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Hernández-Venegas PA, Martínez-Martínez RE, Zaragoza-Contreras EA, Domínguez-Pérez RA, Reyes-López SY, Donohue-Cornejo A, Cuevas-González JC, Molina-Frechero N, Espinosa-Cristóbal LF. Bactericidal Activity of Silver Nanoparticles on Oral Biofilms Related to Patients with and without Periodontal Disease. J Funct Biomater 2023; 14:311. [PMID: 37367275 DOI: 10.3390/jfb14060311] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Periodontal disease (PD) is a multifactorial oral disease regularly caused by bacterial biofilms. Silver nanoparticles (AgNP) have offered good antimicrobial activity; moreover, there is no available scientific information related to their antimicrobial effects in biofilms from patients with PD. This study reports the bactericidal activity of AgNP against oral biofilms related to PD. MATERIALS AND METHODS AgNP of two average particle sizes were prepared and characterized. Sixty biofilms were collected from patients with (30 subjects) and without PD (30 subjects). Minimal inhibitory concentrations of AgNP were calculated and the distribution of bacterial species was defined by polymerase chain reaction. RESULTS Well-dispersed sizes of AgNP were obtained (5.4 ± 1.3 and 17.5 ± 3.4 nm) with an adequate electrical stability (-38.2 ± 5.8 and -32.6 ± 5.4 mV, respectively). AgNP showed antimicrobial activities for all oral samples; however, the smaller AgNP had significantly the most increased bactericidal effects (71.7 ± 39.1 µg/mL). The most resistant bacteria were found in biofilms from PD subjects (p < 0.05). P. gingivalis, T. denticola, and T. forsythia were present in all PD biofilms (100%). CONCLUSIONS The AgNP showed efficient bactericidal properties as an alternative therapy for the control or progression of PD.
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Affiliation(s)
- Perla Alejandra Hernández-Venegas
- Chemical Biological Department, Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Chihuahua, Mexico
| | - Rita Elizabeth Martínez-Martínez
- Master Program in Advanced Dentistry, Faculty of Dentistry, Autonomous University of San Luis Potosi, Manuel Nava Avenue, Universitary Campus, San Luis Potosí 78290, San Luis Potosi, Mexico
| | - Erasto Armando Zaragoza-Contreras
- Department of Engineering and Materials Chemistry, Centro de Investigación en Materiales Avanzados, S. C., Miguel de Cervantes No. 120, Chihuahua 31109, Chihuahua, Mexico
| | - Rubén Abraham Domínguez-Pérez
- Laboratory of Multidisciplinary Dental Research, Faculty of Medicine, Autonomous University of Queretaro, Clavel Street, Prados de La Capilla, Santiago de Querétaro 76176, Queretaro, Mexico
| | - Simón Yobanny Reyes-López
- Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Chihuahua, Mexico
| | - Alejandro Donohue-Cornejo
- Master Program in Dental Sciences, Stomatology Department, Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Chihuahua, Mexico
| | - Juan Carlos Cuevas-González
- Master Program in Dental Sciences, Stomatology Department, Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Chihuahua, Mexico
| | - Nelly Molina-Frechero
- Division of Biological and Health Sciences, Autonomous Metropolitan University Xochimilco (UAM), Mexico City 04960, Mexico
| | - León Francisco Espinosa-Cristóbal
- Master Program in Dental Sciences, Stomatology Department, Institute of Biomedical Sciences, Autonomous University of Juarez City (UACJ), Envolvente del PRONAF and Estocolmo s/n, Ciudad Juárez 32310, Chihuahua, Mexico
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Morozumi T, Nakayama Y, Shirakawa S, Imamura K, Nohno K, Nagano T, Miyazawa H, Hokari T, Takuma R, Sugihara S, Gomi K, Saito A, Ogata Y, Komaki M. Effect of Locally Delivered Minocycline on the Profile of Subgingival Bacterial Genera in Patients with Periodontitis: A Prospective Pilot Study. Biomolecules 2022; 12:biom12050719. [PMID: 35625646 PMCID: PMC9138390 DOI: 10.3390/biom12050719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023] Open
Abstract
This prospective pilot study aimed to evaluate the effect of minocycline-HCl ointment (MO), locally delivered as an adjunct to scaling and root planing (SRP), on subgingival microflora. A total of 59 periodontitis patients received SRP as an initial periodontal therapy. In the selected periodontal pockets with probing depths (PD) of 6−9 mm, the sites that exhibited a positive reaction following a bacterial test using an immunochromatographic device were subsequently treated with MO (SRP + MO group, n = 25). No additional treatment was performed at sites showing a negative reaction (SRP group, n = 34). In addition to subgingival plaque sampling, measurement of clinical parameters including PD, clinical attachment level (CAL), bleeding on probing (BOP), plaque index and gingival index (GI) were performed at baseline and 4 weeks after the initial periodontal therapy. The subgingival microflora were assessed by terminal restriction fragment-length polymorphism analysis. Relative to baseline values, the mean scores for PD-, CAL-, BOP-, and GI-sampled sites were significantly decreased post treatment in both groups (p < 0.01). The intra-comparisons showed a significant decrease in the counts of the genera Eubacterium, Parvimonas, Filifactor, Veillonella, Fusobacterium, Porphyromonas, Prevotella, and unknown species in the SRP + MO group (p < 0.05). Inter-comparisons indicated a significant decrease in the genera Veillonella in the SRP + MO group (p = 0.01). Combination therapy of SRP and local MO induced a change in the subgingival microbial community: particularly, the number of Veillonella spp. was markedly reduced.
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Affiliation(s)
- Toshiya Morozumi
- Department of Periodontology, Faculty of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan; (R.T.); (S.S.); (M.K.)
- Correspondence: ; Tel.: +81-46-822-8855
| | - Yohei Nakayama
- Departments of Periodontology and Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-nishi, Matsudo 271-8587, Japan; (Y.N.); (Y.O.)
| | - Satoshi Shirakawa
- Department of Dental Hygiene, Tsurumi Junior College, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan;
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, 2-9-18 Kanda-Misakicho, Chiyoda-ku, Tokyo 101-0061, Japan; (K.I.); (A.S.)
| | - Kaname Nohno
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan;
| | - Takatoshi Nagano
- Department of Periodontology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan; (T.N.); (K.G.)
| | - Haruna Miyazawa
- Clinical and Translational Research Center, Niigata University Medical and Dental Hospital, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan;
| | - Takahiro Hokari
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan;
| | - Ryo Takuma
- Department of Periodontology, Faculty of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan; (R.T.); (S.S.); (M.K.)
| | - Shuntaro Sugihara
- Department of Periodontology, Faculty of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan; (R.T.); (S.S.); (M.K.)
| | - Kazuhiro Gomi
- Department of Periodontology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan; (T.N.); (K.G.)
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, 2-9-18 Kanda-Misakicho, Chiyoda-ku, Tokyo 101-0061, Japan; (K.I.); (A.S.)
| | - Yorimasa Ogata
- Departments of Periodontology and Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-nishi, Matsudo 271-8587, Japan; (Y.N.); (Y.O.)
| | - Motohiro Komaki
- Department of Periodontology, Faculty of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan; (R.T.); (S.S.); (M.K.)
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Professionally Delivered Local Antimicrobials in the Treatment of Patients with Periodontitis-A Narrative Review. Dent J (Basel) 2020; 9:dj9010002. [PMID: 33375176 PMCID: PMC7822216 DOI: 10.3390/dj9010002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
This review sheds light on the recent published scientific evidence relating to the use of professionally delivered local antimicrobial agents (LA’s). The review also analyses drug delivery systems available to date and provides an update on the latest scientific evidence about the benefits, limitations, and clinical results obtained by use of local drugs in the treatment of periodontal disease. The search strategy revealed randomized controlled trials (RCTs) that compared the efficacy of adjunctive LA’s to mechanical therapy alone. Based on the available evidence gathered from this review, we can infer that the use of local antimicrobial agents in conjunction to scaling and root debridement (SRD) delivers significant benefits in periodontal therapy and it is a useful aid, avoiding many of the side effects that systemic antibiotic therapy may involve. Local drug delivery (LDD) is an efficient and effective means of delivering drugs based on the evidence presented in the review. The authors of this review would suggest the use of local antimicrobials in cases of localized periodontitis or individual areas that do not respond to the usual mechanical therapy alone. This review summarizes the current use of local drug delivery in periodontal management ensuring that the general practitioners are able to choose an appropriate local antimicrobial.
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Song Y, Lin J, Zhang Z, Xu B, Bi L. Antimicrobial effect of photodynamic therapy using sinoporphyrin sodium and 390-400 nm light-emitting diode on Porphyromonas gingivalis in vitro. Lasers Med Sci 2020; 36:153-164. [PMID: 32621127 DOI: 10.1007/s10103-020-03067-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/09/2020] [Indexed: 01/10/2023]
Abstract
This study aims to investigate the effect of antimicrobial photodynamic therapy (a-PDT) using a novel combination of sinoporphyrin sodium (DVDMS) and light-emitting diode (LED) with a wavelength of 390-400 nm on Porphyromonas gingivalis in vitro. Absorption spectrum of DVDMS was determined by spectrometer for selecting suitable wavelength light source. The uptake of DVDMS by P. gingivalis was evaluated according to fluorescence intensity detected by a spectrometer. Then effects of DVDMS alone, 390-400 nm LED alone, and photodynamic therapy produced by 10, 20, 40, and 80 μg/mL DVDMS and 390-400 nm LED on the suspension of P. gingivalis were evaluated by counting the number of colony forming units (CFU) after incubation. In the experiment, the LED illumination time was 30, 60, 90, 120, 180, 240, and 360 s, respectively, and the corresponding energy density was 1, 2, 3, 4, 6, 8, and 12 J/cm2, respectively. According to the absorption spectrum of DVDMS, the 390-400-nm light emitted by the LED was selected as the light source. The fluorescence intensity of DVDMS on P. gingivalis increased significantly at 5 min, and with the extension of time, it decreased at 30 min. DVDMS alone did not produce a significant toxicity on P. gingivalis compared with PBS (p = 0.979). While 390-400 nm LED alone had a certain bactericidal effect on P. gingivalis, the bactericidal effect was more obvious as the light dose increased (p < 0.001). The effect of a-PDT produced by 20, 40, and 80 μg/mL DVDMS and 390-400 nm LED were significantly better than that of 390-400 nm LED alone (p < 0.05). Both DVDMS concentration and light dose could enchance the bactericidal effect. The strongest photo-killing effect was generated by 80 μg/mL DVDMS with 360 s illumination (energy density is 12 J/cm2), and the log reduction of bacteria was 5.69 ± 1.70. a-PDT using the combination of DVDMS with 390-400 nm LED shows promise as a new treatment modality for pathogens elimination in periodontal therapy.
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Affiliation(s)
- Yuqi Song
- Department of Stomatology, The Fourth Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, 150001, China
| | - Jiang Lin
- Department of Stomatology, The Fourth Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, 150001, China.,Department of Stomatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhiguo Zhang
- Department of Applied Physics, School of Instrument Science and Engineering, Harbin Institute of Technology, Harbin, China
| | - Bin Xu
- Department of Stomatology, The Fourth Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, 150001, China
| | - Liangjia Bi
- Department of Stomatology, The Fourth Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, 150001, China.
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Sulijaya B, Yamada‐Hara M, Yokoji‐Takeuchi M, Matsuda‐Matsukawa Y, Yamazaki K, Matsugishi A, Tsuzuno T, Sato K, Aoki‐Nonaka Y, Takahashi N, Kishino S, Ogawa J, Tabeta K, Yamazaki K. Antimicrobial function of the polyunsaturated fatty acid KetoC in an experimental model of periodontitis. J Periodontol 2019; 90:1470-1480. [DOI: 10.1002/jper.19-0130] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/26/2019] [Accepted: 05/14/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Benso Sulijaya
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Department of PeriodontologyFaculty of DentistryUniversitas Indonesia Jakarta Indonesia
| | - Miki Yamada‐Hara
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Research Center for Advanced Oral ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Mai Yokoji‐Takeuchi
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Yumi Matsuda‐Matsukawa
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Kyoko Yamazaki
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Aoi Matsugishi
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Takahiro Tsuzuno
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Keisuke Sato
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Yukari Aoki‐Nonaka
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Naoki Takahashi
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Research Center for Advanced Oral ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Shigenobu Kishino
- Division of Applied Life SciencesGraduate School of AgricultureKyoto University Kyoto Japan
| | - Jun Ogawa
- Division of Applied Life SciencesGraduate School of AgricultureKyoto University Kyoto Japan
| | - Koichi Tabeta
- Division of PeriodontologyDepartment of Oral Biological ScienceNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Kazuhisa Yamazaki
- Research Unit for Oral‐Systemic ConnectionDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
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A New Controlled-Release Material Containing Metronidazole and Doxycycline for the Treatment of Periodontal and Peri-Implant Diseases: Formulation and In Vitro Testing. Int J Dent 2019; 2019:9374607. [PMID: 30956660 PMCID: PMC6425423 DOI: 10.1155/2019/9374607] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/22/2019] [Accepted: 01/28/2019] [Indexed: 11/17/2022] Open
Abstract
Background Several locally administered antimicrobials have been studied in the literature as adjunctive or primary treatments for periodontitis and peri-implantitis with conflicting results. Objective The aim of this study was twofold: (1) the formulation of a controlled-release material containing metronidazole and doxycycline; (2) an in vitro evaluation of its antibacterial properties against planktonic and biofilm species involved in periodontal and peri-implant diseases. Methods Doxycycline (10 mg/ml) and metronidazole (20 mg/ml) were incorporated into a hydroxyethylcellulose-polyvinylpyrrolidone-calcium polycarbophil gel. Three milliliters of gel were dialyzed against Dulbecco's phosphate-buffered saline for 13 days. Antibiotics release at 3, 7, 10, and 13 days was determined spectroscopically. The inhibitory activity of the experimental gel was tested against A. actinomycetemcomitans, S. sanguinis, P. micra, and E. corrodens with an agar diffusion test, an inactivation biofilm test, and a confocal laser scanning microscope study (CLSMS) for S. sanguinis up to 20 days. Results After 13 days, the released doxycycline was 9.7% (at 3 days = 1.2 mg; 7 days = 0.67 mg; 10 days = 0.76 mg; 13 days = 0.29 mg), while metronidazole was 67% (30 mg, 6.8 mg, 2.5 mg, and 0.9 mg at the same intervals). The agar diffusion test highlights that the formulated gel was active against tested microorganisms up to 312 h. Quantitative analysis of biofilm formation for all strains and CLSMS for S. sanguinis showed a high growth reduction up to 13 days. Conclusions The in vitro efficacy of the newly formulated gel was confirmed both on planktonic species and on bacterial biofilm over a period of 13 days. The controlled-release gel containing metronidazole and doxycycline had an optimal final viscosity and mucoadhesive properties. It can be argued that its employment could be useful for the treatment of periodontal and peri-implant diseases, where conventional therapy seems not successful.
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Rocha-Roa C, Cossio-Pérez R, Molina D, Patiño J, Cardona N. In silico study of Moxifloxacin derivatives with possible antibacterial activity against a resistant form of DNA gyrase from Porphyromonas gingivalis. Arch Oral Biol 2018; 95:30-39. [DOI: 10.1016/j.archoralbio.2018.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 07/18/2018] [Accepted: 07/18/2018] [Indexed: 11/24/2022]
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Fadare JO, Oshikoya KA, Obimakinde OS, Sijuade AO, Afolayan JM, Adeleke AA, Godman B, Ojumu DO. Patterns of drugs prescribed for dental outpatients in Nigeria: findings and implications. Acta Odontol Scand 2017; 75:496-506. [PMID: 28693407 DOI: 10.1080/00016357.2017.1347822] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES There are concerns with inappropriate prescribing of medicines among dentists especially antimicrobials. It is more concerning if this increases resistance rates. This study aimed to address this by assessing patterns of drugs prescribed for outpatients attending a hospital dental clinic in Nigeria. The findings will be used to plan future interventions, particularly around antimicrobial prescribing, where there are concerns. METHODS AND MATERIALS Medical records of patients attending the dental clinic of a leading teaching hospital in Nigeria were evaluated. Patients referred for admission, without a prescription, or prescribed medicines without a documented diagnosis were excluded. RESULTS Overall, 607 prescriptions were analysed, 314 (51.7%) were for females. Periodontal and gum diseases (414; 68.1%) were the most frequent diagnoses, followed by pulpitis (49; 8.2%), and dentoalveolar abscess (43; 7.1%). A total of 1798 medicines were prescribed for all patients with a mean of 3.0 ± 0.48 medicines per prescription. Antimicrobials (1178; 65.5%) and analgesics (620; 34.5%) were the two drug classes prescribed. Ascorbic acid and vitamin B complex were prescribed for 361 (59.5%) patients. Among antimicrobials, amoxicillin (564; 95.1%) either alone or combined with clavulanic acid was the most frequently prescribed, followed by metronidazole (561; 94.6%). Brand name prescribing was also appreciably higher than WHO recommendations. CONCLUSION Polypharmacy, brand name prescriptions, and the frequent prescription of antimicrobials were common practices at the dental clinic of this teaching hospital in Nigeria. We suggest a review of the current standard treatment guidelines in Nigeria to guide dentists on current knowledge- and evidence-based treatment of common oral diseases.
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Affiliation(s)
- Joseph O. Fadare
- Department of Pharmacology and Therapeutics, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Kazeem A. Oshikoya
- Department of Pharmacology, College of Medicine, Lagos State University, Lagos, Nigeria
| | - Obitade S. Obimakinde
- Department of Dentistry, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Abayomi O. Sijuade
- Department of Pharmacology and Therapeutics, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Jide M. Afolayan
- Department of Anaesthesia, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Adeyinka A. Adeleke
- Department of Dentistry, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Brian Godman
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Health Economics Centre, Liverpool University Management School, Liverpool, UK
| | - Damilola O. Ojumu
- Department of Dentistry, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
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Jepsen K, Jepsen S. Antibiotics/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced periodontitis. Periodontol 2000 2017; 71:82-112. [PMID: 27045432 DOI: 10.1111/prd.12121] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 02/06/2023]
Abstract
This review gives an update of the current scientific evidence on the efficacy of the adjunctive use of systemic and local antibiotics/antimicrobials in the treatment of periodontitis. In particular, it addresses whether their use can improve the results of nonsurgical mechanical therapy in mild-to-moderate forms of the disease. Large numbers of randomized clinical trials and systematic reviews with meta-analyses have clearly established that adjunctive systemic antibiotics, combined with mechanical debridement, offer clinical improvements additional to those obtained with scaling and root planing alone. These effects are more pronounced in aggressive periodontitis and in initially deep pockets, whereas more limited additional improvements, of 0.3 mm for additional pocket reduction and 0.2 mm for additional clinical attachment gain, have been documented for moderately deep sites (4-6 mm) in patients with chronic periodontitis. The marginal clinical benefit in patients with moderate disease has to be balanced against possible side effects. Notably, it has to be realized that an increasing number of warnings have been articulated against the unrestricted use of antibiotics in treating periodontal diseases because of the emerging global public health issue of bacterial resistance. The effects of the adjunctive local administration of antimicrobials have also been very well documented in several systematic reviews. Overall, in persistent or recurrent localized deep sites, the application of antimicrobials by sustained-delivery devices may offer a benefit of an additional 0.4 mm in pocket depth reduction and 0.3 mm in clinical attachment level gain. In conclusion, the slight additional benefits of adjunctive antimicrobials, which were shown for moderate forms of periodontitis, have to be balanced against their side effects and therefore their prescription should be limited as much as possible.
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Lang PM, Jacinto RC, Dal Pizzol TS, Ferreira MBC, Montagner F. Resistance profiles to antimicrobial agents in bacteria isolated from acute endodontic infections: systematic review and meta-analysis. Int J Antimicrob Agents 2016; 48:467-474. [DOI: 10.1016/j.ijantimicag.2016.08.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 08/02/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023]
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Ré ACS, Ferreira MP, Freitas O, Aires CP. Local antibiotic delivery in periodontitis: drug release and its effect on supragingival biofilms. BIOFOULING 2016; 32:1061-1066. [PMID: 27642673 DOI: 10.1080/08927014.2016.1230735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/25/2016] [Indexed: 06/06/2023]
Abstract
The effect of a drug-delivery system containing antibacterial metronidazole (MDZ) prescribed for periodontitis on supragingival biofilm was evaluated, and possible interference by this biofilm in the drug release profile was investigated. Streptococcus mutans biofilms were grown and exposed to a controlled-release formulation of MDZ or the same formulation without MDZ (vehicle control). Untreated biofilms were used as a negative control (NC). Biofilms and culture medium (containing detached cells) were collected 24, 48, 72, and 96 h after first exposure to treatments. The biomass of the MDZ group was lower than that of the NC group at all times. Although MDZ yielded low drug-release rates in the presence of the biofilm, it was sufficient for reducing viability for 24 h and affecting bacterial metabolism for 48 h. These results suggest that MDZ appears to destabilize supragingival biofilm. This biofilm may interfere with MDZ release from the formulation.
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Affiliation(s)
- A C S Ré
- a Department of Physics and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto , University of São Paulo , São Paulo , Brazil
| | - M P Ferreira
- b Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirão Preto , University of São Paulo , São Paulo , Brazil
| | - O Freitas
- b Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirão Preto , University of São Paulo , São Paulo , Brazil
| | - C P Aires
- a Department of Physics and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto , University of São Paulo , São Paulo , Brazil
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Farsi D, Tanner A. In vitro Resistance Testing of Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia to Triclosan. J Contemp Dent Pract 2016; 17:282-5. [PMID: 27340161 DOI: 10.5005/jp-journals-10024-1842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To determine the sensitivity of Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia to triclosan, and determine if these bacteria develop resistance to triclosan upon prolonged exposure. MATERIALS AND METHODS Susceptibility to triclosan was tested against three periodontal pathogens P. gingivalis, P. intermedia, and T. forsythia. Escherichia coli strains sensitive and resistant to triclosan were used as biological controls to confirm the efficacy of triclosan in the assays. Agar plates were prepared locally with vitamin K and hemin-supplemented medium. RESULTS Porphyromonas gingivalis and P. intermedia did not grow on plates containing ≥ 2 μg/ml triclosan, while T. forsythia did not grow on ≥ 1.66 μg/ml. Colonies of P. intermedia resistant to triclosan developed after prolonged incubation at 2 μg/ml, but this resistance disappeared during subculture in the absence of triclosan. CONCLUSION No significant resistance to triclosan was detected for these species. CLINICAL SIGNIFICANCE Dental products containing triclosan can be beneficial in controlling periodontal disease.
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Affiliation(s)
- Deema Farsi
- Assistant Professor, Department of Pediatric Dentistry, King Abdulaziz University Jeddah, Kingdom of Saudi Arabia, e-mail:
| | - Anne Tanner
- Department of Microbiology, The Forsyth Institute, Cambridge Massachusetts, USA
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13
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Grover S, Tewari S, Sharma RK, Singh G, Yadav A, Naula SC. Effect of Subgingivally Delivered 10% Emblica officinalis
Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis - A Randomized Placebo-controlled Clinical Trial. Phytother Res 2016; 30:956-62. [DOI: 10.1002/ptr.5600] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 12/18/2015] [Accepted: 02/02/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Shilpa Grover
- Department of Periodontics and Oral Implantology; Post Graduate Institute of Dental Sciences; Rohtak Haryana India
| | - Shikha Tewari
- Department of Periodontics and Oral Implantology; Post Graduate Institute of Dental Sciences; Rohtak Haryana India
| | - Rajinder K Sharma
- Department of Periodontics and Oral Implantology; Post Graduate Institute of Dental Sciences; Rohtak Haryana India
| | - Gajendra Singh
- College of Pharmacy Pt. B.D. Sharma; University of Health Sciences; Rohtak Haryana India
| | - Aparna Yadav
- Department of Microbiology; Post Graduate Institute of Medical Sciences; Rohtak Haryana India
| | - Satish C Naula
- Department of Periodontics and Oral Implantology; Post Graduate Institute of Dental Sciences; Rohtak Haryana India
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Merchant SN, Vovk A, Kalash D, Hovencamp N, Aukhil I, Harrison P, Zapert E, Bidwell J, Varnado P, Shaddox LM. Localized aggressive periodontitis treatment response in primary and permanent dentitions. J Periodontol 2015; 85:1722-9. [PMID: 25186780 DOI: 10.1902/jop.2014.140171] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The comparative treatment response of children and young adults with localized aggressive periodontitis treatment (LAgP) affecting primary and permanent dentition is unknown. The objective of this study is to evaluate the influence of non-surgical periodontal therapy with adjunctive systemic antibiotics on the clinical outcome of children and young adults with primary versus permanent dentition affected by LAgP. METHODS A cohort of 97 African American participants aged 5 to 21 years (30 males and 67 females; 22 primary and 75 permanent dentitions affected) diagnosed with LAgP were included. Patients presented with no significant medical history. All patients underwent periodontal therapy, which consisted of full-mouth mechanical debridement at baseline and the 3-, 6-, and 12-month appointments. Additionally, all patients were prescribed a 1-week regimen of systemic antibiotics at the initial appointment. Clinical parameters were analyzed, including probing depth, clinical attachment level (CAL), bleeding on probing, and percentage of visible plaque. RESULTS Overall, periodontal therapy was found to be effective in improving the clinical outcomes of both primary and permanent dentitions. Although baseline CALs were similar between the groups, the reduction in mean CAL at 3, 6, and 12 months and reduction in percentage plaque at 3 months were significantly greater in primary dentition compared with permanent dentition. CONCLUSIONS Non-surgical therapy with systemic antibiotics is effective for LAgP in both primary and permanent dentitions. A greater reduction in CAL in LAgP of primary dentition may suggest that younger children may carry a greater propensity for positive treatment outcomes and healing potential compared with children/young adults with permanent dentition.
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Affiliation(s)
- Sherin N Merchant
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL
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Tian Y, Shen Y, Jv M. Synthesis, characterization and evaluation of tinidazole-loaded mPEG-PDLLA (10/90) in situ gel forming system for periodontitis treatment. Drug Deliv 2015; 23:2726-2735. [PMID: 26289210 DOI: 10.3109/10717544.2015.1061069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Traditional in situ gel forming systems are potential applications for parenteral administration but always accompanied with burst release. To overcome this limitation, the tinidazole (TNZ)-loaded in situ gel forming system using a diblock copolymer, monomethoxy poly(ethylene glycol)-block-poly(d,l-lactide) (mPEG-PDLLA), was designed. The formulation of the mPEG-PDLLA-based TNZ in situ gel forming system contained 5% (w/w) TNZ, 0.4% glycerol, 5 ml N-methyl pyrrolidone (NMP) and 35% (w/w) mPEG-PDLLA. The in situ gel forming system showed sustained TNZ release over 192 h with low burst effect (around 7% in the first 8 h) in the in vitro release study. Additionally, in vivo studies were performed on rabbits with ligature-induced periodontitis, and the concentration of TNZ in the gingival crevicular fluid (GCF) as well as the pharmacokinetic parameters was calculated and the pharmacological effect of TNZ-loaded in situ gel forming (mPEG-PDLLA)-based system was found effective. Finally, histological studies revealed that the gel was a safe formulation with low irritation. The desirable drug release kinetics combined with the excellent in vivo characteristics highlight the potential of the gel in the treatment of periodontitis. Therefore, these results confirmed that the TNZ-loaded in situ gel forming mPEG-PDLLA-based system could reduce burst release of TNZ and act as a sustained-release and injectable drug depot for periodontitis treatment.
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Affiliation(s)
- Yu Tian
- a State Key Laboratory of Natural Medicines, Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University , Nanjing , China and
| | - Yan Shen
- a State Key Laboratory of Natural Medicines, Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University , Nanjing , China and
| | - Minli Jv
- b China State Institute of Pharmaceutical Industry , Shanghai , China
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16
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Jervøe-Storm PM, Jepsen S, Worthington HV, Needleman I, Eberhard J. Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri-implant diseases. Hippokratia 2015. [DOI: 10.1002/14651858.cd011778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Pia-Merete Jervøe-Storm
- University Hospital Bonn; Department of Periodontology, Operative and Preventive Dentistry; Welschnonnenstrasse 17 Bonn Germany 53111
| | - Søren Jepsen
- University Hospital Bonn; Department of Periodontology, Operative and Preventive Dentistry; Welschnonnenstrasse 17 Bonn Germany 53111
| | - Helen V Worthington
- School of Dentistry, The University of Manchester; Cochrane Oral Health Group; Coupland III Building, Oxford Road Manchester UK M13 9PL
| | - Ian Needleman
- UCL Eastman Dental Institute; Unit of Periodontology and International Centre for Evidence-Based Oral Healthcare; 256 Gray's Inn Road London UK WC1X 8LD
| | - Jörg Eberhard
- Hannover Medical School; Prosthetic Dentistry and Biomaterials Science; Carl-Neuberg-Straße 1 Hannover Germany 30625
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Anyanechi CE, Chukwuneke FN, Ngim N. Clinical Evaluation of the Efficacy of Arthocare Forte, a Chondro-Protective and Anti-Arthritic Drug in the Management of Bacterial Plaque-Induced Chronic Periodontitis. Ann Med Health Sci Res 2015; 5:157-62. [PMID: 26097755 PMCID: PMC4455003 DOI: 10.4103/2141-9248.157481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Arthocare forte medication is made up of different constituents and the advantages offered by this disposition have not been explored in the management of chronic periodontitis. AIM The aim was to assess the clinical response of bacterial plaque-induced generalized chronic periodontitis to arthocare medication, and the relationship of age and gender to the prevalence of chronic periodontal disease. SUBJECTS AND METHODS This study was done at the Dental Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria. It was a Prospective randomized controlled trial evaluating the effect of arthocare treatment on 81/162 patients with teeth mobility over a period of 5 years. All the patients (162) underwent root planing, and 81/162 (50%) were treated with arthocare for comparative analysis. The variables recorded were patient's age, gender, and degree of tooth mobility, periodontal pocket, and bleeding from the pocket after treatment. Statistical analysis was done using EPI INFO 7. RESULTS Majority of the patients were between 46 and 75 years in both control (n = 59/81, 72.8%) and experimental groups (n = 52/81, 64.2%). There were 86/162 (53.1%) males and 76/162 (46.9%) females, giving a male-to-female ratio of 1.1:1. Seventy-seven patients (95.1%) in the experimental group had total remission in comparison to 32/81 (39.5%) in control group which was statistically significant (P < 0.001). CONCLUSION The arthocare administered to patients in the experimental group speeds up the regenerative capacity and stability of the periodontium when compared with the control. Multicentre clinical trials are recommended to validate the use of arthocare forte in the treatment of generalized chronic periodontitis.
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Affiliation(s)
- C E Anyanechi
- Department of Dental Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - F N Chukwuneke
- Department of Oral and Maxillofacial Surgery, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - N Ngim
- Department of Orthopedics and Trauma, University of Calabar Teaching Hospital, Calabar, Nigeria
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Hau H, Rohanizadeh R, Ghadiri M, Chrzanowski W. A mini-review on novel intraperiodontal pocket drug delivery materials for the treatment of periodontal diseases. Drug Deliv Transl Res 2015; 4:295-301. [PMID: 25786883 DOI: 10.1007/s13346-013-0171-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Periodontal disease is defined as chronic inflammatory condition characterized by the destruction of the periodontal tissues causing loss of connective tissue attachment, loss of alveolar bone, and the formation of pathological pockets around the diseased teeth. The use of systemic antibiotics has been advocated for its treatment, but concerns emerged with respect to adverse drug reactions and its contribution to bacterial resistance. Thus local drug delivery devices have been developed that aim to deliver a high concentration of antimicrobial drugs directly to the affected site, while minimizing drug's systemic exposure. A burst release of antimicrobial agent from carrier, resulting in a short and inadequate exposure of bacteria residing in periodontal pocket to the agent, remains the main challenge of current local delivery systems for the treatment of periodontal disease. This review aims to investigate and compare different local antimicrobial delivery systems with regard to the treatment of periodontal disease.
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Affiliation(s)
- H Hau
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia
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Abstract
Physicians may encounter patients with dental and periodontal diseases in the context of outpatient medical practice. It is important for physicians to be aware of common dental and periodontal conditions and be able to assess for the presence and severity of these diseases. This article reviews common dental and periodontal conditions, their cardinal signs and symptoms, outpatient-setting assessment techniques, as well as common methods of treatment. Physicians detecting gross abnormalities on clinical examination should refer the patient to a dentist for further evaluation and management.
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Affiliation(s)
- Joel M Laudenbach
- Oral Medicine and Geriatric Dentistry, College of Dental Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA; Private Oral Medicine Practice, 350 S. Beverly Drive, Suite 160, Beverly Hills, CA 90212, USA; Department of Surgery - Dentistry, Cedars-Sinai Medical Center, Los Angeles, California, USA.
| | - Ziv Simon
- Department of Continuing Education, Ostrow School of Dentistry, University of Southern California, 925 West 34th Street, Los Angeles, CA 90089, USA; Private Practice Limited to Periodontics and Dental Implants, 9400 Brighton Way, #311, Beverly Hills, CA 90210, USA
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Teughels W, Dhondt R, Dekeyser C, Quirynen M. Treatment of aggressive periodontitis. Periodontol 2000 2014; 65:107-33. [PMID: 24738589 DOI: 10.1111/prd.12020] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2012] [Indexed: 12/12/2022]
Abstract
Despite etiological differences between aggressive and chronic periodontitis, the treatment concept for aggressive periodontitis is largely similar to that for chronic periodontitis. The goal of treatment is to create a clinical condition that is conducive to retaining as many teeth as possible for as long as possible. When a diagnosis has been made and risk factors have been identified, active treatment is commenced. The initial phase of active treatment consists of mechanical debridement, either alone or supplemented with antimicrobial drugs. Scaling and root planing has been shown to be effective in improving clinical indices, but does not always guarantee long-term stability. Antimicrobials can play a significant role in controlling aggressive periodontitis. Few studies have been published on this subject for localized aggressive periodontitis, but generalized aggressive periodontitis has been subject to more scrutiny. Studies have demonstrated that systemic antibiotics as an adjuvant to scaling and root planing are more effective in controlling disease compared with scaling and root planing alone or with supplemental application of local antibiotics or antiseptics. It has also become apparent that antibiotics ought to be administered with, or just after, mechanical debridement. Several studies have shown that regimens of amoxicillin combined with metronidazole or regimens of clindamycin are the most effective and are preferable to regimens containing doxycycline. Azithromycin has been shown to be a valid alternative to the regimen of amoxicillin plus metronidazole. A limited number of studies have been published on surgical treatment in patients with aggressive periodontitis, but the studies available show that the effect can be comparable with the effect on patients with chronic periodontitis, provided that proper oral hygiene is maintained, a strict maintenance program is followed and modifiable risk factors are controlled. Both access surgery and regenerative techniques have shown good results in patients with aggressive periodontitis. Once good periodontal health has been obtained, patients must be enrolled in a strict maintenance program that is directed toward controlling risk factors for disease recurrence and tooth loss. The most significant risk factors are noncompliance with regular maintenance care, smoking, high gingival bleeding index and poor plaque control. There is no evidence to suggest that daily use of antiseptic agents should be part of the supportive periodontal therapy for aggressive periodontitis.
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Preus HR, Scheie AA, Baelum V. Letter to the Editor: Re: The Clinical Effect of Scaling and Root Planing and the Concomitant Administration of Systemic Amoxicillin and Metronidazole: A Systematic Review; Re: Effectiveness of Systemic Amoxicillin/Metronidazole as Adjunctive Therapy to Scaling and Root Planing in the Treatment of Chronic Periodontitis: A Systematic Review and Meta-Analysis; Re: Effectiveness of Systemic Amoxicillin/Metronidazole as an Adjunctive Therapy to Full-Mouth Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A Systematic Review and Meta-Analysis. J Periodontol 2014; 85:374-84. [DOI: 10.1902/jop.2014.130379] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Pradeep AR, Singh SP, Martande SS, Naik SB, N P, Kalra N, Suke DK. Clinical and microbiological effects of levofloxacin in the treatment of chronic periodontitis: a randomized, placebo-controlled clinical trial. ACTA ACUST UNITED AC 2014; 6:170-8. [DOI: 10.1111/jicd.12091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 11/24/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Avani R. Pradeep
- Department of Periodontics; Government Dental College and Research Institute; Bangalore Karnataka India
| | - Sonender P. Singh
- Department of Periodontics; Government Dental College and Research Institute; Bangalore Karnataka India
| | - Santosh S. Martande
- Department of Periodontics; Government Dental College and Research Institute; Bangalore Karnataka India
| | - Savitha B. Naik
- Department of Conservative Dentistry and Endodontics; Government Dental College and Research Institute; Bangalore Karnataka India
| | - Priyanka N
- Department of Conservative Dentistry and Endodontics; Government Dental College and Research Institute; Bangalore Karnataka India
| | - Nitish Kalra
- Department of Periodontics; Government Dental College and Research Institute; Bangalore Karnataka India
| | - Deepak K. Suke
- Department of Periodontics; Government Dental College and Research Institute; Bangalore Karnataka India
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23
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Bottino MC, Arthur RA, Waeiss RA, Kamocki K, Gregson KS, Gregory RL. Biodegradable nanofibrous drug delivery systems: effects of metronidazole and ciprofloxacin on periodontopathogens and commensal oral bacteria. Clin Oral Investig 2014; 18:2151-8. [PMID: 24535074 DOI: 10.1007/s00784-014-1201-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 01/30/2014] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The purposes of this study were to fabricate biodegradable polydioxanone (PDS II®) electrospun periodontal drug delivery systems (hereafter referred to as matrices) containing either metronidazole (MET) or ciprofloxacin (CIP) and to investigate the effects of antibiotic incorporation on both periodontopathogens and commensal oral bacteria. MATERIALS AND METHODS Fibrous matrices were processed from PDS polymer solution by electrospinning. Antibiotic-containing PDS solutions were prepared to obtain four distinct groups: 5 wt.% MET, 25 wt.% MET, 5 wt.% CIP, and 25 wt.% CIP. Pure PDS was used as a control. High-performance liquid chromatography (HPLC) was done to evaluate MET and CIP release. Dual-species biofilms formed by Lactobacillus casei (Lc) and Streptococcus salivarius (Ss) were grown on the surface of all electrospun matrices. After 4 days of biofilm growth, the viability of bacteria on biofilms was assessed. Additionally, antimicrobial properties were evaluated against periodontopathogens Fusobacterium nucleatum (Fn) and Aggregatibacter actinomycetemcomitans (Aa) using agar diffusion assay. RESULTS A three-dimensional interconnected porous network was observed in the different fabricated matrices. Pure PDS showed the highest fiber diameter mean (1,158 ± 402 nm) followed in a descending order by groups 5 wt.% MET (1,108 ± 383 nm), 25 wt.% MET (944 ± 392 nm), 5 wt.% CIP (871 ± 309 nm), and 25 wt.% CIP (765 ± 288 nm). HPLC demonstrated that groups containing higher amounts (25 wt.%) of incorporated drugs released more over time, while those with lower levels (5 wt.%) the least. No inhibitory effect of the tested antibiotics was detected on biofilm formation by the tested commensal oral bacteria. Meanwhile, CIP-containing matrices inhibited growth of Fn and Aa. CONCLUSION CIP-containing matrices led to a significant inhibition of periodontopathogens without negatively impairing the growth of periodontal beneficial bacteria. CLINICAL RELEVANCE Based on the proven in vitro inhibition of periodontitis-related bacteria, future in vivo research using relevant animal models is needed to confirm the effectiveness of these drug delivery systems.
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Affiliation(s)
- Marco C Bottino
- Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry (IUSD), 1121 W. Michigan Street, Indianapolis, IN, 46202, USA,
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25
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Reeves BD, Young M, Grieco PA, Suci P. Aggregatibacter actinomycetemcomitans biofilm killing by a targeted ciprofloxacin prodrug. BIOFOULING 2013; 29:1005-1014. [PMID: 23952779 PMCID: PMC3818142 DOI: 10.1080/08927014.2013.823541] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A pH-sensitive ciprofloxacin prodrug was synthesized and targeted against biofilms of the periodontal pathogen Aggregatibacter actinomycetemcomitans (Aa). The dose required to reduce the viability of a mature biofilm of Aa by ~80% was in the range of ng cm(-2) of colonized area (mean biofilm density 2.33 × 10(9) cells cm(-2)). A mathematical model was formulated that predicts the temporal change in the concentration of ciprofloxacin in the Aa biofilm as the drug is released and diffuses into the bulk medium. The predictions of the model were consistent with the extent of killing obtained. The results demonstrate the feasibility of the strategy to induce mortality, and together with the mathematical model, provide the basis for design of targeted antimicrobial prodrugs for the topical treatment of oral infections such as periodontitis. The targeted prodrug approach offers the possibility of optimizing the dose of available antimicrobials in order to kill a chosen pathogen while leaving the commensal microbiota relatively undisturbed.
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Affiliation(s)
- Benjamin D. Reeves
- Department of Chemistry & Biochemistry, Montana State
University, Bozeman, Montana 59717
| | - Mark Young
- Department of Chemistry & Biochemistry, Montana State
University, Bozeman, Montana 59717
- Department of Plant Sciences, Montana State University, Bozeman,
Montana 59717
| | - Paul A. Grieco
- Department of Chemistry & Biochemistry, Montana State
University, Bozeman, Montana 59717
| | - Peter Suci
- Department of Plant Sciences, Montana State University, Bozeman,
Montana 59717
- Center for Biofilm Engineering, Montana State University, Bozeman,
Montana 59717
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Preus HR, Gunleiksrud TM, Sandvik L, Gjermo P, Baelum V. A Randomized, Double-Masked Clinical Trial Comparing Four Periodontitis Treatment Strategies: 1-Year Clinical Results. J Periodontol 2013; 84:1075-86. [DOI: 10.1902/jop.2012.120400] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Oettinger-Barak O, Dashper SG, Catmull DV, Adams GG, Sela MN, Machtei EE, Reynolds EC. Antibiotic susceptibility of Aggregatibacter actinomycetemcomitans JP2 in a biofilm. J Oral Microbiol 2013; 5:20320. [PMID: 23671757 PMCID: PMC3650220 DOI: 10.3402/jom.v5i0.20320] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 03/13/2013] [Accepted: 03/18/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Localized aggressive periodontitis (LAgP) is an inflammatory disease associated with specific bacteria, particularly Aggregatibacter actinomycetemcomitans, which can result in early tooth loss. The bacteria grow as a biofilm known as subgingival plaque. Treatment includes mechanical debridement of the biofilm, often associated with empirical antibiotic treatment. OBJECTIVE The aims of this study were to test in vitro the sensitivity of A. actinomycetemcomitans JP2 during planktonic and biofilm growth to doxycycline and to the combination of metronidazole and amoxicillin, which are two antibiotic protocols commonly used in clinical practice. DESIGN Two in vitro biofilm models were used to test the effects of the antibiotics: a static 96-well plate assay was used to investigate the effect of these antibiotics on biofilm formation whilst a flow chamber model was used to examine the effect on established biofilms. RESULTS Of the antibiotics tested in this model system, doxycycline was most efficacious with a minimal inhibitory concentration (MIC) against planktonic cells of 0.21 mg/L and minimal biofilm inhibitory concentration (MBIC) of 2.10 mg/L. The most commonly prescribed antibiotic regimen, amoxicillin + metronidazole, was much less effective against both planktonic and biofilm cells with an MIC and MBIC of 12.0 mg/L and 20.2 mg/L, respectively. A single treatment of the clinically achievable concentration of 10 mg/L doxycycline to sparse A. actinomycetemcomitans biofilms in the flow chamber model resulted in significant decreases in biofilm thickness, biovolume, and cell viability. Dense A. actinomycetemcomitans biofilms were significantly more resistant to doxycycline treatment. Low concentrations of antibiotics enhanced biofilm formation. CONCLUSION A. actinomycetemcomitans JP2 homotypic biofilms were more susceptible in vitro to doxycycline than amoxicillin + metronidazole.
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Affiliation(s)
- Orit Oettinger-Barak
- Melbourne Dental School, Oral Health CRC, Bio21 Institute, University of Melbourne, Parkville, VIC, Australia
| | - Stuart G. Dashper
- Melbourne Dental School, Oral Health CRC, Bio21 Institute, University of Melbourne, Parkville, VIC, Australia
| | - Deanne V. Catmull
- Melbourne Dental School, Oral Health CRC, Bio21 Institute, University of Melbourne, Parkville, VIC, Australia
| | - Geoffrey G. Adams
- Melbourne Dental School, Oral Health CRC, Bio21 Institute, University of Melbourne, Parkville, VIC, Australia
| | - Michael N. Sela
- Betty and Walter Cohen Chair for Periodontal Research, The Faculty of Dental Medicine, The Hebrew University, Jerusalem, Israel
| | - Eli E. Machtei
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- School of Dental Medicine, Harvard Medical Center, Boston, MA, USA
| | - Eric C. Reynolds
- Melbourne Dental School, Oral Health CRC, Bio21 Institute, University of Melbourne, Parkville, VIC, Australia
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Ghadiri M, Hau H, Chrzanowski W, Agus H, Rohanizadeh R. Laponite clay as a carrier for in situ delivery of tetracycline. RSC Adv 2013. [DOI: 10.1039/c3ra43217c] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Therapeutic management of a case of generalised aggressive periodontitis in an 8-year old child: 18-month results. Eur Arch Paediatr Dent 2012; 13:266-71. [PMID: 23043885 DOI: 10.1007/bf03262883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Generalised aggressive periodontitis (GAP) is a rare condition associated with rapid periodontal destruction, in multiple teeth. The paper aims to present a case of an 8-year old with GAP and discuss his response to treatment. CASE REPORT An 8-year old male was referred to the postgraduate clinic of paediatric dentistry of the University of Athens due to increased mobility in his primary dentition. At initial clinical examination, plaque accumulation, gingival inflammation and temporary restorations were noted. Detailed periodontal examination revealed bleeding on probing, pocket depths of up to 9 mm and second degree mobility in primary teeth. Radiographic examination showed advanced bone loss and carious lesions. Microbiological analysis revealed increased percentages of peri-opathogens in pooled subgingival samples. Final diagnosis of GAP was made after ruling out any underlying systemic disorder. TREATMENT Periodontal therapy involved non-surgical subgingival debridement, systemic administration of antibiotics and retention of periodontally involved teeth. FOLLOW-UP This was based on a monthly recall program for the first 6 months and a 3-monthly regime thereafter. At 18-months after initial examination, a substantial improvement in clinical parameters was seen, while levels of periodontal pathogens were sustained at low levels. CONCLUSION Non-surgical root debridement along with systemic administration of antibiotics and retention of the periodontally involved teeth, can be successful in achieving improvement and maintenance of periodontal health in the mixed dentition.
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Ardila CM, Alzate J, Guzmán IC. Relationship between Gram negative enteric rods, Aggregatibacter actinomycetemcomitans, and clinical parameters in periodontal disease. J Indian Soc Periodontol 2012; 16:65-9. [PMID: 22628966 PMCID: PMC3357038 DOI: 10.4103/0972-124x.94607] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Accepted: 12/05/2011] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The association between Gram negative enteric rods and Aggregatibacter actinomycetemcomitans in periodontal diseases has received little attention in the literature. The objective of this study was to explore the relationship between these organisms and clinical parameters of periodontal disease. MATERIALS AND METHODS Clinical parameters and occurrence of Gram-negative enteric rods and A. actinomycetemcomitans were examined in 76 patients with chronic periodontitis. Chi-square and Mann-Whitney tests were used to determine differences in clinical variables versus the presence or absence of both microorganisms. Correlation among both organisms and clinical data were determined using Spearman rank correlation coefficient. RESULTS Gram-negative enteric rods and A. actinomycetemcomitans were detected in 20 (26.3%) and 18 (23.7%) individuals, respectively. A total of 14 (18.4%) patients harbored both microorganisms studied. There were significantly positive correlations between enteric rods and presence of A. actinomycetemcomitans (r=0.652, P<0.0001). Both microorganisms were significant and positively correlated with probing depth (PD), clinical attachment level, and bleeding on probing (P<0.0001). The mean PD (mm) of the sampled sites was significantly deeper in patients with presence of A. actinomycetemcomitans and Gram-negative enteric rods. CONCLUSION The results of the present study suggest a strong positive correlation between Gram-negative enteric rods and A. actinomycetemcomitans in the population studied. This finding must be taken into account when considering the best therapeutic approach, including the utilization of antimicrobials. The adverse clinical outcomes observed in presence of these microorganisms could have implications in the pathogenesis of periodontal disease and a possible impact on outcomes after treatment.
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Affiliation(s)
- Carlos M Ardila
- Department of Periodontology, School of Dentistry, University of Antioquia, Medellín, Colombia
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Nath SG, Raveendran R. "What is there in a name?": A literature review on chronic and aggressive periodontitis. J Indian Soc Periodontol 2012; 15:318-22. [PMID: 22368353 PMCID: PMC3283926 DOI: 10.4103/0972-124x.92561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 09/29/2011] [Indexed: 01/18/2023] Open
Abstract
The objective of this review is to bring the reader up-to-date on the current understanding of chronic and aggressive forms of periodontitis and the implications for diagnosis and treatment of these diseases. The only difference between chronic periodontitis and aggressive periodontitis with regard to tissue destruction appear to be perhaps the magnitude, sequelae, and control of the response. While there may be some differences in the cellular infiltrate between these two diseases, the molecular mediators and pathologic processes are generally the same.
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Affiliation(s)
- Sameera G Nath
- Department of Periodontics, Govt. Dental College, Calicut, India
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Aparna S, Srirangarajan S, Malgi V, Setlur KP, Shashidhar R, Setty S, Thakur S. A Comparative Evaluation of the Antibacterial Efficacy of Honey In Vitro and Antiplaque Efficacy in a 4-Day Plaque Regrowth Model In Vivo: Preliminary Results. J Periodontol 2012; 83:1116-21. [DOI: 10.1902/jop.2012.110461] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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A randomized clinical trial on the clinical and microbiological efficacy of a xanthan gel with chlorhexidine for subgingival use. Clin Oral Investig 2012; 17:55-66. [DOI: 10.1007/s00784-012-0685-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 01/27/2012] [Indexed: 10/28/2022]
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Roshna T, Nandakumar K. Generalized aggressive periodontitis and its treatment options: case reports and review of the literature. Case Rep Med 2012; 2012:535321. [PMID: 22291715 PMCID: PMC3265097 DOI: 10.1155/2012/535321] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 10/04/2011] [Accepted: 10/07/2011] [Indexed: 01/19/2023] Open
Abstract
Generalized aggressive periodontitis results in rapid destruction of the periodontium and can lead to early tooth loss in the affected individuals if not diagnosed early and treated appropriately. The diagnostic features of the disease are characteristic, but the clinical presentation and patterns of destructions may vary between patients. Successful management of the disease is challenging especially if diagnosed at advanced stages of the disease, but not impossible with the current therapeutic choices for the disease. A vast array of treatment modalities is available which can be employed in the treatment of generalized aggressive periodontitis with varying success rates, but a definite guideline for the management is yet to be formulated. However, with the exponential rate of developments in periodontal research, regenerative therapy, tissue engineering, and genetic technologies, the future seems promising in regard to options at managing the disease. This paper attempts to describe the clinical and radiographic diagnostic features and the current treatment options along with a suggested protocol for comprehensive management of generalized aggressive periodontitis patients with case reports and a brief review.
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Affiliation(s)
- T. Roshna
- Department of Periodontics, People's Dental Academy, Bhopal 462010, India
| | - K. Nandakumar
- Department of Periodontics, Azeezia Dental College, Kollam 691537, India
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Varela VM, Heller D, Silva-Senem MX, Torres MCMB, Colombo APV, Feres-Filho EJ. Systemic Antimicrobials Adjunctive to a Repeated Mechanical and Antiseptic Therapy for Aggressive Periodontitis: A 6-Month Randomized Controlled Trial. J Periodontol 2011; 82:1121-30. [DOI: 10.1902/jop.2011.100656] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Fernandez y Mostajo M, Zaura E, Crielaard W, Beertsen W. Does routine analysis of subgingival microbiota in periodontitis contribute to patient benefit? Eur J Oral Sci 2011; 119:259-64. [PMID: 21726285 DOI: 10.1111/j.1600-0722.2011.00828.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In clinical periodontology it is common practice to sample subgingival plaque from periodontitis patients and to search for the presence of alleged periodontal pathogens using routine laboratory techniques such as culture, DNA-DNA hybridization or real-time PCR. Usually, special attention is given to the recognition of 'red complex' microorganisms and to Aggregatibacter actinomycetemcomitans. Recently, molecular open-ended techniques have been introduced which are distinct from the more 'classical' approaches in that they do not preselect for certain species. In this study, we investigated to what extent the outcome of these techniques has changed our insight into the composition of the subgingival microbiota and whether this has consequences on clinical decision making. The open-ended approaches showed that the composition of subgingival plaque is much more complex than previously thought. Next to the 'classical' putative periodontal pathogens, several non-culturable and fastidious species are now recognized as being associated with periodontitis, thus enlarging the group of suspected periodontal pathogens. We conclude that routine analyses of subgingival plaque in the clinic are not necessarily of benefit to the patient.
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Comparison of real-time polymerase chain reaction and DNA-strip technology in microbiological evaluation of periodontitis treatment. Diagn Microbiol Infect Dis 2011; 69:12-20. [DOI: 10.1016/j.diagmicrobio.2010.08.017] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Revised: 08/20/2010] [Accepted: 08/23/2010] [Indexed: 12/20/2022]
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Tenenbaum H, Luc J, Schaaf JF, Federlin-Ducani M, Cotton C, Elkaim R, Cuisinier FJG, Roques C. An 8-week, randomized, controlled, clinical study of the use of a 0.1% chlorhexidine mouthwash by chronic periodontitis patients. ACTA ACUST UNITED AC 2010; 2:29-37. [PMID: 25427325 DOI: 10.1111/j.2041-1626.2010.00031.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
AIM To evaluate the efficacy of a 2-week administration of a 0.1% chlorhexidine mouthwash in the short-term treatment of chronic periodontitis patients and the impact of this product when administered twice by pocket irrigation. METHODS Sixty patients were enrolled in a single-centre, placebo-controlled, randomized study with the blind allocation of product to two parallel groups. Clinical assessments were performed, and samples from six selected subgingival sites were collected for microbial analysis by culture at baseline, D15 and D56. Three of the six sites were randomly selected and were treated by subgingival irrigation with the same 0.1% chlorhexidine product at D0 and D7. A subsequent statistical analysis was performed using the paired Student's t-test and Wilcoxon rank sum test for within-group analyses; analysis of variance and the Kruskall-Wallis test were used for between-group analyses. RESULTS Two-week treatment with a 0.1% chlorhexidine mouthwash slightly reduced the gingival inflammation associated with periodontitis. We observed a significant decrease in Gram-negative, facultative anaerobes and micro-aerophiles, and a significant increase in Gram-positive cocci. No increase in the treatment effect was demonstrated by irrigation of the periodontal pockets. CONCLUSION The 0.1% chlorhexidine mouthwash showed limited beneficial effects in the treatment of periodontitis patients.
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Affiliation(s)
- Henri Tenenbaum
- Department of Periodontology, Dental Faculty, University of Strasbourg, Strasbourg, France INSERM 977, Strasbourg, France Laboratory of Bacteriology, Virology and Industrial Microbiology, Faculty of Pharmaceutical Sciences, University of Toulouse, Toulouse, France Pierre Fabre Oral Care, Castres, France Parogene, Strasbourg, France
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Ardila CM, Granada MI, Guzmán IC. Antibiotic resistance of subgingival species in chronic periodontitis patients. J Periodontal Res 2010; 45:557-63. [PMID: 20546113 DOI: 10.1111/j.1600-0765.2010.01274.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVE The increasing rate of resistance of microorganisms to penicillin and other antibiotics has generated concern among health authorities in Latin America. The present investigation determined the in vitro susceptibility of Porphyromonas gingivalis, Fusobacterium nucleatum, black-pigmented Prevotella spp. and Aggregatibacter actinomycetemcomitans to metronidazole, amoxicillin, amoxicillin/clavulanic acid, clindamycin and moxifloxacin in patients with chronic periodontitis. MATERIAL AND METHODS Subgingival plaque samples from patients with periodontitis were collected and cultured on selective and nonselective culture media. The antimicrobial susceptibility of periodontopathogenic isolates was studied in chronic periodontitis patients in Colombia. Metronidazole, amoxicillin, amoxicillin/clavulanic acid, clindamycin and moxifloxacin were tested on all bacterial isolates and the percentage of resistant strains was calculated. RESULTS Of the 150 bacteria identified, 51 were P. gingivalis, 45 were black-pigmented Prevotella spp., 36 were F. nucleatum and 18 were A. actinomycetemcomitans. All the isolates were sensitive to amoxicillin/clavulanic acid and to moxifloxacin, but exhibited variable susceptibility patterns to the other antimicrobial agents tested. CONCLUSION The results of the present study suggest that periodontal microorganisms in patients with chronic periodontitis can be resistant to the antimicrobial agents commonly used in anti-infective periodontal therapy. We suggest that the indiscriminate use of antimicrobials could result in the appearance of more highly antibiotic-resistant strains of bacteria associated with periodontal diseases in our population compared with the populations of other countries.
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Affiliation(s)
- C M Ardila
- Epidemiology Group, University of Antioquia, Medellín, Colombia.
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Ngom PI, Benoist HM, Soulier-Peigue D, Niang A. [Reciprocal relationships between orthodontics and periodontics: relevance of a synergistic action]. Orthod Fr 2010; 81:41-58. [PMID: 20359448 DOI: 10.1051/orthodfr/2010002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The aim of this article is to review evidence on the reciprocal relationships between orthodontics and periodontics. Normal intra-arch and inter-arch relationships have long been considered as an anatomic prerequisite for the preservation of dental health and function. Certain malocclusion traits are associated with difficulties in maintaining good oral hygiene and as a consequence to poor periodontal condition. Therefore, proper alignment of the teeth provided by orthodontic treatment may promote good control of soft deposit and calculus and subsequent periodontal inflammation. The tendency of orthodontic appliances, particularly the brackets and bands to promote the accumulation of plaque and thus increasing the risk of developing localized periodontal disease must however be constantly emphasized. Periodontitis involves progressive loss of the alveolar bone around the teeth, pathological tooth migration and gingival recession with pathological tooth migration and gingival recession as a possible outcome. The effectiveness of orthodontics in conjunction with periodontics in the management of these esthetic and functional defects is highlighted in this review.
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Affiliation(s)
- Papa Ibrahima Ngom
- Département d'Odontologie, Faculté de Médecine, Pharmacie et Odontologie, Université Cheikh Anta Diop Dakar, Sénégal.
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Takasaki AA, Aoki A, Mizutani K, Schwarz F, Sculean A, Wang CY, Koshy G, Romanos G, Ishikawa I, Izumi Y. Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases. Periodontol 2000 2010; 51:109-40. [PMID: 19878472 DOI: 10.1111/j.1600-0757.2009.00302.x] [Citation(s) in RCA: 175] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Jowett AK, Orr MTS, Rawlinson A, Robinson PG. Psychosocial impact of periodontal disease and its treatment with 24-h root surface debridement. J Clin Periodontol 2009; 36:413-8. [PMID: 19419442 DOI: 10.1111/j.1600-051x.2009.01384.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To assess the impact of periodontal disease and treatment with 24-h root surface debridement on the oral health-related quality of life of patients (OHQoL). METHODS Two cohorts were recruited: 20 patients with moderate to advanced periodontal disease and 16 dentally healthy patients. Patients with periodontal disease were treated with 24-h root surface debridement. OHQoL was assessed, using Oral Health Impact Profile-14, during the initial assessment and by a telephonic interview daily for 7 days for both groups. OHQoL was also assessed at review for the treated cohort. The number of impacts each patient experienced "occasionally" or more often was analysed by non-parametric tests. RESULTS Patients with periodontal disease reported significantly more impacts on their quality of life than dentally healthy patients (p<0.05). After root surface debridement the impact was significantly reduced (p<0.05) and sustained at review (p<0.05); however, the impact on quality of life was still greater than that experienced by the dentally healthy cohort (p<0.05). CONCLUSIONS Patients with periodontal disease have worse OHQoL than healthy patients, but this impact can be partly ameliorated by periodontal treatment. This implies that periodontal disease is not "silent" and that conventional non-surgical treatment provided in a secondary referral centre can be effective from patients' perspectives.
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Affiliation(s)
- Adrian K Jowett
- Department of Adult Dental Care, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
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Shaddox LM, Walker C. Microbial testing in periodontics: value, limitations and future directions. Periodontol 2000 2009; 50:25-38. [DOI: 10.1111/j.1600-0757.2008.00285.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Abstract
AIM To determine whether genetic variants of the TLR4 gene are associated with either chronic or aggressive periodontitis. METHODS A systematic electronic search of literature was conducted to identify all published studies without any language restriction on the association between TLR4 and periodontal diseases, including chronic periodontitis and aggressive periodontitis. All case-control studies evaluating the TLR4 Asp299Gly and Thr399Ile polymorphisms in chronic or aggressive periodontitis were identified. A meta-analysis of the studies that fulfilled the inclusion criteria was performed. RESULTS Seven studies comprising 744 chronic periodontitis cases and 855 controls and four studies consisting of a total of 295 aggressive periodontitis cases and 456 controls were included in the meta-analysis. In the pooled analysis, the TLR4 299Gly allele (TLR4+896 A>G) appeared to be a genetic risk factor for susceptibility to chronic periodontitis with a random effects and fixed effects odds ratio (OR) of 1.43 [95% confidence interval (CI):1.04-1.97; p=0.03]. On the other hand, the TLR4 399Ile polymorphism (TLR4+1196 C>T) showed a protective effect against aggressive periodontitis with a random effects OR of 0.29 (95% CI: 0.13-0.61; p=0.001). CONCLUSION Our results suggest that the alleles 299Gly and 399Ile in TLR4 can be a potential genetic marker for periodontal disease.
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Affiliation(s)
- Ayla Ozturk
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
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46
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Guentsch A, Jentsch H, Pfister W, Hoffmann T, Eick S. Moxifloxacin as an Adjunctive Antibiotic in the Treatment of Severe Chronic Periodontitis. J Periodontol 2008; 79:1894-903. [DOI: 10.1902/jop.2008.070493] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Haas AN, de Castro GD, Moreno T, Susin C, Albandar JM, Oppermann RV, Rösing CK. Azithromycin as an adjunctive treatment of aggressive periodontitis: 12-months randomized clinical trial. J Clin Periodontol 2008; 35:696-704. [DOI: 10.1111/j.1600-051x.2008.01254.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sedlacek MJ, Walker C. Antibiotic resistance in an in vitro subgingival biofilm model. ORAL MICROBIOLOGY AND IMMUNOLOGY 2007; 22:333-9. [PMID: 17803631 PMCID: PMC2040071 DOI: 10.1111/j.1399-302x.2007.00366.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The purpose of this study was to utilize an in vitro biofilm model of subgingival plaque to investigate resistances in subgingival biofilm communities to antibiotics commonly used as adjuncts to periodontal therapy. METHODS Biofilms were grown on saliva-coated hydroxyapatite supports in trypticase-soy broth for 4 h-10 days and then exposed for 48 h to either increasing twofold concentrations of tetracycline, amoxicillin, clindamycin, and erythromycin or therapeutically achievable concentrations of tetracycline, doxycycline, minocycline, amoxicillin, metronidazole, amoxicillin/clavulanate, and amoxicillin/metronidazole. RESULTS Concentrations necessary to inhibit bacterial strains in steady-state biofilms were up to 250 times greater than the concentrations needed to inhibit the same strains grown planktonically. In the presence of therapeutically available antibiotic concentrations, significantly higher proportions of the biofilms remained viable as the biofilms reached steady-state growth. The combinations of amoxicillin/clavulanate and amoxicillin/metronidazole were the most effective in suppressing growth. These combinations were particularly effective against biofilms up to and including 7 days of age and inhibited 90% or more of the bacteria present relative to untreated controls. As the biofilms approached steady state, these combinations were less effective with 50-60% of the bacteria retaining viability. CONCLUSION Most, but not all, species of subgingival bacteria are considerably more resistant in biofilms than in planktonic cultures. Resistance appeared to be age-related because biofilms demonstrated progressive antibiotic resistance as they matured with maximum resistance coinciding with the steady-state phase of biofilm growth.
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Affiliation(s)
- M J Sedlacek
- Department of Oral Biology, University of Florida, Gainesville, FL 32610-0424, USA
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Greenstein G. Local Drug Delivery in the Treatment of Periodontal Diseases: Assessing the Clinical Significance of the Results. J Periodontol 2006; 77:565-78. [PMID: 16584336 DOI: 10.1902/jop.2006.050140] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Local drug delivery can be used in the management of periodontal patients. However, statistically significant responses to therapy recorded in clinical trials may not be clinically significant. METHODS Controlled clinical trials were selected that assessed the capability of local drug delivery to improve periodontal health. RESULTS Several local drug delivery systems employed as monotherapies improved periodontal health and provided results that were not statistically significantly different than attained with scaling and root planing (SRP) alone. In contrast, many local drug delivery devices when used as adjuncts to SRP provided a statistically significant enhancement of parameters commonly used to monitor periodontal status. However, mean improvements with respect to probing depth reduction or gain of clinical attachment were often limited to tenths of millimeters. Several devices also achieved specific criteria that can be used to identify clinically significant findings (e.g., number of sites with probing depth reduction >or=2 mm). However, there are conflicting data with respect to the ability of local drug delivery to enhance results of SRP at deep probing sites, and there is limited information relative to its capability to inhibit disease progression or enhance osseous repair in infrabony defects. CONCLUSION The decision to use local drug delivery during active treatment or maintenance should be based upon clinical findings, responses to therapy recorded in the literature, desired clinical outcomes, and the patient's dental and medical history.
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Affiliation(s)
- Gary Greenstein
- Department of Periodontology, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
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Abstract
This position paper addresses the role of systemic antibiotics in the treatment of periodontal disease. Topical antibiotic therapy is not discussed here. The paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology. The document consists of three sections: 1) concept of antibiotic periodontal therapy; 2) efficacy of antibiotic periodontal therapy; and 3) practical aspects of antibiotic periodontal therapy. The conclusions drawn in this paper represent the position of the American Academy of Periodontology and are intended for the information of the dental profession.
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