by ELISA. RESULTS At baseline all clinical parameters and GCF HIF-1α, VEGF, and TNF-α levels were significantly higher in G-AgP patients compared to healthy control (P < 0.05). All clinical parameters improved over the 3-month-period in G-AgP patients (P < 0.05). GCF HIF-1α levels in G-AgP reduced at 1 and 3 months post-treatment, however, this did not reach to statistical significance (P > 0.05). GCF VEGF and TNF-α levels remained unchanged throughout the study period (P > 0.05). CONCLUSIONS Within the limitations of the present study, although HIF-1α seems to possess a potential diagnostic value for G-AgP, it might not be a proper predictor of clinically favorable treatment outcome. SRP plus different adjunctive therapies could provide better information about the prognostic role of hypoxia-inducible angiogenic pathway in G-AgP.
Collapse
Affiliation(s)
- Beral Afacan
- Department of Periodontology, School of Dentistry, Adnan Menderes University, Aydın, Turkey
| | | | - Çiğdem Paşali
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Harika Atmaca İlhan
- Section of Molecular Biology, Department of Biology, School of Science, Celal Bayar University, Manisa, Turkey
| | - Timur Köse
- Department of Biostatistics and Medical Informatics, School of Medicine, Ege University, İzmir, Turkey
| | - Gülnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| |
Collapse
|
43
|
Hbibi A, Sikkou K, Khedid K, El Hamzaoui S, Bouziane A, Benazza D. Antimicrobial activity of honey in periodontal disease: a systematic review. J Antimicrob Chemother 2020; 75:807-826. [PMID: 31977042 DOI: 10.1093/jac/dkz527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/04/2019] [Accepted: 11/15/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Honey has shown positive antimicrobial and anti-inflammatory actions in several dermatological studies; however, it is unclear if it could be effective in the treatment of periodontal disease. OBJECTIVES To answer the question: Does honey have antimicrobial activity against periodontopathogens? METHODS Six electronic databases were screened from initiation to 31 January 2019 for randomized clinical trials (RCTs) and controlled in vitro studies exploring the antimicrobial effect of honey against periodontopathogens. Honey's botanical origin, periopathogens that showed microbial susceptibility to honey, MICs, microbial growth conditions, control product and clinical follow-up were the main investigated outcomes. The risk of bias (RoB) of included RCTs was assessed using the Cochrane Collaboration RoB tool. The RoB of in vitro studies was evaluated based on the Sarkis-Onofre judgement model adapted to the context of honey. RESULTS A total of 1448 publications were found as search results in the screened databases. Sixteen eligible papers were included based on predetermined inclusion criteria. Retained studies included 5 RCTs and 11 in vitro controlled trials. Manuka and multifloral honeys were the most studied varieties. The tested honeys showed a significant antimicrobial action, with different MICs, against eight periopathogens. Four of the five RCTs showed a high RoB, while 4 of the 11 retained in vitro studies showed a medium RoB. CONCLUSIONS Honey showed a significant antimicrobial activity against all targeted periopathogens. Additional experiments are required to explore the entire antimicrobial spectrum of honey towards all pathogens involved in periodontal disease.
Collapse
Affiliation(s)
- Abdelhadi Hbibi
- Laboratory of Oral Microbiology and Biotechnology, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, Morocco.,Centre des Soins Dentaires, Hôpital Provincial Moulay Abdellah, Salé, Morocco
| | - Khadija Sikkou
- Centre des Soins Dentaires, Hôpital Provincial Moulay Abdellah, Salé, Morocco
| | - Khadija Khedid
- Department of Microbiology, National Institute of Health, Rabat, Morocco
| | - Sakina El Hamzaoui
- Department of Microbiology, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Amal Bouziane
- Department of Periodontology, Faculty of Dental Medicine, Biostatistical Clinical and Epidemiological Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Driss Benazza
- Department of Periodontology, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, Morocco
| |
Collapse
|
44
|
Avila-Ortiz G, Chambrone L, Vignoletti F. Effect of alveolar ridge preservation interventions following tooth extraction: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:195-223. [PMID: 30623987 DOI: 10.1111/jcpe.13057] [Citation(s) in RCA: 214] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/22/2018] [Accepted: 11/08/2018] [Indexed: 12/21/2022]
Abstract
AIM The aim of this systematic review was to critically analyse the available evidence on the effect of different modalities of alveolar ridge preservation (ARP) as compared to tooth extraction alone in function of relevant clinical, radiographic and patient-centred outcomes. MATERIAL AND METHODS A comprehensive search aimed at identifying pertinent literature for the purpose of this review was conducted by two independent examiners. Only randomized clinical trials (RCTs) that met the eligibility criteria were selected. Relevant data from these RCTs were collated into evidence tables. Endpoints of interest included clinical, radiographic and patient-reported outcome measures (PROMs). Interventions reported in the selected studies were clustered into ARP treatment modalities. All these different ARP modalities were compared to the control therapy (i.e. spontaneous socket healing) in each individual study after a 3- to 6-month healing period. Random-effects meta-analyses were conducted if at least two studies within the same ARP treatment modality reported on the same outcome of interest. RESULTS A combined database, grey literature and hand search identified 3,003 records, of which 1,789 were screened after removal of duplicates. Following the application of the eligibility criteria, 25 articles for a total of 22 RCTs were included in the final selection, from which nine different ARP treatment modalities were identified: (a) bovine bone particles (BBP) + socket sealing (SS), (b) construct made of 90% bovine bone granules and 10% porcine collagen (BBG/PC) + SS, (c) cortico-cancellous porcine bone particles (CPBP) + SS, (d) allograft particles (AG) + SS, (e) alloplastic material (AP) with or without SS, (f) autologous blood-derived products (ABDP), (g) cell therapy (CTh), (h) recombinant morphogenic protein-2 (rhBMP-2) and (i) SS alone. Quantitative analyses for different ARP modalities, all of which involved socket grafting with a bone substitute, were feasible for a subset of clinical and radiographic outcomes. The results of a pooled quantitative analysis revealed that ARP via socket grafting (ARP-SG), as compared to tooth extraction alone, prevents horizontal (M = 1.99 mm; 95% CI 1.54-2.44; p < 0.00001), vertical mid-buccal (M = 1.72 mm; 95% CI 0.96-2.48; p < 0.00001) and vertical mid-lingual (M = 1.16 mm; 95% CI 0.81-1.52; p < 0.00001) bone resorption. Whether there is a superior ARP or SS approach could not be determined on the basis of the selected evidence. However, the application of particulate xenogenic or allogenic materials covered with an absorbable collagen membrane or a rapidly absorbable collagen sponge was associated with the most favourable outcomes in terms of horizontal ridge preservation. A specific quantitative analysis showed that sites presenting a buccal bone thickness >1.0 mm exhibited more favourable ridge preservation outcomes (difference between ARP [AG + SS] and control = 3.2 mm), as compared to sites with a thinner buccal wall (difference between ARP [AG + SS] and control = 1.29 mm). The effect of other local and systemic factors could not be assessed as part of the quantitative analyses. PROMs were comparable between the experimental and the control group in two studies involving the use of ABDP. The effect of other ARP modalities on PROMs could not be investigated, as these outcomes were not reported in any other clinical trial included in this study. CONCLUSION Alveolar ridge preservation is an effective therapy to attenuate the dimensional reduction of the alveolar ridge that normally takes place after tooth extraction.
Collapse
Affiliation(s)
| | - Leandro Chambrone
- Department of Periodontics, University of Iowa, Iowa City, Iowa.,School of Dentistry, Ibirapuera University, São Paulo, Brazil
| | - Fabio Vignoletti
- Department of Periodontology, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
45
|
Al-Khureif AA, Mohamed BA, Siddiqui AZ, Khan AA, Divakar DD. Repeated application of photodynamic and antibiotic therapy as an adjunct to root surface debridement in patients with grade C and stage III or IV aggressive periodontitis. Photodiagnosis Photodyn Ther 2019; 29:101610. [PMID: 31785387 DOI: 10.1016/j.pdpdt.2019.101610] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) and antimicrobial therapy on clinical and immunological outcomes of periodontal treatment in patients with periodontitis grade C and stage III or IV. MATERIAL AND METHOD The patients recruited in the current research fulfil the clinical case definition of periodontitis 'grade C' in terms of onset of the infection and stage III or IV that defines degree and severity of the disease. One-stage full-mouth ultrasonic debridement (UD) was performed and randomly divided in two groups: Group-I - four applications of aPDT, and Group-II - combination of metronidazole (MTZ) and amoxicillin (AMX) 3 tablets each for 7 days. Whole-mouth periodontal parameters were recorded at baseline, 3-, 6-months after completion of treatment. Gingival crevicular fluid samples were obtained for assessment of inflammatory interleukin (IL)-10 and IL-17 at the same time points. RESULTS Seventeen healthy patients completed the study protocol and revealed similar clinical findings at baseline. Bleeding scores significantly reduced in group-I at 3 months post treatment (p < 0.05). It could be seen that group-I showed statistically significant reduction of deep periodontal pockets and gain in CAL in patients with GAP at 3 months (p < 0.05). This difference was maintained at 6 months of follow-up (p < 0.001). Group-II was capable of increasing the levels of IL-10 and reducing IL-17 in GCF at both time periods compared to Group-I (p < 0.05). Group-I did not have significant effect on either cytokine levels in GCF (p > 0.05). CONCLUSION Antimicrobial photodynamic therapy improved severe deep periodontal pockets. However, the combination of antimicrobial therapy helped in reducing proinflammation in grade C and stage III or IV periodontitis.
Collapse
Affiliation(s)
| | - Badreldin A Mohamed
- Community Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Adel Zia Siddiqui
- Dental Materials Department, Baqai Dental College, Baqai Medical University, Karachi, Pakistan
| | - Aftab Ahmed Khan
- Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
46
|
Araujo CF, Andere NM, Castro dos Santos NC, Mathias‐Santamaria IF, Reis AA, Oliveira LD, Jardini MA, Casarin RC, Santamaria MP. Two different antibiotic protocols as adjuncts to one‐stage full‐mouth ultrasonic debridement to treat generalized aggressive periodontitis: A pilot randomized controlled clinical trial. J Periodontol 2019; 90:1431-1440. [DOI: 10.1002/jper.18-0399] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 02/02/2019] [Accepted: 02/02/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Cássia F. Araujo
- Division of PeriodonticsInstitute of Science and TechnologySão Paulo State University (Unesp) São José dos Campos São Paulo Brazil
| | - Naira M.R.B. Andere
- Division of PeriodonticsInstitute of Science and TechnologySão Paulo State University (Unesp) São José dos Campos São Paulo Brazil
| | - Nídia C. Castro dos Santos
- Division of PeriodonticsInstitute of Science and TechnologySão Paulo State University (Unesp) São José dos Campos São Paulo Brazil
| | - Ingrid F. Mathias‐Santamaria
- Division of PeriodonticsInstitute of Science and TechnologySão Paulo State University (Unesp) São José dos Campos São Paulo Brazil
| | - Aurélio A. Reis
- Department of Prosthodontics and PeriodonticsDivision of PeriodonticsPiracicaba Dental SchoolUniversity of Campinas (Unicamp) Piracicaba São Paulo Brazil
| | - Luciane D. Oliveira
- Division of PeriodonticsInstitute of Science and TechnologySão Paulo State University (Unesp) São José dos Campos São Paulo Brazil
| | - Maria A.N. Jardini
- Division of PeriodonticsInstitute of Science and TechnologySão Paulo State University (Unesp) São José dos Campos São Paulo Brazil
| | - Renato C.V. Casarin
- Department of Prosthodontics and PeriodonticsDivision of PeriodonticsPiracicaba Dental SchoolUniversity of Campinas (Unicamp) Piracicaba São Paulo Brazil
| | - Mauro P. Santamaria
- Division of PeriodonticsInstitute of Science and TechnologySão Paulo State University (Unesp) São José dos Campos São Paulo Brazil
| |
Collapse
|
47
|
Jensen AB, Haubek D, Claesson R, Johansson A, Nørskov‐Lauritsen N. Comprehensive antimicrobial susceptibility testing of a large collection of clinical strains ofAggregatibacter actinomycetemcomitansdoes not identify resistance to amoxicillin. J Clin Periodontol 2019; 46:846-854. [DOI: 10.1111/jcpe.13148] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 03/21/2019] [Accepted: 05/20/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Anne B. Jensen
- Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
- Department of Clinical Microbiology Aarhus University Hospital Aarhus Denmark
| | - Dorte Haubek
- Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
| | - Rolf Claesson
- Division of Oral Microbiology, Department of Odontology, Faculty of Medicine and Odontology Umeå University Umeå Sweden
| | - Anders Johansson
- Division of Periodontology, Department of Odontology, Faculty of Medicine and Odontology Umeå University Umeå Sweden
| | | |
Collapse
|
48
|
Aoki-Nonaka Y, Tabeta K, Yokoji M, Matsugishi A, Matsuda Y, Takahashi N, Sulijaya B, Domon H, Terao Y, Taniguchi M, Yamazaki K. A peptide derived from rice inhibits alveolar bone resorption via suppression of inflammatory cytokine production. J Periodontol 2019; 90:1160-1169. [PMID: 31032912 DOI: 10.1002/jper.18-0630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Periodontitis is an inflammatory disease that results in alveolar bone resorption due to inflammatory cytokine production induced by bacterial antigens such as lipopolysaccharides (LPS). Here, the preventive effect of the Amyl-1-18 peptide derived from rice in an experimental model of periodontitis and the effect on the anti-inflammatory response were assessed. METHODS Alveolar bone resorption, gene transcription of proinflammatory cytokines in the gingiva, and the endotoxin level in the oral cavity were evaluated after oral administration of the Amyl-1-18 peptide for 14 days using a ligature-induced periodontitis model in mice. Additionally, murine macrophages were incubated with LPS of Escherichia coli or Porphyromonas gingivalis in the presence of Amyl-1-18 to analyze the suppressive effects of Amyl-1-18 on the cell signaling pathways associated with proinflammatory cytokine production, including inflammasome activities. RESULTS Oral administration of Amyl-1-18 suppressed alveolar bone resorption and gene transcription of interleukin (il)6 in the gingiva of the periodontitis model, and decreased endotoxin levels in the oral cavity, suggesting modulation of periodontal inflammation by inhibition of endotoxin activities in vivo. Also, Amyl-1-18 suppressed IL-6 production induced by LPS and recombinant IL-1β in macrophages in vitro but had no effect on inflammasome activity. CONCLUSIONS The Amyl-1-18 peptide from rice inhibited alveolar bone destruction in mouse periodontitis model via suppressing inflammatory cytokine production induced by LPS. It was suggested that Amyl-1-18 peptide has anti-inflammatory property against LPS, not only by neutralization of LPS and subsequent inhibition of nuclear factor-κB signaling but also by inhibition of the IL-1R-related signaling cascade.
Collapse
Affiliation(s)
- Yukari Aoki-Nonaka
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koichi Tabeta
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Mai Yokoji
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Aoi Matsugishi
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Matsuda
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoki Takahashi
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Benso Sulijaya
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Hisanori Domon
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Terao
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masayuki Taniguchi
- Department of Materials Science and Technology, Graduate School of Science and Technology, Niigata University, Niigata, Japan
| | - Kazuhisa Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
49
|
Martins E, César-Neto J, Albuquerque-Souza E, Rebeis E, Holzhausen M, Pannuti C, Mayer M, Saraiva L. One-year follow-up of the immune profile in serum and selected sites of generalized and localized aggressive periodontitis. Cytokine 2019; 116:27-37. [DOI: 10.1016/j.cyto.2018.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 11/26/2018] [Accepted: 12/28/2018] [Indexed: 12/16/2022]
|
50
|
Rebeis ES, Albuquerque-Souza E, Paulino da Silva M, Giudicissi M, Mayer MPA, Saraiva L. Effect of periodontal treatment onAggregatibacter actinomycetemcomitanscolonization and serum IgG levels againstA. actinomycetemcomitansserotypes and Omp29 of aggressive periodontitis patients. Oral Dis 2018; 25:569-579. [DOI: 10.1111/odi.13010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/04/2018] [Accepted: 11/22/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Estela Sanches Rebeis
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - Emmanuel Albuquerque-Souza
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - Maike Paulino da Silva
- Department of Microbiology, Institute of Biomedical Sciences; University of São Paulo; Sao Paulo Brazil
| | - Marcela Giudicissi
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - Marcia P. A. Mayer
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
- Department of Microbiology, Institute of Biomedical Sciences; University of São Paulo; Sao Paulo Brazil
| | - Luciana Saraiva
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| |
Collapse
|