1
|
Manciocchi E, Xhajanka E, D'Addazio G, Tafuri G, Santilli M, Rexhepi I, Caputi S, Sinjari B. Antibiotic prescribing patterns among dentists in Italy and Albania: A comparative questionnaire analysis. Heliyon 2024; 10:e33575. [PMID: 39040368 PMCID: PMC11261076 DOI: 10.1016/j.heliyon.2024.e33575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 06/11/2024] [Accepted: 06/24/2024] [Indexed: 07/24/2024] Open
Abstract
Objective To investigate the therapeutic and prophylactic use of antibiotics in dentistry in two countries. Methods This study used questionnaires to examine the prescribing habits of dentists in Italy (9th country in Europe for systemic antibiotic administration) and Albania an Extra European Union Country. A total of 1300 questionnaires were sent to Italian and Albanian dentists. Results In total, 180 Italian and 180 Albanian dentists completed the questionnaire. Penicillin use was higher in Italy (96.6 %) than Albania (82.8 %). Only 26.1 % of Italian dentists and 32 % of Albanian dentists followed the national guidelines for antibiotic administration. Conclusions Dentists tend to overprescribe antibiotics for treating existing conditions or as prophylaxis. They also highlighted a lack of adherence to established guidelines for antibiotic use. In addition, factors such as age, nationality, and sex appeared to influence the choice of antibiotics. Clinical significance Recently, the growth of antibiotic-resistant bacteria has become a global concern. The authors of this article highlight how dentists often prescribe antibiotics without a real need. Limiting the use of antibiotics in this category may help mitigate antibiotic resistance.
Collapse
Affiliation(s)
- Eugenio Manciocchi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Edit Xhajanka
- Department of Dental Medicine, Medical University of Tirana, Rruga E Dibres, 1001, Albania
| | - Gianmaria D'Addazio
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Giuseppe Tafuri
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Manlio Santilli
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Imena Rexhepi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Sergio Caputi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Bruna Sinjari
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| |
Collapse
|
2
|
Rattanaprukskul K, Neiva R, Korostoff J. Optimizing esthetic zone periodontal regeneration in a 1-2-wall infrabony defect using recombinant human platelet-derived growth factor BB and β-tricalcium phosphate: A case report. Clin Exp Dent Res 2024; 10:e908. [PMID: 38798052 PMCID: PMC11128747 DOI: 10.1002/cre2.908] [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: 11/16/2023] [Revised: 04/16/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE Periodontitis is an inflammatory condition induced by subgingival bacterial dysbiosis, resulting in inflammatory-mediated destruction of tooth-supporting structures, potentially leading to the formation of infrabony defects. This case report describes the treatment of a patient who presented with a combination 1-2-wall defect on tooth 21. To maintain the residual periodontal attachment and minimize esthetic consequences, a regenerative approach was performed using recombinant human platelet-derived growth factor-BB (rh-PDGF-BB) and β-tricalcium phosphate (β-TCP). MATERIALS AND METHODS At the time of postscaling/root planing reevaluation, a 34-year-old Asian male initially diagnosed with molar/incisor pattern stage III grade C periodontitis exhibited a 6-mm residual probing depth on the mesiopalatal aspect of tooth 21. Periodontal regenerative surgery was performed using rh-PDGF-BB with β-TCP, without the use of a membrane. RESULTS At the 1-year follow-up, a significant reduction in probing depth and radiographic evidence of bone fill were observed. Additionally, re-entry surgery for implant placement at site tooth 23 confirmed bone fill in the defect on tooth 21. CONCLUSION These results demonstrate the efficacy of rh-PDGF-BB with β-TCP in enhancing periodontal regeneration and support its use as a treatment option when treating poorly contained infrabony defects in the esthetic zone.
Collapse
Affiliation(s)
- Kantapon Rattanaprukskul
- Department of Periodontics, School of Dental MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of Periodontology, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Rodrigo Neiva
- Department of Periodontics, School of Dental MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Jonathan Korostoff
- Department of Periodontics, School of Dental MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| |
Collapse
|
3
|
Rams TE, Freedman IS, Chialastri SM, Slots J. Systemic ciprofloxacin treatment of multidrug-resistant Aggregatibacter actinomycetemcomitans in severe periodontitis. Diagn Microbiol Infect Dis 2024; 108:116162. [PMID: 38113673 DOI: 10.1016/j.diagmicrobio.2023.116162] [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: 07/16/2023] [Revised: 11/03/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
An adult periodontitis patient treated with mechanical/surgical therapy experienced gingival necrosis and granulomas post-treatment. Aggregatibacter actinomycetemcomitans, a tissue-invasive pathogen, was recovered and multidrug-resistant but susceptible to ciprofloxacin. Systemic ciprofloxacin eliminated A. actinomycetemcomitans with marked clinical improvement. Ciprofloxacin may be prescribed for A. actinomycetemcomitans periodontal infection unresponsive to the common amoxicillin-metronidazole treatment.
Collapse
Affiliation(s)
- Thomas E Rams
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, Pennsylvania, USA.
| | - Ira S Freedman
- Department of Periodontics, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida, USA
| | - Susan M Chialastri
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, Pennsylvania, USA
| | - Jørgen Slots
- Division of Periodontology and Diagnostic Sciences, University of Southern California School of Dentistry, Los Angeles, California, USA
| |
Collapse
|
4
|
Poulose M, Gujar D, Panicker S, Rokade S, Guruprasad M, Gopalakrishnan D. Efficacy and Viability of Subgingival Application of Probiotics as an Adjunct to Scaling and Root Planing in Periodontitis. Indian J Dent Res 2024; 35:59-64. [PMID: 38934751 DOI: 10.4103/ijdr.ijdr_533_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/10/2023] [Indexed: 06/28/2024] Open
Abstract
AIM This study aimed to compare the efficacy of subgingivally applied probiotics as an adjunct to scaling and root planing (SRP) vs SRP alone in patients with periodontitis. MATERIALS AND METHODS Patients diagnosed with periodontitis, with probing pocket depth (PPD) of 5-7 mm on at least two teeth on contralateral sites, were selected for the study and randomly allocated to the test group (n = 31) who underwent SRP along with subgingival application of probiotic paste and the control group (n = 31) who underwent only SRP. Clinical parameters were evaluated in both groups at baseline and after 12 weeks. The viability of probiotic bacteria was evaluated in the test group at baseline, day 4 and day 8. RESULTS All clinical parameters showed a statistically significant difference between baseline and 12 weeks on intragroup and intergroup comparison, with a greater improvement in the test group. Microbiological evaluation showed that the mean colony-forming units (CFUs) in the test group were 38.39 ± 7.76, 7.25 ± 2.72 and 1.57 ± 1.29 at baseline, day 4 and day 8, respectively. The mean CFUs significantly reduced with an increase in time from baseline to 8-day time interval. CONCLUSION It was seen that the probiotic bacteria remained viable in the periodontal pocket for up to 8 days after placement, but stable improvements were seen in all clinical parameters even at 12 weeks, indicating its prolonged efficacy. Thus, commercially available probiotics can prove to be an inexpensive method to treat periodontitis when combined with SRP.
Collapse
Affiliation(s)
- Mariam Poulose
- Department of Periodontology, Dr. D Y Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Dnyaneshwari Gujar
- Department of Periodontology, Dr. D Y Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Suneeta Panicker
- Department of Microbiology, Dr. D. Y. Patil Arts Commerce and Science College, Pimpri, Pune, Maharashtra, India
| | - Shreya Rokade
- Department of Periodontology, Dr. D Y Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Meghana Guruprasad
- Department of Periodontology, Dr. D Y Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Dharmarajan Gopalakrishnan
- Department of Periodontology, Dr. D Y Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| |
Collapse
|
5
|
Rams TE, Sautter JD, van Winkelhoff AJ. Emergence of Antibiotic-Resistant Porphyromonas gingivalis in United States Periodontitis Patients. Antibiotics (Basel) 2023; 12:1584. [PMID: 37998786 PMCID: PMC10668829 DOI: 10.3390/antibiotics12111584] [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: 10/18/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
Antibiotic resistance patterns of the major human periodontal pathogen Porphyromonas gingivalis were assessed over a 20-year period in the United States. Subgingival P. gingivalis was cultured pre-treatment from 2193 severe periodontitis patients during three time periods: 1999-2000 (936 patients), 2009-2010 (685 patients), and 2019-2020 (572 patients). The clinical isolates were tested for in vitro resistance to 4 mg/L for clindamycin and doxycycline, 8 mg/L for amoxicillin, and 16 mg/L for metronidazole, with a post hoc combination of data for metronidazole plus amoxicillin. Clindamycin-resistant P. gingivalis was significantly more prevalent in 2009-2010 (9.1% of patients) and 2019-2020 (9.3%; 15-fold increase) as compared to 1999-2000 (0.6%). P. gingivalis resistance to amoxicillin also significantly increased from 0.1% of patients in 1999-2000 to 1.3% in 2009-2010 and 2.8% (28-fold increase) in 2019-2020. P. gingivalis resistance to metronidazole, metronidazole plus amoxicillin, and doxycycline was low (≤0.5% prevalence), and statistically unchanged, over the 20-year period. These findings are the first to reveal marked increases over 20 years in clindamycin-resistant and amoxicillin-resistant P. gingivalis in United States periodontitis patients. Increased antibiotic resistance of P. gingivalis and other periodontitis-associated bacteria threatens the efficacy of periodontal antimicrobial chemotherapy.
Collapse
Affiliation(s)
- Thomas E. Rams
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA;
| | - Jacqueline D. Sautter
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA;
| | - Arie J. van Winkelhoff
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| |
Collapse
|
6
|
Zhao J, Wei Y, Xiong J, Liu H, Lv G, Zhao J, He H, Gou J, Yin T, Tang X, Zhang Y. Antibacterial-Anti-Inflammatory-Bone Restoration Procedure Achieved by MIN-Loaded PLGA Microsphere for Efficient Treatment of Periodontitis. AAPS PharmSciTech 2023; 24:74. [PMID: 36890400 DOI: 10.1208/s12249-023-02538-3] [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: 12/19/2022] [Accepted: 02/12/2023] [Indexed: 03/10/2023] Open
Abstract
The main development process of periodontitis involves periodontal pathogenic bacteria as the initiating factor causing the onset of destructive inflammation, which in turn stimulates the destruction of periodontal tissue. It is difficult to achieve the eradication of periodontitis due to the complex interaction among antibacterial, anti-inflammatory, and bone restoration. Herein, we propose an antibacterial-anti-inflammatory-bone restoration procedural treatment strategy with minocycline (MIN) for the efficient treatment of periodontitis. In brief, MIN was prepared into PLGA microspheres with tunable release behavior using different species of PLGA, respectively. The optimally selected PLGA microspheres (LA:GA with 50:50, 10 kDa, and carboxyl group) had a drug loading of 16.91%, an in vitro release of approximately 30 days, which also had a particle size of approximately 11.8 µm with a smooth appearance and a rounded morphology. The DSC and XRD results showed that the MIN was completely encapsulated in the microspheres as an amorphous state. Cytotoxicity tests demonstrated the safety and biocompatibility of the microspheres (cell viabilities at a concentration of 1-200 μg/mL were greater than 97%), and in vitro bacterial inhibition tests showed that the selected microspheres could achieve effective bacterial inhibition at the initial stage after administration. The favorable anti-inflammatory (low TNF-α and IL-10 levels) and bone restoration effects (BV/TV: 71.8869%; BMD: 0.9782 g/cm3; TB.Th: 0.1366 mm; Tb.N: 6.9318 mm-1; Tb.Sp: 0.0735 mm) were achieved in a SD rat periodontitis model after administering once a week for four weeks. The MIN-loaded PLGA microspheres were proved to be an efficient and safe treatment for periodontitis by procedural antibacterial, anti-inflammatory, and bone restoration.
Collapse
Affiliation(s)
- Jiansong Zhao
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Ying Wei
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Jian Xiong
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Hongbing Liu
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Gaoshuai Lv
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Jingyi Zhao
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Haibing He
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Jingxin Gou
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Tian Yin
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Xing Tang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China
| | - Yu Zhang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning, 110016, China.
| |
Collapse
|
7
|
Micu IC, Muntean A, Roman A, Stratul ȘI, Pall E, Ciurea A, Soancă A, Negucioiu M, Barbu Tudoran L, Delean AG. A Local Desiccant Antimicrobial Agent as an Alternative to Adjunctive Antibiotics in the Treatment of Periodontitis: A Narrative Review. Antibiotics (Basel) 2023; 12:antibiotics12030456. [PMID: 36978324 PMCID: PMC10044681 DOI: 10.3390/antibiotics12030456] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Periodontitis is one of the most common oral polymicrobial infectious diseases induced by the complex interplay between the altered subgingival microbiota and the host’s dysregulated immune-inflammatory response, leading to the initiation of progressive and irreversible destruction of the periodontal tissues and eventually to tooth loss. The main goal of cause-related periodontal therapy is to eliminate the dysbiotic subgingival biofilm in order to arrest local inflammation and further periodontal tissue breakdown. Because, in some cases, subgingival mechanical instrumentation has limited efficiency in achieving those goals, various adjunctive therapies, mainly systemic and locally delivered antimicrobials, have been proposed to augment its effectiveness. However, most adjunctive antimicrobials carry side effects; therefore, their administration should be precociously considered. HybenX® (HY) is a commercial therapeutical agent with decontamination properties, which has been studied for its effects in treating various oral pathological conditions, including periodontitis. This review covers the current evidence regarding the treatment outcomes and limitations of conventional periodontal therapies and provides information based on the available experimental and clinical studies related to the HY mechanism of action and effects following its use associated with subgingival instrumentation and other types of dental treatments.
Collapse
Affiliation(s)
- Iulia C. Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Alexandrina Muntean
- Department of Pedodontics, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu St., No. 31, 400117 Cluj-Napoca, Romania
- Correspondence: (A.M.); (A.S.)
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Ștefan I. Stratul
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-Implant Diseases, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy Timișoara, Bulevardul Revoluției din 1989, No.9, 300230 Timișoara, Romania
| | - Emöke Pall
- Department of Infectious Disease, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Mănăștur St., No. 3-5, 400372 Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
- Correspondence: (A.M.); (A.S.)
| | - Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania
| | - Lucian Barbu Tudoran
- Electron Microscopy Center, Department of Molecular Biology and Biotechnologies, Faculty of Biology and Geology, Babeş-Bolyai University, Clinicilor St., No. 5-7, 400006 Cluj-Napoca, Romania
- Electron Microscopy Integrated Laboratory (LIME), National Institute for Research and Development of Isotopic and Molecular Technologies, Institutul Național de Cercetare-Dezvoltare pentru Tehnologii Izotopice și Moleculare, 67-103 Donath St., 400293 Cluj-Napoca, Romania
| | - Ada G. Delean
- Department of Cariology, Endodontics and Oral Pathology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Moților St., No. 33, 400001 Cluj-Napoca, Romania
| |
Collapse
|
8
|
Alkayali MFMT, Badria FA, ElBaiomy AAB, Youssef JM. Effect of polycaprolactone nanofibers loaded with oxytetracycline hydrochloride and zinc oxide as an adjunct to SRP on GCF lipocalin-2 levels in periodontitis patients: A clinical and laboratory study. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2022; 14:76-83. [PMID: 36714082 PMCID: PMC9871181 DOI: 10.34172/japid.2022.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/31/2022] [Indexed: 01/09/2023]
Abstract
Background. The aim of this study was the clinical and laboratory evaluation of using polycaprolactone (PCL) nanofibers loaded with oxytetracycline hydrochloride (OTC) and zinc oxide (ZnO) as an adjunct to mechanical therapy in managing stage II grade A periodontitis patients concerning GCF lipocalin2- levels. Methods. Fifty stage II grade A periodontitis patients (27 women and 23 men, with an age range of 30‒60) were enrolled in the study. The patients were randomly assigned to five equal groups and treated with scaling and root planing (SRP), followed by local application of PCL nanofibers: group I: SRP + PCL loaded with OTC and ZnO, group II: SRP + PCL loaded with OTC, group III: SRP + PCL loaded with ZnO, group IV: SRP + unloaded PCL, and group V: SRP alone. Additionally, 10 healthy subjects with healthy periodontium (group VI) (age- and gender-matched) served as the negative control. Nanofibers were applied in the selected pockets of periodontitis patients in groups I to IV once weekly for two months. All the participants were examined clinically by assessing periodontal indices (gingival index, plaque index, pocket depth, and clinical attachment level), and biochemically by assessing GCF lipocalin-2 levels. Results. Compared to controls, periodontitis groups (I, II, III, IV, and V) showed significant elevation of both clinical parameters and GCF lipocalin2- levels at baseline. In addition, these parameters improved significantly after treatment, which was more pronounced in groups I, II-, and III) compared to groups IV and V. However, it did not reach normal values. Conclusion. In association with SRP, PCL nanofibers loaded with OTC and ZnO had beneficial therapeutic effects at both clinical and laboratory levels.
Collapse
Affiliation(s)
| | - Farid A. Badria
- Department of Pharmacognosy, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | | | - Jilan Mohamed Youssef
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt,Corresponding author: Jilan M. Youssef, E-mail:
| |
Collapse
|
9
|
Nomiyama LM, Matumoto EK, Corrêa MG, Cirano FR, Ribeiro FV, Pimentel SP, Casati MZ. Comparison between flapless-guided and conventional surgery for implant placement: a 12-month randomized clinical trial. Clin Oral Investig 2022; 27:1665-1679. [PMID: 36401742 DOI: 10.1007/s00784-022-04793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/13/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The study was aimed at comparing implants installed with guided and conventional surgery. MATERIAL AND METHODS Twenty-nine total edentulous patients were selected, and maxillary contralateral quadrants were randomly assigned to static computer-aided implant surgery (S-CAIS): flapless computer-guided surgery, and conventional surgery (CS): flap surgery with conventional planning. Tomography scans were performed at baseline and 10 days after the surgery for deviation measurement, and radiography was done at baseline and after 6 and 12 months, for peri-implant bone level (PIBL) analysis. Peri-implant fluid and subgingival biofilm were collected to evaluate bone markers and periodontal pathogens. RESULTS S-CAIS showed less linear deviation at the apical point and the midpoint and less angular deviation (p < 0.05), with greater depth discrepancy in the positioning of the platform (p < 0.05). Higher values of vertical PIBL were observed for the S-CAIS group at baseline (p < 0.05), while lower values of horizontal PIBL were observed for CS (p < 0.05). Bone markers and Tf presented higher levels in CS (p < 0.05). Flapless S-CAIS allowed smaller linear and angular deviations than the conventional technique. CONCLUSION However, PIBL was higher in S-CAIS; the conventional technique led to a greater angiogenic and bone remodeling activity by elevating the angiogenic levels and bone markers. CLINICAL RELEVANCE Evaluating the different implant insertion techniques can guide clinical and surgical regarding the accuracy, the release pattern of bone markers, and the peri-implant bone level. TRIAL REGISTRATION ReBEC-RBR-8556fzp.
Collapse
Affiliation(s)
- Lucas Massaru Nomiyama
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Edson Ken Matumoto
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Mônica Grazieli Corrêa
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Fabiano Ribeiro Cirano
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Fernanda Vieira Ribeiro
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Suzana Peres Pimentel
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Marcio Zaffalon Casati
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil.
- Departamento de Odontologia, Universidade Paulista (UNIP), São Paulo, Brazil.
| |
Collapse
|
10
|
Slots J. Concise evaluation and therapeutic guidelines for severe periodontitis: A public health perspective. Periodontol 2000 2022; 90:262-265. [PMID: 35913496 PMCID: PMC9804657 DOI: 10.1111/prd.12463] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The main goal of periodontology is to prevent and arrest gingivitis and periodontitis to avoid tooth loss and focal infection of periodontal origin. Periodontal scaling or flap surgery of moderate-to-severe periodontitis have shortcomings, most likely because removal of herpesviruses and bacterial pathogens in deep periodontal lesions and the adjacent inflamed gingiva requires systemic antimicrobial treatment (or gingivectomy). Valacyclovir (1000 mg twice daily on day 1, and 500 mg twice daily on day 2 and on day 3) is a potent anti-herpesvirus agent. Antibiotic combinations against bacterial pathogens include amoxicillin-metronidazole (250 mg of each, thrice daily for 4 days; for systemically healthy adults) and ciprofloxacin-metronidazole (500 mg of each, twice daily for 4 days; for immunosuppressed individuals and patients exposed to contaminated water and poor sanitation). Supportive antiseptic treatment may consist of 0.1%-0.2% sodium hypochlorite (regular household bleach) as cooling spray in ultrasonic scalers, flosser fluid in oral irrigators, and mouthrinse in patient self-care. The anti-infective treatment described here helps control cases of severe periodontitis and constitutes an exceedingly inexpensive alternative to conventional (mechanical) periodontal therapy.
Collapse
Affiliation(s)
- Jørgen Slots
- Ostrow School of DentistryUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| |
Collapse
|
11
|
Ioannidou E, Geurs N, Lipman R, Araujo MWB, Elkareh J, Engebretson S, Eber R, Oates T, Diaz P, Spino C. Antibiotic prescription patterns among US general dentists and periodontists. J Am Dent Assoc 2022; 153:979-988. [PMID: 36038399 DOI: 10.1016/j.adaj.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/19/2022] [Accepted: 06/02/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND In the absence of a full spectrum of evidence-based guidelines for the appropriate use of antimicrobial agents, dentists, including periodontists, remain a highly frequent antibiotic prescribing group. With the goal of understanding antibiotic prescribing practices, the authors surveyed a convenience sample of dental practitioners and periodontists to identify differences between the 2 cohorts and assess the factors that affect prescribing practices. METHODS An institutional review board-approved 15-item survey was developed to capture antibiotic prescribing practices addressing the main research question, factors affecting systemic antibiotic prescription patterns, and prescription timing. The authors collaborated with the American Dental Association (ADA) and the American Academy of Periodontology (AAP) for survey dissemination. Responses were summarized using descriptive statistics. Multivariable models were developed to identify antibiotic prescription predictors. RESULTS Overall, 32.4% of the participants prescribed systemic antibiotics with scaling and root planing. When comparing the 2 groups, the authors found that 46.4% and 18.7% of the AAP and ADA members, respectively, prescribed systemic antibiotics with scaling and root planing (P = .0001). The authors found a significant difference between the AAP and ADA groups in prescription timing (P = .01). The multivariable model revealed that practitioner sex (P = .03), AAP membership (P = .0001), and years of practitioner experience (P = .04) predicted antibiotic prescription practices. The geographic location, practice setting, and occupation type did not predict antibiotic prescription patterns. CONCLUSION The authors found a lack of clarity related to prescription timing, factors determining prescription patterns, and selection of patient population who would benefit more from antibiotics. PRACTICAL IMPLICATIONS This study confirmed a lack of clarity related to antibiotic prescription patterns in combination with nonsurgical periodontal treatment.
Collapse
|
12
|
Leroy R, Bourgeois J, Verleye L, Toma S. Should systemic antibiotics be prescribed in periodontal abscesses and pericoronitis? A systematic review of the literature. Eur J Oral Sci 2022; 130:e12884. [PMID: 35781706 DOI: 10.1111/eos.12884] [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: 01/18/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022]
Abstract
This study assessed whether systemic antibiotics are beneficial or harmful in patients who present with an acute periodontal abscess or pericoronitis, with or without systemic involvement, and, if antibiotics are beneficial, which type, dosage, and duration are the most effective. Medline, Embase, and the Cochrane Library were screened from 1948 up to 1 April 2022 for systematic reviews, randomised clinical trials (RCTs), and other studies. Dedicated websites were consulted for systematic reviews, clinical practice guidelines, and health technology assessments on the topic. Outcomes of interest comprised tooth survival, swelling, pain, tooth mobility, periodontal probing depth, suppuration, adverse effects, quality of life measurements, and medication required for pain relief. Overall, five guidelines, seven systematic reviews, 15 RCTs, and 34 other studies were identified and selected for full-text assessment, but none of them fulfilled the inclusion criteria. At present there is no single randomised or non-randomised controlled trial assessing the harms and clinical effectiveness of systemic antibiotics in adults with a periodontal abscess or pericoronitis.
Collapse
Affiliation(s)
- Roos Leroy
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | | | - Leen Verleye
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | - Selena Toma
- Department of Periodontology, Institut de Recherche Experimentale et Clinique (IREC), Cliniques universitaires Saint-Luc, Brussels, Belgium
| |
Collapse
|
13
|
Lertsuphotvanit N, Santimaleeworagun W, Narakornwit W, Chuenbarn T, Mahadlek J, Chantadee T, Phaechamud T. Borneol-based antisolvent-induced in situ forming matrix for crevicular pocket delivery of vancomycin hydrochloride. Int J Pharm 2022; 617:121603. [DOI: 10.1016/j.ijpharm.2022.121603] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/23/2022] [Accepted: 02/16/2022] [Indexed: 01/31/2023]
|
14
|
Antimicrobial effect of Casiopeinas® copper- and ruthenium-based compounds on Aggregatibacter actinomycetemcomitans and in vitro cell viability onto osteoblasts cells. Braz J Microbiol 2021; 53:179-184. [PMID: 34741282 DOI: 10.1007/s42770-021-00648-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES The present study aims to evaluate the antimicrobial property of Casiopeinas® copper- and ruthenium-based compounds against Aggregatibacter actinomycetemcomitans serotype b (ATCC® 43,718™), as well as the cytotoxicity on an osteoblasts cell line of both compounds. MATERIAL AND METHODS The antibacterial effect of the copper-based compounds (CasII-gly, CasIII-ia) and the ruthenium-based compound (RuN-6) at four different concentrations was evaluated as the inhibition ratio of the bacterial growth after 48 h under anaerobic conditions, and the cell viability was measured through resazurin assay. RESULTS The copper- and ruthenium-based compounds used for this assay were (CasII-gly, CasIII-ia, and RuN-6), showing inhibitory activity between 39 and 62% compared to the antibiotic employed as control 66%. Cell viability was established between 61 and 96%. CONCLUSIONS Casiopeinas® and ruthenium showed dose and time dependent, inhibitory activity on A. actinomycetemcomitans, and low toxicity on cells (osteoblast) underexposure. The compound CasII-gly showed the best antimicrobial effect, and it could be considered a possible antimicrobial agent in periodontal therapy.
Collapse
|
15
|
Lin P, Niimi H, Ohsugi Y, Tsuchiya Y, Shimohira T, Komatsu K, Liu A, Shiba T, Aoki A, Iwata T, Katagiri S. Application of Ligature-Induced Periodontitis in Mice to Explore the Molecular Mechanism of Periodontal Disease. Int J Mol Sci 2021; 22:ijms22168900. [PMID: 34445604 PMCID: PMC8396362 DOI: 10.3390/ijms22168900] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is an inflammatory disease characterized by the destruction of the periodontium. In the last decade, a new murine model of periodontitis has been widely used to simulate alveolar bone resorption and periodontal soft tissue destruction by ligation. Typically, 3-0 to 9-0 silks are selected for ligation around the molars in mice, and significant bone loss and inflammatory infiltration are observed within a week. The ligature-maintained period can vary according to specific aims. We reviewed the findings on the interaction of systemic diseases with periodontitis, periodontal tissue destruction, the immunological and bacteriological responses, and new treatments. In these studies, the activation of osteoclasts, upregulation of pro-inflammatory factors, and excessive immune response have been considered as major factors in periodontal disruption. Multiple genes identified in periodontal tissues partly reflect the complexity of the pathogenesis of periodontitis. The effects of novel treatment methods on periodontitis have also been evaluated in a ligature-induced periodontitis model in mice. This model cannot completely represent all aspects of periodontitis in humans but is considered an effective method for the exploration of its mechanisms. Through this review, we aimed to provide evidence and enlightenment for future studies planning to use this model.
Collapse
Affiliation(s)
- Peiya Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Hiromi Niimi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
- Correspondence: (H.N.); (Y.O.); Tel.: +81-3-5803-5488 (H.N. & Y.O.)
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
- Correspondence: (H.N.); (Y.O.); Tel.: +81-3-5803-5488 (H.N. & Y.O.)
| | - Yosuke Tsuchiya
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Tsuyoshi Shimohira
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Keiji Komatsu
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan;
| | - Anhao Liu
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Takahiko Shiba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan; (P.L.); (Y.T.); (T.S.); (A.L.); (T.S.); (A.A.); (T.I.); (S.K.)
| |
Collapse
|
16
|
Sabeti M, Zhong J, Hildebrandt K, Slots J. Valacyclovir in Pain Management of Acute Apical Abscesses: A Randomized Placebo-Controlled Double-Blind Pilot Study. J Endod 2021; 47:1724-1728. [PMID: 34363831 DOI: 10.1016/j.joen.2021.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The acute (symptomatic) apical abscess is characterized by pulp necrosis, rapid onset, spontaneous pain, percussion pain, pus formation, and tissue swelling. The etiopathology of acute apical abscesses includes active (lytic) herpesviruses and gram-negative anaerobic bacteria. The present study examined the potential of valacyclovir, an anti-herpesvirus agent, and systemic amoxicillin to manage the pain of acute apical abscesses. METHODS Twenty emergency patients with moderate to severe apical abscess pain received randomly either amoxicillin (1 g immediate dose followed by 500 mg, 4 times a day, totally 7 days) + valacyclovir (2 g immediate dose followed by 500 mg, twice a day, totally 3 days) ("valacyclovir" group, 10 patients) OR amoxicillin (1 g immediate dose followed by 500 mg, 4 times a day, totally 7 days) + placebo ("placebo" group, 10 patients). Daily telephone calls during the 6-day follow-up period assessed pain level on a numeric rating scale and analgesic intake. The Mann-Whitney and the Friedman statistical tests analyzed the outcome data. RESULTS At the baseline examination, all 10 valacyclovir and 9 placebo patients exhibited moderate to severe pain and 18 patients needed pain medication. On the first day after baseline, the valacyclovir group showed 2 patients with moderate/severe pain and 1 patient on pain medication, but the placebo group revealed as many as 8 patients with moderate/severe pain and 9 patients on pain medication. The difference in pain level and analgesic usage between the valacyclovir and the placebo group remained statistically significant during the entire post-baseline study period (P < .05). CONCLUSION The present study points to valacyclovir as a promising adjunctive agent in pain control with acute apical abscesses.
Collapse
Affiliation(s)
- Mohammad Sabeti
- Department of Preventive and Restorative Dental Science, University of California, San Francisco, San Francisco, California.
| | - John Zhong
- Division of Endodontics, University of California, San Francisco, San Francisco, California
| | - Kevin Hildebrandt
- Community Health Clinic, University of California, San Francisco, San Francisco, California
| | - Jørgen Slots
- Division of Periodontology, Diagnostic Sciences and Dental Hygiene, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Los Angeles, California
| |
Collapse
|
17
|
Chen N, Ren R, Wei X, Mukundan R, Li G, Xu X, Zhao G, Zhao Z, Lele SM, Reinhardt RA, Wang D. Thermoresponsive Hydrogel-Based Local Delivery of Simvastatin for the Treatment of Periodontitis. Mol Pharm 2021; 18:1992-2003. [PMID: 33754729 DOI: 10.1021/acs.molpharmaceut.0c01196] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Except for routine scaling and root planing, there are few effective nonsurgical therapeutic interventions for periodontitis and associated alveolar bone loss. Simvastatin (SIM), one of the 3-hydroxy-3-methylglutaryl-cosenzyme A reductase inhibitors, which is known for its capacity as a lipid-lowering medication, has been proven to be an effective anti-inflammatory and bone anabolic agent that has shown promising benefits in mitigating periodontal bone loss. The local delivery of SIM into the periodontal pocket, however, has been challenging due to SIM's poor water solubility and its lack of osteotropicity. To overcome these issues, we report a novel SIM formulation of a thermoresponsive, osteotropic, injectable hydrogel (PF127) based on pyrophosphorolated pluronic F127 (F127-PPi). After mixing F127-PPi with F127 at a 1:1 ratio, the resulting PF127 was used to dissolve free SIM to generate the SIM-loaded formulation. The thermoresponsive hydrogel's rheologic behavior, erosion and SIM release kinetics, osteotropic property, and biocompatibility were evaluated in vitro. The therapeutic efficacy of SIM-loaded PF127 hydrogel on periodontal bone preservation and inflammation resolution was validated in a ligature-induced periodontitis rat model. Given that SIM is already an approved medication for hyperlipidemia, the data presented here support the translational potential of the SIM-loaded PF127 hydrogel for better clinical management of periodontitis and associated pathologies.
Collapse
Affiliation(s)
- Ningrong Chen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Rongguo Ren
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Xin Wei
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Roshni Mukundan
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Guojuan Li
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Xiaoke Xu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Gang Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Zhifeng Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Subodh M Lele
- Department of Pathology & Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Richard A Reinhardt
- Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, Nebraska 68583, United States
| | - Dong Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| |
Collapse
|
18
|
Peikert SA, Fischer A, Kruse AB, Al-Ahmad A, Woelber JP, Vach K, Braun A, Ratka-Krüger P. Adjuvant Transgingival Therapy with Visible Light Plus Water-Filtered Infrared-A (VIS + wIRA) in Periodontal Therapy-A Randomized, Controlled, Stratified, Double-Blinded Clinical Trial. Antibiotics (Basel) 2021; 10:antibiotics10030251. [PMID: 33802497 PMCID: PMC7999319 DOI: 10.3390/antibiotics10030251] [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: 02/01/2021] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 12/03/2022] Open
Abstract
The aim of this randomized, controlled, double-blinded clinical trial was to examine the additional healing effect of transgingival visible light and water-filtered infrared-A (VIS + wIRA) in the treatment of periodontitis patients compared with the standard therapy by subgingival instrumentation (SI). Therefore, forty patients with untreated periodontitis received a non-surgical periodontal treatment. Using a split-mouth study design, one quadrant of the upper jaw was randomly either exposed to VIS + wIRA four times for 20 min within two weeks in addition to SI or received only SI. Three and 6 months after intervention, clinical parameters (probing depths (PDs), clinical attachment level, bleeding on probing (BOP), furcation, tooth mobility, plaque control record, and papilla bleeding index) were re-evaluated. In the presence of PD of 4 mm and positive BOP or PD > 4 mm, SI was performed again. Moreover, the patients were asked about their discomfort using a visual analog scale from 1 to 10 for each side of the maxilla. Statistical analysis demonstrated no differences between quadrants at re-evaluation for clinical parameters (p > 0.05) after 3 and 6 months. Concerning pain perception, patients described less pain on the irradiated side (p = 0.016). In the treatment of patients with periodontitis, VIS + wIRA did not show an additional effect on the clinical outcome after 3 and 6 months. Patients described less pain on the irradiated quadrant after treatment.
Collapse
Affiliation(s)
- Stefanie Anna Peikert
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany; (A.F.); (A.B.K.); (A.A.-A.); (J.P.W.); (P.R.-K.)
- Correspondence: ; Tel.: +49-761-270-48800
| | - Anil Fischer
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany; (A.F.); (A.B.K.); (A.A.-A.); (J.P.W.); (P.R.-K.)
- Practice Dr. Stefan Bertram, Gewerbegasse 5, 83395 Freilassing, Germany
| | - Anne Brigitte Kruse
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany; (A.F.); (A.B.K.); (A.A.-A.); (J.P.W.); (P.R.-K.)
| | - Ali Al-Ahmad
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany; (A.F.); (A.B.K.); (A.A.-A.); (J.P.W.); (P.R.-K.)
| | - Johan Peter Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany; (A.F.); (A.B.K.); (A.A.-A.); (J.P.W.); (P.R.-K.)
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Stefan-Meier-Straße 26, 79104 Freiburg, Germany;
| | - Andreas Braun
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH University Aachen, Pauwelsstraße 30, 52074 Aachen, Germany;
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany; (A.F.); (A.B.K.); (A.A.-A.); (J.P.W.); (P.R.-K.)
| |
Collapse
|
19
|
An T, Chen Y, Li M, Liu Y, Zhang Z, Yang Q. Inhibition of experimental periodontitis by a monoclonal antibody against Porphyromonas gingivalis HA2. Microb Pathog 2021; 154:104633. [PMID: 33667618 DOI: 10.1016/j.micpath.2020.104633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/12/2022]
Abstract
It is known that complexes of the multi-protein, gingipain, possess heme binding domains (hemagglutinin 2, HA2) that bind hemoglobin to provide heme and iron to the bacterium, Porphyromonas gingivalis. The DHYAVMISK peptide sequence was proposed to act as an inhibitor of hemin binding, and thus, it might be used to control or prevent periodontal disease. In this study, we created a monoclonal antibody (mAb) that targeted the DHYAVMISK peptide, aimed to determine whether it could inhibit the growth of P. gingivalis in vitro, and block its induction of experimental periodontitis and subsequent bone loss. Peptide DGFPG-DHYAVMISK conjugated to KLH (DK-KLH) was synthetic, and injected subcutaneously into BALB/c mice to generate specific mAbs with the hybridoma technique. We isolated mAb 1H11, which showed specific binding to DK. When we incubated these mAbs with P. gingivalis in vitro for 18 h, bacterial growth was significantly lower in cultures treated with mAb 1H11 compared to those treated with control (PBS; P < 0.05). Next, we induced experimental periodontitis in mouse models with a silk ligature and a P. gingivalis infection. When we injected the mAbs into the gingival sulcus, the group treated with mAb 1H11 displayed a reduction in bone loss compared to the other treatment groups. Thus, mAb 1H11 might provide protection against a P. gingivalis infection. Accordingly, this antibody could serve as a candidate therapy for periodontitis or other infections caused by P. gingivalis.
Collapse
Affiliation(s)
- Ting An
- Beijing Institute for Dental Research, Capital Medical University School of Stomatology, China
| | - Yuanyuan Chen
- Beijing Institute for Dental Research, Capital Medical University School of Stomatology, China
| | - Mingxia Li
- Beijing Institute for Dental Research, Capital Medical University School of Stomatology, China
| | - Ying Liu
- Beijing Institute for Dental Research, Capital Medical University School of Stomatology, China
| | - Zilu Zhang
- Beijing Institute for Dental Research, Capital Medical University School of Stomatology, China
| | - Qiubo Yang
- Beijing Institute for Dental Research, Capital Medical University School of Stomatology, China.
| |
Collapse
|
20
|
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
|
21
|
Antibiotic Resistance of Human Periodontal Pathogen Parvimonas micra Over 10 Years. Antibiotics (Basel) 2020; 9:antibiotics9100709. [PMID: 33080856 PMCID: PMC7602954 DOI: 10.3390/antibiotics9100709] [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: 09/22/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/12/2022] Open
Abstract
Changes were evaluated over 10 years in the in vitro resistance of human periodontopathic strains of Parvimonas micra to four antibiotics. Subgingival biofilms culture positive for P. micra from 300 United States adults with severe periodontitis in 2006, and from a similar group of 300 patients in 2016, were plated onto anaerobically incubated enriched Brucella blood agar alone, or supplemented with either doxycycline (4 mg/L), clindamycin (4 mg/L), amoxicillin (8 mg/L), or metronidazole (16 mg/L). P. micra growth on antibiotic-supplemented media indicated in vitro resistance to the evaluated antibiotic concentration. P. micra resistance was significantly more frequent among patients in 2016, as compared to 2006, for doxycycline (11.3% vs. 0.3% patients; 37.7-fold increase), and clindamycin (47.3% vs. 2.0% patients; 23.7-fold increase) (both p < 0.001), whereas resistance to amoxicillin (2.3% vs. 1.0% patients) and metronidazole (0% vs. 0.3% patients) remained low and statistically unchanged between the two patient groups (p-values > 0.05). No P. micra isolates in 2006 or 2016 were jointly resistant in vitro to both amoxicillin and metronidazole. The alarming increases in subgingival P. micra resistance to doxycycline and clindamycin raise serious questions about the empiric use of these antibiotics, either locally or systemically, in the treatment of United States periodontitis patients harboring subgingival P. micra.
Collapse
|
22
|
Bai Y, Bai YL, Lai J, Huang J. [Efficacy of clarithromycin in the adjuvant treatment of chronic periodontitis: a Meta-analysis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:290-296. [PMID: 32573137 DOI: 10.7518/hxkq.2020.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the clinical efficacy of clarithromycin (CLM) in the adjuvant treatment of chronic periodontitis systematically, obtain reasonable conclusions through evidence-based medicine, and provide guidance for clinical rational drug use. METHODS Literature about CLM in the adjuvant treatment of chronic periodontitis was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect, and Embase databases from inception to February 2019 using a computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after two independent reviewers screened the literature, evaluated the quality of the study, extracted the data, and evaluated the risk of bias in the included studies. RESULTS Six randomized controlled trials were included in 316 subjects. The meta-analysis showed that compared with the scaling and root planning (SRP) group, the probing depth (PD) was reduced in patients with CLM and SRP [MD=-1.00, 95%CI (-1.55, -0.45), P=0.000 04]. Clinical attachment loss was obtained [MD=-0.03, 95%CI (0.43, 0.65), P<0.000 01], and the difference between the groups was statistically significant. The modified sulcus bleeding index (mSBI) was reduced [MD=-0.01, 95%CI (-0.14, 0.19), P=0.66]. No significant difference was observed between the groups, but the decrease in mSBI was more significant in CLM combined with SRP group. CONCLUSIONS CLM combined with subgingival SRP can achieve remarkable results in treating chronic periodontitist.
Collapse
Affiliation(s)
- Yin Bai
- Dept. of Periodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 400015, China
| | - Yuan-Liang Bai
- Dept. of Periodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 400015, China
| | - Jing Lai
- Dept. of Periodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 400015, China
| | - Jiao Huang
- Dept. of Periodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 400015, China
| |
Collapse
|
23
|
Rams TE, Sautter JD, van Winkelhoff AJ. Comparative In Vitro Resistance of Human Periodontal Bacterial Pathogens to Tinidazole and Four Other Antibiotics. Antibiotics (Basel) 2020; 9:antibiotics9020068. [PMID: 32046045 PMCID: PMC7168304 DOI: 10.3390/antibiotics9020068] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 12/13/2022] Open
Abstract
The in vitro resistance of selected red/orange complex periodontal pathogens to tinidazole was compared with four other antibiotics. Subgingival biofilm samples from 88 adults with severe periodontitis were anaerobically incubated on enriched Brucella blood agar with and without supplementation with tinidazole (16 mg/L), metronidazole (16 mg/L), amoxicillin (8 mg/L), doxycycline (4 mg/L), or clindamycin (4 mg/L). Growth of Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia/nigrescens, Parvimonas micra, Fusobacterium nucleatum, Streptococcus constellatus, or Campylobacter rectus on antibiotic-supplemented plates indicated their in vitro antibiotic resistance. Tinidazole inhibited all test species, except P. intermedia/nigrescens, P. micra, and S. constellatus in 3.8%, 10.2%, and 88.9% of species-positive patients, respectively. Significantly fewer patients yielded tinidazole-resistant test species, and had significantly lower subgingival proportions of tinidazole-resistant organisms, than patients with amoxicillin, doxycycline, or clindamycin-resistant species, but not those with metronidazole-resistant strains. Joint in vitro species resistance to tinidazole and amoxicillin, or metronidazole and amoxicillin, was rare. Tinidazole performed in vitro similar to metronidazole, and markedly better than amoxicillin, doxycycline, or clindamycin, against fresh clinical isolates of red/orange complex periodontal pathogens. As a result of its similar antimicrobial spectrum, and more convenient once-a-day oral dosing, tinidazole should be considered in place of metronidazole for systemic periodontitis drug therapy.
Collapse
Affiliation(s)
- Thomas E. Rams
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA
- Department of Microbiology and Immunology, Temple University School of Medicine, Philadelphia, PA 19140, USA
- Correspondence:
| | - Jacqueline D. Sautter
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA
| | - Arie J. van Winkelhoff
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
- Department of Periodontology, University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, 9713 GZ Groningen, The Netherlands
| |
Collapse
|
24
|
Gibson I, Momeni A, Filiaggi M. Minocycline-loaded calcium polyphosphate glass microspheres as a potential drug-delivery agent for the treatment of periodontitis. J Appl Biomater Funct Mater 2020; 17:2280800019863637. [PMID: 31452442 DOI: 10.1177/2280800019863637] [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] [Indexed: 01/25/2023] Open
Abstract
Background: Periodontitis is an inflammatory disease with a bacterial etiology that affects the supporting structures of the teeth and is a major cause of tooth loss. The objective of this study was to investigate the drug loading and in vitro release of minocycline from novel calcium polyphosphate microspheres intended for use in treating periodontitis. Methods: Calcium polyphosphate coacervate, produced by a precipitation reaction of calcium chloride and sodium polyphosphate solutions, was loaded with minocycline and subsequently used to produce microspheres by an emulsion/solvent extraction technique. Microspheres classified by size were subjected to a 7-day elution in a Tris-buffer solution under dynamic conditions. The physicochemical characteristics of the drug-loaded microspheres were investigated using scanning electron microscopy, particle size analysis, Phosphorus-31 Nuclear Magnetic Resonance spectroscopy, and Inductively Coupled Plasma Optical Emission Spectroscopy. Drug loading and release were determined using ultraviolet -visible (UV/VIS) spectrophotometry. Results: Minocycline-loaded calcium polyphosphate microspheres of varying size were successfully produced, with small and large microspheres having volume mean diameters of 22 ± 1 µm and 193 ± 5 µm, respectively. Polyphosphate chain length and calcium to phosphorus mole ratio remained stable throughout microsphere production. Drug loading was 1.64 ± 0.16, 1.35 ± 0.55, and 0.84 ± 0.14 weight% for the coacervate and large and small microspheres, respectively, corresponding to mean encapsulation efficiencies of 81.7 ± 12.2 % and 50.9 ± 3.9 % for the large and small microspheres. Sustained drug release was observed in vitro over a clinically relevant 7-day period, with small and large microspheres exhibiting similar elution profiles. Antibiotic release generally followed microsphere degradation as measured by Ca and P ion release. Conclusions: This study demonstrated successful drug loading of calcium polyphosphate microspheres with minocycline. Furthermore, in vitro sustained release of minocycline over a 7-day period was observed, suggesting potential utility of this approach for treating periodontitis.
Collapse
Affiliation(s)
- Iain Gibson
- 1 Faculty of Dentistry, Dalhousie University, Halifax, Canada
| | - Arash Momeni
- 1 Faculty of Dentistry, Dalhousie University, Halifax, Canada
| | - Mark Filiaggi
- 1 Faculty of Dentistry, Dalhousie University, Halifax, Canada.,2 School of Biomedical Engineering, Dalhousie University, Halifax, Canada
| |
Collapse
|
25
|
Kittaka M, Yoshimoto T, Schlosser C, Rottapel R, Kajiya M, Kurihara H, Reichenberger EJ, Ueki Y. Alveolar Bone Protection by Targeting the SH3BP2-SYK Axis in Osteoclasts. J Bone Miner Res 2020; 35:382-395. [PMID: 31613396 PMCID: PMC7012678 DOI: 10.1002/jbmr.3882] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/26/2019] [Accepted: 09/15/2019] [Indexed: 12/18/2022]
Abstract
Periodontitis is a bacterially induced chronic inflammatory condition of the oral cavity where tooth-supporting tissues including alveolar bone are destructed. Previously, we have shown that the adaptor protein SH3-domain binding protein 2 (SH3BP2) plays a critical role in inflammatory response and osteoclastogenesis of myeloid lineage cells through spleen tyrosine kinase (SYK). In this study, we show that SH3BP2 is a novel regulator for alveolar bone resorption in periodontitis. Micro-CT analysis of SH3BP2-deficient (Sh3bp2 -/- ) mice challenged with ligature-induced periodontitis revealed that Sh3bp2 -/- mice develop decreased alveolar bone loss (male 14.9% ± 10.2%; female 19.0% ± 6.0%) compared with wild-type control mice (male 25.3% ± 5.8%; female 30.8% ± 5.8%). Lack of SH3BP2 did not change the inflammatory cytokine expression and osteoclast induction. Conditional knockout of SH3BP2 and SYK in myeloid lineage cells with LysM-Cre mice recapitulated the reduced bone loss without affecting both inflammatory cytokine expression and osteoclast induction, suggesting that the SH3BP2-SYK axis plays a key role in regulating alveolar bone loss by mechanisms that regulate the bone-resorbing function of osteoclasts rather than differentiation. Administration of a new SYK inhibitor GS-9973 before or after periodontitis induction reduced bone resorption without affecting inflammatory reaction in gingival tissues. In vitro, GS-9973 treatment of bone marrow-derived M-CSF-dependent macrophages suppressed tartrate-resistant acid phosphatase (TRAP)-positive osteoclast formation with decreased mineral resorption capacity even when GS-9973 was added after RANKL stimulation. Thus, the data suggest that SH3BP2-SYK is a novel signaling axis for regulating alveolar bone loss in periodontitis and that SYK can be a potential therapeutic target to suppress alveolar bone resorption in periodontal diseases. © 2019 American Society for Bone and Mineral Research. © 2019 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Mizuho Kittaka
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN, USA.,Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tetsuya Yoshimoto
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN, USA.,Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Collin Schlosser
- Department of Orthodontics and Dentofacial Orthopedics, University of Missouri-Kansas City, School of Dentistry, Kansas City, MO, USA
| | - Robert Rottapel
- Department of Medicine, Immunology and Medical Biophysics, University of Toronto, Toronto, Canada
| | - Mikihito Kajiya
- Department of Periodontal Medicine, Applied Life Sciences, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hidemi Kurihara
- Department of Periodontal Medicine, Applied Life Sciences, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ernst J Reichenberger
- Department of Reconstructive Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Yasuyoshi Ueki
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN, USA.,Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
26
|
Lim SY, Dafydd M, Ong J, Ord-McDermott LA, Board-Davies E, Sands K, Williams D, Sloan AJ, Heard CM. Mucoadhesive thin films for the simultaneous delivery of microbicide and anti-inflammatory drugs in the treatment of periodontal diseases. Int J Pharm 2020; 573:118860. [DOI: 10.1016/j.ijpharm.2019.118860] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 12/19/2022]
|
27
|
Longitudinal antibiotic prescribing trends among US dental specialists within a pharmacy benefits manager, 2013 through 2015. J Am Dent Assoc 2019; 150:846-853.e5. [PMID: 31561761 DOI: 10.1016/j.adaj.2019.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Reducing inappropriate antibiotic prescriptions (Rxs) is a major quality improvement initiative in the United States. Tracking antibiotic prescribing trends is 1 method of assessing improvement in antibiotic prescribing. The purpose of this study was to assess longitudinal antibiotic prescribing practices among dental specialists. METHODS This was a retrospective ecological longitudinal trend study. The authors calculated monthly systemic antibiotic Rx counts, and rates per 100,000 beneficiaries, from a pharmacy benefits manager in the United States from 2013 through 2015. The authors calculated average annual antibiotic Rx rates (AARs) for the 3-year study period. The authors used a quasi-Poisson regression model to analyze antibiotic Rx trends. The authors quantified seasonal trends, when present, via peak-to-trough ratios (PTTRs). RESULTS Dental specialists prescribed 2.4 million antibiotics to the cohort of 38 million insurance beneficiaries during the 3-year study period (AAR = 2,086 Rxs per 100,000 beneficiaries). Oral and maxillofacial surgeons prescribed the most antibiotics (1,172,104 Rxs; AAR = 1,018 Rxs per 100,000 beneficiaries), followed by periodontists (527,038 Rxs; AAR = 457 Rxs per 100,000 beneficiaries), and endodontists (447,362 Rxs; AAR = 388 Rxs per 100,000 beneficiaries). Longitudinal antibiotic prescribing trends were stable among all dental specialties in the regression models (P > .05). The authors observed substantial seasonal variation in antibiotic Rxs in 2 specialties: pediatric dentistry (PTTR, 1.18; 95% confidence interval, 1.13 to 1.25) and orthodontics and dentofacial orthopedics (PTTR, 1.41; 95% confidence interval, 1.21 to 1.71), with the highest rates of antibiotic Rxs in the spring and winter. CONCLUSIONS Antibiotic prescribing practices for dental specialists remained stable. The authors observed seasonal trends in 2 specialties. PRACTICAL IMPLICATIONS Public health efforts are needed improve antibiotic prescribing among dental specialties.
Collapse
|
28
|
Zupančič Š, Casula L, Rijavec T, Lapanje A, Luštrik M, Fadda AM, Kocbek P, Kristl J. Sustained release of antimicrobials from double-layer nanofiber mats for local treatment of periodontal disease, evaluated using a new micro flow-through apparatus. J Control Release 2019; 316:223-235. [DOI: 10.1016/j.jconrel.2019.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 12/27/2022]
|
29
|
Stein K, Farmer J, Singhal S, Marra F, Sutherland S, Quiñonez C. The use and misuse of antibiotics in dentistry: A scoping review. J Am Dent Assoc 2019; 149:869-884.e5. [PMID: 30261952 DOI: 10.1016/j.adaj.2018.05.034] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/10/2018] [Accepted: 05/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND To describe antibiotic prescribing behaviors in dentistry, including clinical and nonclinical indications for their use, the type and regimen of antibiotics prescribed, and factors influencing their prescription, the authors conducted a scoping review. TYPES OF STUDIES REVIEWED The authors conducted a scoping review of published literature by searching multiple databases. Key search terms included dentist, antibiotic, antimicrobial, antibacterial, prophylaxis, prescription, pattern, habit, knowledge, and practice. Two authors independently reviewed titles and abstracts by using detailed eligibility criteria. The authors placed no restrictions on study design or publication year. The authors qualitatively assessed studies by using a modified version of the Center for Evidence-Based Management's critical appraisal of a survey checklist. RESULTS The authors identified 1,912 studies but considered only 118 studies eligible for review. Most included studies were either cross-sectional surveys (81 studies) or prescription audits (25 studies) from various geographic locations. Publication dates ranged from 1982 through 2017. The authors examined prophylactic and therapeutic antibiotic use in 48 and 29 studies, respectively. Another 29 studies examined the use of both prophylactic and therapeutic antibiotics in dentistry. Overall, dentists prescribed a wide variety of antibiotic regimens for various clinical and nonclinical indications. Dentists have acquired their prescribing knowledge from a variety of sources and have changed their antibiotic prescribing practices throughout their careers for various reasons. CONCLUSIONS AND PRACTICAL IMPLICATIONS Considering the seriousness of antibiotic resistance, the authors highlight trends in antibiotic prescribing practices, characterize factors contributing to the use and misuse of antibiotics in dentistry, provide insight into the importance of antibiotic stewardship in the oral health setting, and encourage dentists to reflect on their antibiotic prescription practices.
Collapse
|
30
|
Dutzan N, Kajikawa T, Abusleme L, Greenwell-Wild T, Zuazo CE, Ikeuchi T, Brenchley L, Abe T, Hurabielle C, Martin D, Morell RJ, Freeman AF, Lazarevic V, Trinchieri G, Diaz PI, Holland SM, Belkaid Y, Hajishengallis G, Moutsopoulos NM. A dysbiotic microbiome triggers T H17 cells to mediate oral mucosal immunopathology in mice and humans. Sci Transl Med 2019; 10:10/463/eaat0797. [PMID: 30333238 DOI: 10.1126/scitranslmed.aat0797] [Citation(s) in RCA: 235] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/03/2018] [Accepted: 09/13/2018] [Indexed: 12/13/2022]
Abstract
Periodontitis is one of the most common human inflammatory diseases, yet the mechanisms that drive immunopathology and could be therapeutically targeted are not well defined. Here, we demonstrate an expansion of resident memory T helper 17 (TH17) cells in human periodontitis. Phenocopying humans, TH17 cells expanded in murine experimental periodontitis through local proliferation. Unlike homeostatic oral TH17 cells, which accumulate in a commensal-independent and interleukin-6 (IL-6)-dependent manner, periodontitis-associated expansion of TH17 cells was dependent on the local dysbiotic microbiome and required both IL-6 and IL-23. TH17 cells and associated neutrophil accumulation were necessary for inflammatory tissue destruction in experimental periodontitis. Genetic or pharmacological inhibition of TH17 cell differentiation conferred protection from immunopathology. Studies in a unique patient population with a genetic defect in TH17 cell differentiation established human relevance for our murine experimental studies. In the oral cavity, human TH17 cell defects were associated with diminished periodontal inflammation and bone loss, despite increased prevalence of recurrent oral fungal infections. Our study highlights distinct functions of TH17 cells in oral immunity and inflammation and paves the way to a new targeted therapeutic approach for the treatment of periodontitis.
Collapse
Affiliation(s)
- Nicolas Dutzan
- Oral Immunity and Inflammation Unit, NIDCR, NIH, Bethesda, MD 20892, USA.,Faculty of Dentistry, University of Chile, 8380492 Santiago, Chile
| | - Tetsuhiro Kajikawa
- Department of Microbiology, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Loreto Abusleme
- Oral Immunity and Inflammation Unit, NIDCR, NIH, Bethesda, MD 20892, USA.,Faculty of Dentistry, University of Chile, 8380492 Santiago, Chile
| | | | - Carlos E Zuazo
- Oral Immunity and Inflammation Unit, NIDCR, NIH, Bethesda, MD 20892, USA
| | - Tomoko Ikeuchi
- Oral Immunity and Inflammation Unit, NIDCR, NIH, Bethesda, MD 20892, USA
| | - Laurie Brenchley
- Oral Immunity and Inflammation Unit, NIDCR, NIH, Bethesda, MD 20892, USA
| | - Toshiharu Abe
- Department of Microbiology, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Charlotte Hurabielle
- Mucosal Immunology Section, Laboratory of Parasitic Diseases, NIAID, NIH, MD 20892, USA.,Inserm U976, Hôpital Saint Louis, Université Paris Diderot, Paris 75010, France
| | - Daniel Martin
- Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, MD 20892, USA
| | - Robert J Morell
- Genomics and Computational Biology Core, NIDCD, NIH, Bethesda, MD 20892, USA
| | - Alexandra F Freeman
- Laboratory of Clinical Immunology and Microbiology (LCIM), NIAID, NIH, Bethesda, MD 20892, USA
| | - Vanja Lazarevic
- Experimental Immunology Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA
| | | | - Patricia I Diaz
- School of Dental Medicine, UConn Health, Farmington, CT 06030, USA
| | - Steven M Holland
- Laboratory of Clinical Immunology and Microbiology (LCIM), NIAID, NIH, Bethesda, MD 20892, USA
| | - Yasmine Belkaid
- Mucosal Immunology Section, Laboratory of Parasitic Diseases, NIAID, NIH, MD 20892, USA
| | - George Hajishengallis
- Department of Microbiology, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | |
Collapse
|
31
|
Folwaczny M, Bauer F, Grünberg C. Significance of oral health in adult patients with congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S377-S387. [PMID: 31737544 PMCID: PMC6837931 DOI: 10.21037/cdt.2018.09.17] [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: 08/04/2018] [Accepted: 09/20/2018] [Indexed: 12/30/2022]
Abstract
Due to improved diagnosis and treatment life expectancy of patients with congenital heart disease is steadily increasing resulting in a growing portion of adult patients. When entering, adulthood patients commonly show a shift in their specific needs for medical care. Since the treatment is mostly not curative many patients have life-long cardiovascular anomalies, among others, entailing high risk for the development of infective endocarditis. Several oral diseases, i.e., caries, apical periodontitis and periodontitis show a very high overall prevalence. These entities are primarily initiated by bacterial infections. Hence, they cause an inherent risk for bacteremia and subsequently for infective endocarditis in patients with congenital heart disease during professional dental care and various daily activities. Conversely congenital heart disease seems to be inevitably associated with considerable impairment of oral health resulting in a tight interrelation between both entities. Different preventive strategies are available to address the elevated risk for infective endocarditis due to oral diseases in patients with congenital heart disease during professional dental care and routine daily activities. This review delineates the current evidence regarding the issue of oral health in adult patients with congenital heart disease.
Collapse
Affiliation(s)
- Matthias Folwaczny
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Bauer
- Department of Oral and Maxillofacial Surgery, University of Technology Munich, Munich, Germany
| | - Christina Grünberg
- Department of Oral and Maxillofacial Surgery, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| |
Collapse
|
32
|
Arweiler NB, Marx VK, Laugisch O, Sculean A, Auschill TM. Clinical evaluation of a newly developed chairside test to determine periodontal pathogens. J Periodontol 2019; 91:387-395. [DOI: 10.1002/jper.19-0180] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Nicole B. Arweiler
- Department of Periodontology & Peri‐implant Diseases Philipps‐University Marburg Germany
| | - Vanessa K. Marx
- Department of Periodontology & Peri‐implant Diseases Philipps‐University Marburg Germany
| | - Oliver Laugisch
- Department of Periodontology & Peri‐implant Diseases Philipps‐University Marburg Germany
| | - Anton Sculean
- Department of Periodontology University of Bern Bern Switzerland
| | - Thorsten M. Auschill
- Department of Periodontology & Peri‐implant Diseases Philipps‐University Marburg Germany
| |
Collapse
|
33
|
Hai JH, Lee C, Kapila YL, Chaffee BW, Armitage GC. Antibiotic prescribing practices in periodontal surgeries with and without bone grafting. J Periodontol 2019; 91:508-515. [PMID: 31398776 DOI: 10.1002/jper.19-0195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/05/2019] [Accepted: 05/19/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND The prevention of postoperative infection is often the basis for antibiotic prescription; however, the risks of unwarranted antibiotics and lack of guidelines for procedures involving bone grafts creates additional difficulty in decision making for practitioners. This study aims to evaluate practices in antibiotics prescribed for periodontal surgeries with and without bone grafting and acceptability of guidelines. METHODS An anonymous survey was distributed to periodontists via the California Society of Periodontists e-mail listserv. The survey questioned prescribing practices for periodontal procedures, prescribing rationale, demographic and dental practice information, and acceptability of guidelines. Results were analyzed using McNemar tests and logistic regression. RESULTS Practitioners were significantly less likely to prescribe antibiotics for traditional periodontal surgeries without bone grafting compared with socket preservation, guided tissue regeneration, guided bone regeneration, and sinus augmentation (P < 0.0001). Practitioners were significantly more likely to prescribe antibiotics with more complex bone grafting such as guided bone regeneration and sinus augmentation compared with socket preservation (P < 0.0001). The most common rationale for prescribing antibiotics with bone grafting was to decrease the chances of developing an infection. Seventy-five percent of practitioners reported they would follow guidelines for antibiotic prescription if they were developed by the American Academy of Periodontology. CONCLUSIONS Practitioners are more likely to prescribe antibiotics with bone grafting and as complexity of the bone grafting procedure increases. Based on these results, the low incidence of infection in periodontal surgery cited in the literature, and willingness of practitioners to adopt guidelines, the establishment of evidence-based guidelines would be of benefit to the periodontal practicing community.
Collapse
Affiliation(s)
- Justine Hoda Hai
- Department to Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, CA
| | - Cliff Lee
- Department to Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, CA
| | - Yvonne L Kapila
- Department to Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, CA
| | - Benjamin W Chaffee
- Department of Preventive and Restorative Sciences, University of California San Francisco, School of Dentistry, San Francisco, CA
| | - Gary C Armitage
- Department to Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, CA
| |
Collapse
|
34
|
Saquib SA, AlQahtani NA, Ahmad I, Kader MA, Al Shahrani SS, Asiri EA. Evaluation and Comparison of Antibacterial Efficacy of Herbal Extracts in Combination with Antibiotics on Periodontal pathobionts: An in vitro Microbiological Study. Antibiotics (Basel) 2019; 8:E89. [PMID: 31266146 PMCID: PMC6783985 DOI: 10.3390/antibiotics8030089] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/28/2019] [Accepted: 04/29/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In the past few decades focus of research has been toward herbal medicines because of growing bacterial resistance and side effects of antimicrobial agents. The extract derived from the plants may increase the efficacy of antibiotics when used in combination against pathogenic bacteria. In the current study, the synergistic antibacterial efficacy of plant extracts in combination with antibiotics has been assessed on selected periodontal pathogens. METHODS Ethanolic extracts were prepared from Salvadora persica (Miswak) and Cinnamomum zeylanicum (Ceylon cinnamon), by the soxhalate method. Plaque samples were collected from clinical periodontitis patients to isolate and grow the periodontal pathobionts under favorable conditions. Susceptibility of bacteria to the extracts was assessed by gauging the diameter of the inhibition zones. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of plant extracts were determined against each bacterium. Synergistic activity of plants extract in combination with antibiotics against the bacteria was also assessed by measuring the diameter of the inhibition zones. RESULTS Ethanolic extract of both the plants showed an inhibitory effect on the proliferation and growth of all four strains of periodontal pathobionts. Maximum antibacterial activity was exhibited by C. zeylanicum against Tannerella forsythia (MIC = 1.56 ± 0.24 mg/mL, MBC = 6.25 ± 0.68 mg/mL), whereas among all the studied groups the minimum activity was reported by C. zeylanicum against Aggregatibacter actinomycetemcomitans the (MIC = 12.5 ± 3.25 mg/mL, MBC = 75 ± 8.23 mg/mL). Combination of herbal extracts with different antibiotics revealed a synergistic antibacterial effect. The best synergism was exhibited by S. persica with metronidazole against A. actinomycetemcomitans (27 ± 1.78). CONCLUSIONS Current in vitro study showed variable antibacterial activity by experimented herbal extracts against periodontal pathobionts. The synergistic test showed significant antibacterial activity when plant extracts were combined with antibiotics.
Collapse
Affiliation(s)
- Shahabe Abullais Saquib
- Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia.
| | - Nabeeh Abdullah AlQahtani
- Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Irfan Ahmad
- Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61321, Saudi Arabia
| | - Mohammed Abdul Kader
- Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | | | - Elyas Ali Asiri
- Interns, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| |
Collapse
|
35
|
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.
Collapse
|
36
|
Kaufmann M, Lenherr P, Walter C, Thurnheer T, Attin T, Wiedemeier DB, Schmidlin PR. Comparing the Antimicrobial In Vitro Efficacy of Amoxicillin/Metronidazole against Azithromycin-A Systematic Review. Dent J (Basel) 2018; 6:E59. [PMID: 30347835 PMCID: PMC6313342 DOI: 10.3390/dj6040059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/19/2018] [Accepted: 09/25/2018] [Indexed: 11/16/2022] Open
Abstract
On account of its proven clinical efficacy, the combination of systemically administered amoxicillin and metronidazole is frequently adjuncted to non-operative periodontal therapy and well documented. Potential drawbacks of this regimen, e.g., side effects and problems with the compliance, led to an ongoing search for alternatives. Azithromycin, an antibiotic extensively used in general medicine, has recently found its niche in periodontal therapy as well. This systematic review aimed to analyze the in vitro antimicrobial efficacy of amoxicillin plus metronidazole versus azithromycin. For this purpose, a systematic literature search was performed, and studies published up to 29 March 2018 referenced in Medline, Embase, Cochrane, and Biosis were independently screened by two authors. An additional hand search was performed and studies focusing on the evaluation of in vitro antimicrobial efficacy of amoxicillin + metronidazole or azithromycin on bacteria from the subgingival biofilm were included. English and German language research reports were considered. From 71 identified articles, only three articles were eligible for inclusion. These studies showed heterogeneity in terms of analytical methods and strains explored. However, all studies used multispecies biofilm models for analysis of the antimicrobial activity. Unanimously, studies reported on more pronounced antimicrobial effects when applying the combination of amoxicillin + metronidazole, compared to azithromycin. Based on the few studies available, the combination of amoxicillin + metronidazole seemed to display higher antimicrobial efficacy in vitro than azithromycin.
Collapse
Affiliation(s)
- Manuela Kaufmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland.
| | - Patrik Lenherr
- Private Practice, Zahnmedizin Wiesental, CH-9100 Herisau, Switzerland.
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, CH-4056 Basel, Switzerland.
| | - Thomas Thurnheer
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland.
| | - Thomas Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland.
| | - Daniel B Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland.
| | - Patrick R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland.
| |
Collapse
|
37
|
Kim HY, Park SY, Choung SY. Enhancing effects of myricetin on the osteogenic differentiation of human periodontal ligament stem cells via BMP-2/Smad and ERK/JNK/p38 mitogen-activated protein kinase signaling pathway. Eur J Pharmacol 2018; 834:84-91. [DOI: 10.1016/j.ejphar.2018.07.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 01/12/2023]
|
38
|
Jiao J, Zhang L, Meng HX, Shi D, Lu RF, Xu L, Feng XH, Cao ZQ. Clinical performance of non-surgical periodontal therapy in a large Chinese population with generalized aggressive periodontitis. J Clin Periodontol 2018; 45:1184-1197. [PMID: 29974483 DOI: 10.1111/jcpe.12981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/18/2018] [Accepted: 07/01/2018] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to evaluate clinical performance of non-surgical periodontal treatment (NSPT) and its influential factors in a large Chinese population with generalized aggressive periodontitis (GAgP). MATERIAL AND METHODS Longitudinal periodontal examination data of 1,004 GAgP patients (numbers of patients with observation periods 6 weeks~, 3 months~, 6 months~, 1 year~, 3 years~ and >5 years were 203, 310, 193, 205, 70 and 23, respectively) were extracted from a hospital-based electronic periodontal charting record system and analysed by multilevel analysis. RESULTS Mean probing depth (PD) and attachment loss (AL) reductions at patient level were 1.17 mm and 1.07 mm, respectively. Multilevel analysis demonstrated PD reductions after maintenance were mainly influenced by frequency of supportive periodontal treatment (FSPT), gender, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD and bleeding index reductions were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline AL, baseline mobility, tooth type and baseline PD. CONCLUSION The clinical performance of NSPT on patients with GAgP was proved in the large Chinese population. Outcomes of NSPT were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD.
Collapse
Affiliation(s)
- Jian Jiao
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Zhang
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huan-Xin Meng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Dong Shi
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Rui-Fang Lu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Xu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiang-Hui Feng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zhan-Qiang Cao
- Information Center, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| |
Collapse
|
39
|
Abazi B, Mihani J. Prescription of Antibiotics for Periodontal Disease among Dentists in the Region of Tirana. Open Access Maced J Med Sci 2018; 6:1486-1491. [PMID: 30159082 PMCID: PMC6108801 DOI: 10.3889/oamjms.2018.300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/07/2018] [Accepted: 07/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND: Periodontal disease has been and will be a challenge for dentists in the entirety of oral pathologies. To date, there is no data regarding the prescription of antibiotics for periodontitis in the district of Tirana. AIM: Evaluate aspects related to the pattern of prescription of antibiotics among dentists in Tirana region for periodontitis. METHODS: Prescriptions from dental practitioners were collected from 25 pharmacies, randomly selected. The only prescription containing a diagnosis of periodontitis, with at least one antibiotic given, was included in the study. Data analysis was done with SPSS 20. RESULTS: Out of 1159 initial prescriptions, only 314 met the selection criteria. The average age of patients was 39.91 ± 15.21 years. Mean duration of therapies was 5.57 ± 1.5 days. The most common form of prescription was one broad-spectrum antibiotic (74.5%), combined antibiotics therapy (22.3%) and narrow-spectrum antibiotic (3.2%). Combined antibiotics involved the use of Metronidazole with Amoxicillin (12.1%) and Metronidazole with Spiramycin (10.2%). Significant differences in the patterns of prescription were identified in relation with patient age and therapy duration (P < 0.05). No statistical difference was found in the patient’s gender and the typology of the therapy (P > 0.05). CONCLUSIONS: Our study shows prescription characteristics of antibiotics for periodontal disease by dentists in Tirana for the first time. Amoxycillin is the most prescribed antibiotic, followed by amoxicillin with clavulanic acid. We found variation in dosage, frequency and duration for all antibiotics used, and perceptible discrepancies between observed and recommended practice. Guidelines on rational antibiotic use are needed for dental practitioners in Tirana and the Republic of Albania for better management of periodontitis and resistance prevention.
Collapse
Affiliation(s)
- Besian Abazi
- Albanian University, Faculty of Medical Sciences, Department of Dentistry, Tirana, Albania
| | - Joana Mihani
- University of Medicine Tirana, Department of Pharmacy, Tirana, Albania
| |
Collapse
|
40
|
Zupančič Š, Preem L, Kristl J, Putrinš M, Tenson T, Kocbek P, Kogermann K. Impact of PCL nanofiber mat structural properties on hydrophilic drug release and antibacterial activity on periodontal pathogens. Eur J Pharm Sci 2018; 122:347-358. [PMID: 30017845 DOI: 10.1016/j.ejps.2018.07.024] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 12/19/2022]
Abstract
Electrospinning enables to design and manufacture novel drug delivery systems capable of advancing the local antibacterial therapy. In this study, two hydrophilic drugs - metronidazole and ciprofloxacin hydrochloride - were loaded both individually and in combination into hydrophobic poly(ε-caprolactone) (PCL) matrix using electrospinning. We aimed to develop prolonged release drug delivery systems suitable for the treatment of periodontal diseases and understand how different rarely studied structural features, such as nanofiber mat thickness, surface area, wettability, together with intrinsic properties, like solid state and localization of incorporated drugs in nanofibers, affect the drug release. Furthermore, the safety of nanofiber mats was assessed in vitro on fibroblasts, and their antibacterial activity was tested on selected strains of periodontopathogenic bacteria. The results showed that the structural properties of nanofiber mat are crucial in particular drug-polymer combinations, affecting the drug release and consequently the antibacterial activity. The hydrophobicity of a PCL nanofiber mat and its thickness are the key characteristics in prolonged hydrophilic drug release, but only when wetting is the rate-limiting step for the drug release. Combination of drugs showed beneficial effects by inhibiting the growth of all tested pathogenic bacterial strains important in periodontal diseases.
Collapse
Affiliation(s)
- Špela Zupančič
- Faculty of Pharmacy, University of Ljubljana, Aškerčeva cesta. 7, 1000 Ljubljana, Slovenia.
| | - Liis Preem
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, Nooruse 1, 50411 Tartu, Estonia.
| | - Julijana Kristl
- Faculty of Pharmacy, University of Ljubljana, Aškerčeva cesta. 7, 1000 Ljubljana, Slovenia.
| | - Marta Putrinš
- Institute of Technology, Faculty of Science and Technology, University of Tartu, Nooruse 1, 50411 Tartu, Estonia.
| | - Tanel Tenson
- Institute of Technology, Faculty of Science and Technology, University of Tartu, Nooruse 1, 50411 Tartu, Estonia.
| | - Petra Kocbek
- Faculty of Pharmacy, University of Ljubljana, Aškerčeva cesta. 7, 1000 Ljubljana, Slovenia.
| | - Karin Kogermann
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, Nooruse 1, 50411 Tartu, Estonia.
| |
Collapse
|
41
|
Protective role of flavonoid baicalin from Scutellaria baicalensis in periodontal disease pathogenesis: A literature review. Complement Ther Med 2018; 38:11-18. [DOI: 10.1016/j.ctim.2018.03.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 02/26/2018] [Accepted: 03/23/2018] [Indexed: 12/25/2022] Open
|
42
|
Cieplik F, Deng D, Crielaard W, Buchalla W, Hellwig E, Al-Ahmad A, Maisch T. Antimicrobial photodynamic therapy - what we know and what we don't. Crit Rev Microbiol 2018; 44:571-589. [PMID: 29749263 DOI: 10.1080/1040841x.2018.1467876] [Citation(s) in RCA: 454] [Impact Index Per Article: 75.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Considering increasing number of pathogens resistant towards commonly used antibiotics as well as antiseptics, there is a pressing need for antimicrobial approaches that are capable of inactivating pathogens efficiently without the risk of inducing resistances. In this regard, an alternative approach is the antimicrobial photodynamic therapy (aPDT). The antimicrobial effect of aPDT is based on the principle that visible light activates a per se non-toxic molecule, the so-called photosensitizer (PS), resulting in generation of reactive oxygen species that kill bacteria unselectively via an oxidative burst. During the last 10-20 years, there has been extensive in vitro research on novel PS as well as light sources, which is now to be translated into clinics. In this review, we aim to provide an overview about the history of aPDT, its fundamental photochemical and photophysical mechanisms as well as photosensitizers and light sources that are currently applied for aPDT in vitro. Furthermore, the potential of resistances towards aPDT is extensively discussed and implications for proper comparison of in vitro studies regarding aPDT as well as for potential application fields in clinical practice are given. Overall, this review shall provide an outlook on future research directions needed for successful translation of promising in vitro results in aPDT towards clinical practice.
Collapse
Affiliation(s)
- Fabian Cieplik
- a Department of Conservative Dentistry and Periodontology , University Medical Center Regensburg , Regensburg , Germany.,b Department of Preventive Dentistry , Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - Dongmei Deng
- b Department of Preventive Dentistry , Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - Wim Crielaard
- b Department of Preventive Dentistry , Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - Wolfgang Buchalla
- a Department of Conservative Dentistry and Periodontology , University Medical Center Regensburg , Regensburg , Germany
| | - Elmar Hellwig
- c Department of Operative Dentistry and Periodontology, Faculty of Medicine , Center for Dental Medicine, University of Freiburg , Freiburg , Germany
| | - Ali Al-Ahmad
- c Department of Operative Dentistry and Periodontology, Faculty of Medicine , Center for Dental Medicine, University of Freiburg , Freiburg , Germany
| | - Tim Maisch
- d Department of Dermatology , University Medical Center Regensburg , Regensburg , Germany
| |
Collapse
|
43
|
Cieplik F, Steinwachs VS, Muehler D, Hiller KA, Thurnheer T, Belibasakis GN, Buchalla W, Maisch T. Phenalen-1-one-Mediated Antimicrobial Photodynamic Therapy: Antimicrobial Efficacy in a Periodontal Biofilm Model and Flow Cytometric Evaluation of Cytoplasmic Membrane Damage. Front Microbiol 2018; 9:688. [PMID: 29681899 PMCID: PMC5897782 DOI: 10.3389/fmicb.2018.00688] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 03/23/2018] [Indexed: 01/18/2023] Open
Abstract
In light of increasing resistance toward conventional antibiotics and antiseptics, antimicrobial photodynamic therapy (aPDT) may be a valuable alternative, especially for use in dentistry. In this regard, photosensitizers (PS) based on a phenalen-1-one structure seem to be especially favorable due to their high singlet oxygen quantum yield. However, the actual target structures of phenalen-1-one-mediated aPDT are still unclear. The aim of the present study was to investigate the antimicrobial efficacy of aPDT mediated by phenalen-1-one derivatives SAPYR and SAGUA for inactivation of a polymicrobial biofilm consisting of three putative periodontal pathogens in vitro and to get first insights in the mechanism of action of phenalen-1-one-mediated aPDT by assessing damage of cytoplasmic membranes. aPDT with SAPYR exhibited identical antimicrobial efficacy as compared to chlorhexidine (CHX) [4.4-6.1 log10 reduction of colony forming units (CFUs) depending on bacterial species] while aPDT with SAGUA was less effective (2.0-2.8 log10). Flow cytometric analysis combined with propidium iodide (PI) staining revealed no damage of cytoplasmic membranes after aPDT with both phenalen-1-one derivatives, which was confirmed by spectroscopic measurements for release of nucleic acids after treatment. Spectrophotometric PS-uptake measurements showed no uptake of SAPYR by bacterial cells. Despite the inability to pinpoint the actual target of phenalen-1-one-mediated aPDT, this study shows the high antimicrobial potential of phenalen-1-on mediated aPDT (especially when using SAPYR) and represents a first step for getting insights in the mechanism and damage patterns of aPDT with this class of PS.
Collapse
Affiliation(s)
- Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Viktoria-Sophia Steinwachs
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Denise Muehler
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Thomas Thurnheer
- Division of Oral Microbiology and Immunology, Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Tim Maisch
- Department of Dermatology, University Medical Center Regensburg, Regensburg, Germany
| |
Collapse
|
44
|
The 2016 JAID/JSC guidelines for clinical management of infectious disease-Odontogenic infections. J Infect Chemother 2018; 24:320-324. [PMID: 29503229 DOI: 10.1016/j.jiac.2017.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 09/27/2017] [Accepted: 09/27/2017] [Indexed: 10/17/2022]
|
45
|
Dabija‐Wolter G, Al‐Zubaydi SS, Mohammed MMA, Bakken V, Bolstad AI. The effect of metronidazole plus amoxicillin or metronidazole plus penicillin V on periodontal pathogens in an in vitro biofilm model. Clin Exp Dent Res 2018; 4:6-12. [PMID: 29744209 PMCID: PMC5813892 DOI: 10.1002/cre2.96] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/16/2017] [Accepted: 11/20/2017] [Indexed: 01/12/2023] Open
Abstract
A combination of metronidazole (MET) and amoxicillin (AMX) is commonly used as adjunct to mechanical therapy of periodontal disease. The use of broad spectrum antibiotics such as AMX may contribute to development of antibiotic resistance. The aim was to evaluate the in vitro effect of replacing AMX with penicillin V (PV) in combination with MET on a biofilm model. A biofilm model consisting of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Fusobacterium nucleatum was developed. The biofilms were exposed to AMX + MET and PV + MET in two different concentrations. Bacterial viability in biofilms following antibiotic exposure was assessed by viable counts and by confocal microscopy. No live colonies of P. gingivalis nor F. nucleatum were retrieved from biofilms exposed to AMX + MET or PV + MET. The amount of A. actinomycetemcomitans was 4-5 logs reduced following antibiotic treatment; no statistical significance was achieved between AMX + MET or PV + MET treated biofilms. Replacement of AMX with PV at the same concentration, in combination with MET, resulted in similar effect on bacterial viability in this in vitro model. The option of using PV + MET instead of AMX + MET deserves further investigation, as this may contribute to reduce the risk of antibiotic resistance development.
Collapse
Affiliation(s)
- Gabriela Dabija‐Wolter
- Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenNorway
- Department of Clinical Science, Faculty of MedicineUniversity of BergenNorway
| | | | | | - Vidar Bakken
- Department of Clinical Science, Faculty of MedicineUniversity of BergenNorway
| | - Anne Isine Bolstad
- Department of Clinical Dentistry, Faculty of MedicineUniversity of BergenNorway
| |
Collapse
|
46
|
Constantinides C, Chang J, Fletcher P. Management of an Ailing Anterior Implant Using a Minimally Invasive Flapless Surgical Technique: A Case Report. Clin Adv Periodontics 2017; 7:201-206. [DOI: 10.1902/cap.2017.170004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 06/19/2017] [Indexed: 11/13/2022]
Affiliation(s)
| | - Jaime Chang
- Private practice, Singapore, Republic of Singapore
| | - Paul Fletcher
- Division of Periodontics, Columbia University College of Dental Medicine, New York, NY
- Private practice, New York, NY
| |
Collapse
|
47
|
Abstract
We herein report the case of a 41-year-old Japanese man with well-controlled HIV who presented with diagnostically difficult acute necrotizing ulcerative gingivitis (ANUG). After diet-induced weight loss, he developed oral pain and disturbance of mouth opening, and was admitted to our hospital. Based on preconceptions of HIV-associated diseases, fluconazole was initiated for candidiasis. However, no improvement was seen and ANUG was finally diagnosed. This case suggests that physicians should consider ANUG in HIV-infected individuals when several risk factors are present, even if CD4+ T-lymphocyte counts have remained stable owing to long-term anti-retroviral therapy.
Collapse
Affiliation(s)
- Hirofumi Kato
- Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital, Japan
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan
| | - Akifumi Imamura
- Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital, Japan
| |
Collapse
|
48
|
Abstract
Periodontal diseases comprise a wide range of inflammatory conditions that affect the supporting structures of the teeth (the gingiva, bone and periodontal ligament), which could lead to tooth loss and contribute to systemic inflammation. Chronic periodontitis predominantly affects adults, but aggressive periodontitis may occasionally occur in children. Periodontal disease initiation and propagation is through a dysbiosis of the commensal oral microbiota (dental plaque), which then interacts with the immune defences of the host, leading to inflammation and disease. This pathophysiological situation persists through bouts of activity and quiescence, until the affected tooth is extracted or the microbial biofilm is therapeutically removed and the inflammation subsides. The severity of the periodontal disease depends on environmental and host risk factors, both modifiable (for example, smoking) and non-modifiable (for example, genetic susceptibility). Prevention is achieved with daily self-performed oral hygiene and professional removal of the microbial biofilm on a quarterly or bi-annual basis. New treatment modalities that are actively explored include antimicrobial therapy, host modulation therapy, laser therapy and tissue engineering for tissue repair and regeneration.
Collapse
Affiliation(s)
- Denis F Kinane
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, Pennsylvania 19104, USA
| | - Panagiota G Stathopoulou
- University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, Pennsylvania 19104, USA
| | - Panos N Papapanou
- Columbia University College of Dental Medicine, New York, New York, USA
| |
Collapse
|
49
|
Jepsen K, Jepsen S. Antibiotics/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced periodontitis. Periodontol 2000 2017; 71:82-112. [PMID: 27045432 DOI: 10.1111/prd.12121] [Citation(s) in RCA: 179] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 02/06/2023]
Abstract
This review gives an update of the current scientific evidence on the efficacy of the adjunctive use of systemic and local antibiotics/antimicrobials in the treatment of periodontitis. In particular, it addresses whether their use can improve the results of nonsurgical mechanical therapy in mild-to-moderate forms of the disease. Large numbers of randomized clinical trials and systematic reviews with meta-analyses have clearly established that adjunctive systemic antibiotics, combined with mechanical debridement, offer clinical improvements additional to those obtained with scaling and root planing alone. These effects are more pronounced in aggressive periodontitis and in initially deep pockets, whereas more limited additional improvements, of 0.3 mm for additional pocket reduction and 0.2 mm for additional clinical attachment gain, have been documented for moderately deep sites (4-6 mm) in patients with chronic periodontitis. The marginal clinical benefit in patients with moderate disease has to be balanced against possible side effects. Notably, it has to be realized that an increasing number of warnings have been articulated against the unrestricted use of antibiotics in treating periodontal diseases because of the emerging global public health issue of bacterial resistance. The effects of the adjunctive local administration of antimicrobials have also been very well documented in several systematic reviews. Overall, in persistent or recurrent localized deep sites, the application of antimicrobials by sustained-delivery devices may offer a benefit of an additional 0.4 mm in pocket depth reduction and 0.3 mm in clinical attachment level gain. In conclusion, the slight additional benefits of adjunctive antimicrobials, which were shown for moderate forms of periodontitis, have to be balanced against their side effects and therefore their prescription should be limited as much as possible.
Collapse
|
50
|
Turton MS, Henkel RR, Africa CWJ. A simple point of care test can indicate the need for periodontal therapy to reduce the risk for adverse pregnancy outcomes in mothers attending antenatal clinics. Biomarkers 2017; 22:740-746. [PMID: 28562097 DOI: 10.1080/1354750x.2017.1334151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Although the association between periodontal disease (PD) and adverse pregnancy outcomes has gained recognition amongst antenatal healthcare workers, not much has changed in practice to address it. This prospective study tested the hypothesis that BANA (N-benzoyl-DL-arginine-2-naphthylamide), a diagnostic test for PD, may inform obstetricians and other antenatal healthcare practitioners, of the risk of adverse pregnancy outcomes in mothers attending antenatal clinics. METHODS At first visit, the presence of suspected periodontopathogens was assessed by BANA testing of dental plaque from 443 mothers attending antenatal clinics in KwaZulu-Natal, South Africa and an association later sought with pregnancy outcomes. The accuracy of BANA to predict adverse pregnancy outcomes was evaluated by the calculation of likelihood ratios. The study complied with the Declaration of Helsinki. RESULTS Significant differences were found between pregnancy outcomes of BANA-negative and BANA-positive mothers (p < 0.0001). BANA showed sensitivity and negative predictive values of 87% and 91%; 75% and 78%; 87% and 94% in detecting low birth weight, preterm delivery, and preterm low birth weight delivery respectively. CONCLUSION This study confirms that BANA may indicate the need for periodontal therapy to reduce the risk of adverse pregnancy outcomes and could form part of the routine antenatal examination.
Collapse
Affiliation(s)
- Mervyn Sydney Turton
- a Department of Medical Biosciences , University of the Western Cape , Bellville , Cape Town , South Africa
| | - Ralf Reinhold Henkel
- a Department of Medical Biosciences , University of the Western Cape , Bellville , Cape Town , South Africa
| | | |
Collapse
|