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Kamble TA, Deshpande NC, Shah M, Jha R, Shah A. Clinical and Microbiological Evaluation of Diode Laser and Systemic Doxycycline as an Additive to Scaling and Root Planing for Stage II and Stage III Periodontitis Patients. Cureus 2024; 16:e56509. [PMID: 38646204 PMCID: PMC11026823 DOI: 10.7759/cureus.56509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
AIM To assess and contrast the effectiveness of systemic doxycycline and diode laser as supplements to scaling and root planing (SRP) in terms of clinical and microbiological parameters. MATERIALS AND METHODS A total of 33 patients diagnosed with periodontitis stages II and III were included and randomized into group A (SRP + diode laser), group B (SRP + doxycycline), and group C (SRP alone). Selected sites were assessed for clinical and microbial parameters-plaque index (PI), gingival index (GI), pocket probing depth (PPD), relative attachment level (RAL), and colony-forming units (CFUs). Every clinical parameter was noted at baseline and after three months. The arithmetic mean, followed by the standard deviation, was calculated for the required assessment intervals. Analysis of variance (ANOVA) was used to compare all parameters between groups, and if the results of the ANOVA test were significant, post hoc analysis was performed. For intragroup comparison, student t-tests were performed. RESULTS The clinical parameters significantly improved within three months for all groups. In terms of relative attachment level, a statistically significant difference (P < 0.001) was obtained at the three-month interval compared to the baseline value, with the most statistically significant difference seen in group A (3.36±0.50 to 0.64±0.50), followed by group B (3.18±0.40 to 2.18±0.40). The mean pocket probing depth observed at three months, compared to the baseline value, showed a statistically significant difference (P < 0.001) in group A (5.91±0.70 to 2.18±0.40) compared to group B (6.18±0.75 to 4.36±0.50), followed by group C (5.82±0.75 to 5.27±0.64). CONCLUSION The use of diode laser-assisted pocket disinfection and systemic doxycycline, in addition to scaling and root planing, has proven to be efficient for treating periodontal pockets.
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Affiliation(s)
- Tapaswi A Kamble
- Department of Periodontology, K. M. Shah Dental College and Hospital, Vadodara, IND
| | - Neeraj C Deshpande
- Department of Periodontology, K. M. Shah Dental College and Hospital, Vadodara, IND
| | - Monali Shah
- Department of Periodontology, K. M. Shah Dental College and Hospital, Vadodara, IND
| | - Rashmi Jha
- Department of Periodontology, K. M. Shah Dental College and Hospital, Vadodara, IND
| | - Aayushi Shah
- Department of Periodontology, K. M. Shah Dental College and Hospital, Vadodara, IND
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Hagenfeld D, Kleine Bardenhorst S, Matern J, Prior K, Harks I, Eickholz P, Lorenz K, Kim TS, Kocher T, Meyle J, Kaner D, Schlagenhauf U, Harmsen D, Ehmke B. Long-term changes in the subgingival microbiota in patients with stage III-IV periodontitis treated by mechanical therapy and adjunctive systemic antibiotics: A secondary analysis of a randomized controlled trial. J Clin Periodontol 2023; 50:1101-1112. [PMID: 37160709 DOI: 10.1111/jcpe.13824] [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: 08/16/2022] [Revised: 03/08/2023] [Accepted: 04/21/2023] [Indexed: 05/11/2023]
Abstract
AIM To explore whether adjunctive antibiotics can relevantly influence long-term microbiota changes in stage III-IV periodontitis patients. MATERIALS AND METHODS This is a secondary analysis of a randomized clinical trial on periodontal therapy with adjunctive 500 mg amoxicillin and 400 mg metronidazole or placebo thrice daily for 7 days. Subgingival plaque samples were taken before and 2, 8, 14 and 26 months after mechanical therapy. The V4-hypervariable region of the 16S rRNA gene was sequenced with Illumina MiSeq 250 base pair paired-end reads. Changes at the ribosomal sequence variant (RSV) level, diversity and subgingival-microbial dysbiosis index (SMDI) were explored with a negative binomial regression model and non-parametric tests. RESULTS Overall, 50.2% of all raw reads summed up to 72 RSVs (3.0%) that were generated from 163 stage III-IV periodontitis patients. Of those, 16 RSVs, including Porphyromonas gingivalis, Tannerella forsythia and Aggregatibacter actinomycetemcomitans, changed significantly over 26 months because of adjunctive systemic antibiotics. SMDI decreased significantly more in the antibiotic group at all timepoints, whereas the 2-month differences in alpha and beta diversity between groups were not significant at 8 and 14 months, respectively. CONCLUSIONS Mechanical periodontal therapy with adjunctive antibiotics induced a relevant and long-term sustainable change towards an oral microbiome more associated with oral health.
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Affiliation(s)
- Daniel Hagenfeld
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Sven Kleine Bardenhorst
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
- Department of Clinical Epidemiology, Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Johannes Matern
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Karola Prior
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Inga Harks
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Dentistry and Oral Medicine, Johann Wolfgang Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Katrin Lorenz
- Department of Periodontology, TU Dresden, Dresden, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Jörg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
| | - Doğan Kaner
- Department of Periodontology and Synoptic Dentistry, Charite-Universitätsmedizin Berlin, Berlin, Germany
- Department of Periodontology, Dental School, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - Ulrich Schlagenhauf
- Department of Periodontology, University Hospital Würzburg, Würzburg, Germany
| | - Dag Harmsen
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
| | - Benjamin Ehmke
- Department of Periodontology and Operative Dentistry, Muenster University Hospital, Münster, Germany
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3
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Rams TE, Slots J. Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis. Antibiotics (Basel) 2023; 12:antibiotics12020265. [PMID: 36830176 PMCID: PMC9951977 DOI: 10.3390/antibiotics12020265] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
This study evaluated a combined systemic and topical anti-infective periodontal treatment of 35 adults who had experienced ongoing periodontal breakdown following conventional surgical periodontics. The prescribed anti-infective therapy, based on microbiological testing, consisted of a single course of metronidazole plus ciprofloxacin (23 patients), metronidazole plus amoxicillin/clavulanic acid (10 patients), and metronidazole plus ciprofloxacin followed by metronidazole plus amoxicillin/clavulanic acid (2 patients). In addition, the study patients received 0.1% povidone-iodine subgingival disinfection during non-surgical root debridement and daily patient administered oral irrigation with 0.1% sodium hypochlorite. At 1 and 5 years post-treatment, all study patients showed gains in clinical periodontal attachment with no further attachment loss, and significant decreases in pocket probing depth, bleeding on probing, and subgingival temperature. The greatest disease resolution occurred in patients who at baseline harbored predominantly major periodontal pathogens which post-antibiotics became non-detectable and substituted by non-periodontopathic viridans streptococci. The personalized and minimally invasive anti-infective treatment regimen described here controlled periodontitis disease activity and markedly improved the clinical and microbiological status of the refractory periodontitis patients.
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Affiliation(s)
- Thomas E. Rams
- Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USA
- Correspondence:
| | - Jørgen Slots
- Division of Periodontology and Diagnostic Sciences, University of Southern California School of Dentistry, Los Angeles, CA 90089, USA
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4
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Zhang K, Zhou X, Qin J, Zhang W, Pan Y, Wang H, Lin J, Liu L, Jia Y. Dynamic Change in Oral Microbiota of Children With Cleft Lip and Palate After Alveolar Bone Grafting. Cleft Palate Craniofac J 2021; 59:1352-1360. [PMID: 34524929 DOI: 10.1177/10556656211044396] [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: 11/17/2022] Open
Abstract
To investigate the longitudinal influence of alveolar bone grafting on the oral microbiota of children with cleft lip and palate (CLP). Twenty-eight children with nonsyndromic CLP were recruited and underwent secondary alveolar bone grafting at the first time. Unstimulated saliva and plaque samples were collected from the subjects preoperatively and at 2 days, 1 month, and 3 months postoperatively. The v3-v4 hypervariable regions of the 16S rRNA gene from bacterial DNA were sequenced using the Illumina MiSeq sequencing platform. The alpha diversity of the saliva and plaque microbiota was significantly decreased at 2 days postoperatively and then increased at 1 and 3 months postoperatively. The saliva and plaque microbiota compositions at 2 days postoperatively differed from those at the other time points, and the microbiota compositions at 1 and 3 months postoperatively showed a gradual shift toward the preoperative composition. The saliva, but not plaque, microbiota composition 3 months postoperatively was similar to that preoperatively. The effect of secondary alveolar bone grafting on the plaque microbiota in children with CLP lasted longer than the saliva microbiota. Alveolar bone grafting altered the saliva microbiota in children with CLP within 3 months postoperatively.
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Affiliation(s)
- Kejia Zhang
- 168284The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, P.R. China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, P.R. China.,12461Jiangsu Province Engineering Research Center of Stomatological Translation Medicine, Nanjing, P.R. China
| | - Xuan Zhou
- 159460Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Jinwei Qin
- 168284The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, P.R. China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, P.R. China.,12461Jiangsu Province Engineering Research Center of Stomatological Translation Medicine, Nanjing, P.R. China
| | - Weibing Zhang
- 168284The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, P.R. China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, P.R. China.,12461Jiangsu Province Engineering Research Center of Stomatological Translation Medicine, Nanjing, P.R. China
| | - Yongchu Pan
- 168284The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, P.R. China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, P.R. China.,12461Jiangsu Province Engineering Research Center of Stomatological Translation Medicine, Nanjing, P.R. China
| | - Hua Wang
- 168284The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, P.R. China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, P.R. China.,12461Jiangsu Province Engineering Research Center of Stomatological Translation Medicine, Nanjing, P.R. China
| | - Jiuxiang Lin
- 159460Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Luwei Liu
- 168284The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, P.R. China.,Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, P.R. China.,12461Jiangsu Province Engineering Research Center of Stomatological Translation Medicine, Nanjing, P.R. China
| | - Yilin Jia
- 159460Peking University School and Hospital of Stomatology, Beijing, P.R. China
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Su CT, Chen CJ, Chen CM, Chen CC, Ma SH, Wu JH. Optical profile: A key determinant of antibacterial efficacy of photodynamic therapy in dentistry. Photodiagnosis Photodyn Ther 2021; 35:102461. [PMID: 34314864 DOI: 10.1016/j.pdpdt.2021.102461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/10/2021] [Accepted: 07/22/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Periodontal disease effects 20-50% of the population worldwide, posing a global health challenge. It has been reported to be more prevalent among adults. Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans) is an important organism associated with localized juvenile periodontitis. Photodynamic therapy (PDT) has been widely utilized for the treatment of periodontal disease; however, the effect of laser (light) profile on the antibacterial efficacy of PDT remains to be established. The quantitative measurement of laser profile is required to confirm the in vitro efficacy of PDT. AIM In the present study, a low cost PDT system comprising of six copper tube waveguides (CTW) was developed to provide more uniform irradiation of the culture plate. METHODS The antibacterial effect of PDT, in combination with 200 μg/mL methylene blue (MB) as photosensitizer and 60 sec of irradiation, was studied on A. actinomycetemcomitans and Streptococcus mutans (S. mutans). In the present case, 660 nm laser guided with unpolished CTW, polished CTW, and optical fiber waveguide (OFW) provided radiant exposure of 0.86, 1.38, and 1.36 J/cm2, respectively, for a 24-well culture plate. RESULTS The designed PDT system provided antimicrobial efficacy of 98% and 91% for A. actinomycetemcomitans and S. mutans, respectively, which was significantly higher as compared to OFW guided PDT. CONCLUSION The results of the study highlighted the importance of laser profile as a key parameter that determines the survival rate of bacteria at the edge of the culture plate. Thus, the dose of PDT at the margin of optical profile is important for antibacterial activity for in vitro evaluation.
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Affiliation(s)
- Chuan-Tsung Su
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei City, 10617, Taiwan
| | - Chun-Ju Chen
- Institute of Oral Science, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung City, 40201, Taiwan
| | - Chung-Ming Chen
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei City, 10617, Taiwan
| | - Chun-Cheng Chen
- Department of Stomatology, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung City, 40201, Taiwan; School of Dentistry, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung City, 40201, Taiwan
| | - Shih-Hsin Ma
- Department of Photonics, Feng Chia University, No. 100, Wenhwa Road., Seatwen District, Taichung City, 40724, Taiwan
| | - Jih-Huah Wu
- Department of Biomedical Engineering, Ming Chuan University, No. 5, Deming Road., Gweishan District, Taoyuan, 33348, Taiwan.
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6
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Elashiry M, Morandini AC, Cornelius Timothius CJ, Ghaly M, Cutler CW. Selective Antimicrobial Therapies for Periodontitis: Win the "Battle and the War". Int J Mol Sci 2021; 22:ijms22126459. [PMID: 34208697 PMCID: PMC8235535 DOI: 10.3390/ijms22126459] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/26/2021] [Accepted: 06/07/2021] [Indexed: 12/11/2022] Open
Abstract
Traditional antimicrobial therapies for periodontitis (PD) have long focused on non-selective and direct approaches. Professional cleaning of the subgingival biofilm by instrumentation of dental root surfaces, known as scaling and root planning (SRP), is the mainstay of periodontal therapy and is indisputably effective. Non-physical approaches used as adjuncts to SRP, such as chemical and biological agents, will be the focus of this review. In this regard, traditional agents such as oral antiseptics and antibiotics, delivered either locally or systemically, were briefly reviewed as a backdrop. While generally effective in winning the “battle” against PD in the short term, by reducing its signs and symptoms, patients receiving such therapies are more susceptible to recurrence of PD. Moreover, the long-term consequences of such therapies are still in question. In particular, concern about chronic use of systemic antibiotics and their influence on the oral and gut microbiota is warranted, considering antibiotic resistance plasmids, and potential transfer between oral and non-oral microbes. In the interest of winning the “battle and the war”, new more selective and targeted antimicrobials and biologics for PD are being studied. These are principally indirect, blocking pathways involved in bacterial colonization, nutrient acquisition, inflammation or cellular invasion without directly killing the pathogens. This review will focus on current and prospective antimicrobial therapies for PD, emphasizing therapies that act indirectly on the microbiota, with clearly defined cellular and molecular targets.
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7
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Abusleme L, Hoare A, Hong BY, Diaz PI. Microbial signatures of health, gingivitis, and periodontitis. Periodontol 2000 2021; 86:57-78. [PMID: 33690899 DOI: 10.1111/prd.12362] [Citation(s) in RCA: 133] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The subgingival crevice harbors diverse microbial communities. Shifts in the composition of these communities occur with the development of gingivitis and periodontitis, which are considered as successive stages of periodontal health deterioration. It is not clear, however, to what extent health- and gingivitis-associated microbiota are protective, or whether these communities facilitate the successive growth of periodontitis-associated taxa. To further our understanding of the dynamics of the microbial stimuli that trigger disruptions in periodontal homeostasis, we reviewed the available literature with the aim of defining specific microbial signatures associated with different stages of periodontal dysbiosis. Although several studies have evaluated the subgingival communities present in different periodontal conditions, we found limited evidence for the direct comparison of communities in health, gingivitis, and periodontitis. Therefore, we aimed to better define subgingival microbiome shifts by merging and reanalyzing, using unified bioinformatic processing strategies, publicly available 16S ribosomal RNA gene amplicon datasets of periodontal health, gingivitis, and periodontitis. Despite inherent methodological differences across studies, distinct community structures were found for health, gingivitis, and periodontitis, demonstrating the specific associations between gingival tissue status and the subgingival microbiome. Consistent with the concept that periodontal dysbiosis is the result of a process of microbial succession without replacement, more species were detected in disease than in health. However, gingivitis-associated communities were more diverse than those from subjects with periodontitis, suggesting that certain species ultimately become dominant as dysbiosis progresses. We identified the bacterial species associated with each periodontal condition and prevalent species that do not change in abundance from one state to another (core species), and we also outlined species co-occurrence patterns via network analysis. Most periodontitis-associated species were rarely detected in health but were frequently detected, albeit in low abundance, in gingivitis, which suggests that gingivitis and periodontitis are a continuum. Overall, we provide a framework of subgingival microbiome shifts, which can be used to generate hypotheses with respect to community assembly processes and the emergence of periodontal dysbiosis.
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Affiliation(s)
- Loreto Abusleme
- Laboratory of Oral Microbiology, Faculty of Dentistry, University of Chile, Santiago, Chile.,Laboratory for Craniofacial Translational Research, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Anilei Hoare
- Laboratory of Oral Microbiology, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Bo-Young Hong
- Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Patricia I Diaz
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA.,UB Microbiome Center, University at Buffalo, State University of New York, Buffalo, NY, USA
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8
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Miyazawa H, Nakajima T, Horimizu M, Okuda K, Sugita N, Yamazaki K, Li L, Hayashi-Okada Y, Arita T, Nishimoto M, Nishida M, Genco RJ, Yamazaki K. Impact of Local Drug Delivery of Minocycline on the Subgingival Microbiota during Supportive Periodontal Therapy: A Randomized Controlled Pilot Study. Dent J (Basel) 2020; 8:E123. [PMID: 33121117 PMCID: PMC7711502 DOI: 10.3390/dj8040123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/09/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to examine the effect of adjunct local minocycline administration on the microbiological parameters of subgingival plaque samples in the residual periodontal pockets. Ten chronic periodontitis patients under a supportive periodontal therapy regimen were recruited. After subgingival debridement, either 2% minocycline gel, Periocline™, (Test Group) or a placebo (Control Group) was administered to the selected sites once a week for three weeks. Subgingival plaque was collected at baseline, and at four weeks and eight weeks. The microbiological composition was analyzed by 16S ribosomal RNA sequencing. In the Test Group, α-diversity (evenness) decreased compared to the baseline (p = 0.005) and was lower compared to the control group at four weeks (p = 0.003). The microbial community composition between the two groups was significantly different at four weeks (p = 0.029). These changes were attributable to a decrease in the bacteria associated with periodontitis and an increase in the bacteria associated with periodontal health. Additionally, the improvement in bleeding on probing continued at eight weeks; however, there were little microbial effects of 2% minocycline gel observed at eight weeks. The control group demonstrated no change throughout the eight-week experimental period. Thus, local minocycline administration can change the subgingival microbial community of residual periodontal pockets.
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Affiliation(s)
- Haruna Miyazawa
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (H.M.); (T.N.); (K.Y.)
| | - Takako Nakajima
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (H.M.); (T.N.); (K.Y.)
| | - Makoto Horimizu
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (M.H.); (K.O.); (N.S.)
| | - Kazuhiro Okuda
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (M.H.); (K.O.); (N.S.)
| | - Noriko Sugita
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (M.H.); (K.O.); (N.S.)
| | - Kyoko Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (H.M.); (T.N.); (K.Y.)
| | - Lu Li
- Department of Computer Science and Engineering, State University of New York at Buffalo, 338 Davis Hall, Buffalo, NY 14214, USA;
| | - Yoshiko Hayashi-Okada
- Sunstar Inc., 3-1, Asahimachi, Takatsuki-shi, Osaka 569-1134, Japan; (Y.H.-O.); (T.A.); (M.N.)
| | - Takuya Arita
- Sunstar Inc., 3-1, Asahimachi, Takatsuki-shi, Osaka 569-1134, Japan; (Y.H.-O.); (T.A.); (M.N.)
| | - Misa Nishimoto
- Sunstar Inc., 3-1, Asahimachi, Takatsuki-shi, Osaka 569-1134, Japan; (Y.H.-O.); (T.A.); (M.N.)
| | - Mieko Nishida
- Sunstar Inc., 3-1, Asahimachi, Takatsuki-shi, Osaka 569-1134, Japan; (Y.H.-O.); (T.A.); (M.N.)
| | - Robert J. Genco
- Departments of Oral Biology, and Microbiology and Immunology, and Center for Microbiome Research, University at Buffalo, 135 Foster Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Kazuhisa Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan; (H.M.); (T.N.); (K.Y.)
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Invernici MM, Salvador SL, Silva PHF, Soares MSM, Casarin R, Palioto DB, Souza SLS, Taba M, Novaes AB, Furlaneto FAC, Messora MR. Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: A randomized clinical trial. J Clin Periodontol 2018; 45:1198-1210. [PMID: 30076613 PMCID: PMC6221043 DOI: 10.1111/jcpe.12995] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/14/2018] [Accepted: 08/01/2018] [Indexed: 02/06/2023]
Abstract
AIM This randomized placebo-controlled clinical trial evaluated the effect of Bifidobacterium animalis subsp. lactis (B. lactis) HN019-containing probiotic lozenges as adjuvant to scaling and root planing (SRP) in patients with generalized chronic periodontitis. MATERIALS AND METHODS Forty-one chronic periodontitis patients were recruited and monitored clinically, immunologically, and microbiologically at baseline (before SRP) and 30 and 90 days after SRP. All patients were randomly assigned to a Test (SRP + Probiotic, n = 20) or Control (SRP + Placebo, n = 21) group. The probiotic lozenges were used twice a day for 30 days. The data were statistically analysed. RESULTS The Test group presented a decrease in probing pocket depth and a clinical attachment gain significantly higher than those of the Control group at 90 days. The Test group also demonstrated significantly fewer periodontal pathogens of red and orange complexes, as well as lower proinflammatory cytokine levels when compared to the Control group. Only the Test group showed an increase in the number of B. lactis HN019 DNA copies on subgingival biofilm at 30 and 90 days. CONCLUSION The use of B. lactis HN019 as an adjunct to SRP promotes additional clinical, microbiological, and immunological benefits in the treatment of chronic periodontitis (NCT03408548).
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Affiliation(s)
- Marcos M Invernici
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Sérgio L Salvador
- Department of Clinical Analyses, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Pedro H F Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Mariana S M Soares
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Renato Casarin
- Department of Prosthodontics and Periodontics, School of Dentistry, Campinas State University - UNICAMP, Piracicaba, SP, Brazil
| | - Daniela B Palioto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Sérgio L S Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Mario Taba
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Arthur B Novaes
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Flávia A C Furlaneto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Michel R Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
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10
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Palma ALDR, Paula-Ramos LD, Domingues N, Back-Brito GN, de Oliveira LD, Pereira CA, Jorge AOC. Biofilms of Candida albicans and Streptococcus sanguinis and their susceptibility to antimicrobial effects of photodynamic inactivation. Photodiagnosis Photodyn Ther 2018; 24:95-101. [PMID: 29990641 DOI: 10.1016/j.pdpdt.2018.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 05/30/2018] [Accepted: 07/06/2018] [Indexed: 01/10/2023]
Abstract
This study evaluated the effects of photodynamic inactivation (PDI) on single and multi-species biofilms, compounds by Candida albicans and Streptococcus sanguinis. Biofilms were formed, on microplate of 96 wells, by suspensions of C. albicans (ATCC 18804) and S. sanguinis (ATCC 7073) adjusted in 107 cells/mL, followed by incubation of 48 h (with 5% CO2). The effects of the photosensitizer erythrosine (ER) at 400 μM for 5 min and green light-emitting diode (LED - 532 ± 10 nm) for 3 min, alone and conjugated, were evaluated. After normality test, results was analysed by Tukey´s test (P < 0.05). PDI group promoted reductions of 1.07 and 0.39 log10, respectively, in biofilms of C. albicans alone and in association with S. sanguinis. Biofilms of S. sanguinis alone were more sensitive, with reduction of 4.48 log10. When in association with the yeast, S. sanguinis have a decrease of 2.67 log10. SEM analysis revealed a decrease in bacterial and fungal structures of biofilms treated with PDI. In conclusion PDI promoted significant microbial reductions in both species of microorganisms grown on mixed biofilms. This study is one of the pioneers to evaluate the antimicrobial action of PDI on biofilms of S. sanguinis and C. albicans, demonstrating a way to control these microorganisms of clinical importance.
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Affiliation(s)
- Ana Luiza do Rosário Palma
- São Paulo State University (Unesp), Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo, Brazil.
| | - Lucas de Paula-Ramos
- São Paulo State University (Unesp), Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo, Brazil.
| | - Nádia Domingues
- São Paulo State University (Unesp), Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo, Brazil.
| | - Graziella Nuernberg Back-Brito
- São Paulo State University (Unesp), Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo, Brazil.
| | - Luciane Dias de Oliveira
- São Paulo State University (Unesp), Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo, Brazil.
| | - Cristiane Aparecida Pereira
- São Paulo State University (Unesp), Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo, Brazil.
| | - Antonio Olavo Cardoso Jorge
- São Paulo State University (Unesp), Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo, Brazil.
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11
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Kharazifard MJ, Holakouie-Naieni K, Mansournia MA. Application of Multilevel Models in Dentistry. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2017; 14:352-360. [PMID: 29942330 PMCID: PMC6015589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Multilevel analysis which was primarily introduced to deal with hierarchical data was later applied extensively for research in other fields of science and not only for nested data, but also for repeated measurements or clustered trials. This method of statistical analysis was applied in dental studies in the 1991 for the first time but despite its value for data analysis in dental studies, its application for dental studies remains limited until now. This manuscript reviews the applications of this method in dental studies.
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Affiliation(s)
- Mohammad Javad Kharazifard
- PhD Candidate of Epidemiology, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: MJ. Kharazifard, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
| | - Kurosh Holakouie-Naieni
- Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Assistant Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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12
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Angst PDM, Stadler AF, Oppermann RV, Gomes SC. Microbiological outcomes from different periodontal maintenance interventions: a systematic review. Braz Oral Res 2017; 31:e33. [PMID: 28513785 DOI: 10.1590/1807-3107bor-2017vol310033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/27/2017] [Indexed: 11/21/2022] Open
Abstract
This study aimed to investigate the differences in the subgingival microbiological outcomes between periodontal patients submitted to a supragingival control (SPG) regimen as compared to subgingival scaling and root planing performed combined with supragingival debridement (SPG + SBG) intervention during the periodontal maintenance period (PMP). A systematic literature search using electronic databases (MEDLINE and EMBASE) was conducted looking for articles published up to August 2016 and independent of language. Two independent reviewers performed the study selection, quality assessment and data collection. Only human randomized or non-randomized clinical trials with at least 6-months-follow-up after periodontal treatment and presenting subgingival microbiological outcomes related to SPG and/or SPG+SBG therapies were included. Search strategy found 2,250 titles. Among these, 148 (after title analysis) and 39 (after abstract analysis) papers were considered to be relevant. Finally, 19 studies were selected after full-text analysis. No article had a direct comparison between the therapies. Five SPG and 14 SPG+SBG studies presented experimental groups with these respective regimens and were descriptively analyzed while most of the results were only presented graphically. The results showed that both SPG and SPG+SBG protocols of PMP determined stability in the microbiological results along time. Nevertheless, new studies comparing these interventions in PMP are needed, especially if the limitations herein discussed could be better controlled.
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Affiliation(s)
| | - Amanda Finger Stadler
- Augusta University, The Dental College of Georgia, Department of Periodontics, Augusta, GA, United States of America
| | - Rui Vicente Oppermann
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Sabrina Carvalho Gomes
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
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13
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Bizzarro S, Laine ML, Buijs MJ, Brandt BW, Crielaard W, Loos BG, Zaura E. Microbial profiles at baseline and not the use of antibiotics determine the clinical outcome of the treatment of chronic periodontitis. Sci Rep 2016; 6:20205. [PMID: 26830979 PMCID: PMC4735321 DOI: 10.1038/srep20205] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/23/2015] [Indexed: 01/22/2023] Open
Abstract
Antibiotics are often used in the treatment of chronic periodontitis, which is a major cause of tooth loss. However, evidence in favour of a microbial indication for the prescription of antibiotics is lacking, which may increase the risk of the possible indiscriminate use of antibiotics, and consequent, microbial resistance. Here, using an open-ended technique, we report the changes in the subgingival microbiome up to one year post-treatment of patients treated with basic periodontal therapy with or without antibiotics. Antibiotics resulted in a greater influence on the microbiome 3 months after therapy, but this difference disappeared at 6 months. Greater microbial diversity, specific taxa and certain microbial co-occurrences at baseline and not the use of antibiotics predicted better clinical treatment outcomes. Our results demonstrate the predictive value of specific subgingival bacterial profiles for the decision to prescribe antibiotics in the treatment of periodontitis, but they also indicate the need for alternative therapies based on ecological approaches.
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Affiliation(s)
- S Bizzarro
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
| | - M L Laine
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
| | - M J Buijs
- Department of Preventive Dentistry Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
| | - B W Brandt
- Department of Preventive Dentistry Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
| | - W Crielaard
- Department of Preventive Dentistry Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
| | - B G Loos
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
| | - E Zaura
- Department of Preventive Dentistry Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands
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14
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Kelsen J, Bittinger K, Pauly-Hubbard H, Posivak L, Grunberg S, Baldassano R, Lewis JD, Wu GD, Bushman FD. Alterations of the Subgingival Microbiota in Pediatric Crohn's Disease Studied Longitudinally in Discovery and Validation Cohorts. Inflamm Bowel Dis 2015; 21:2797-805. [PMID: 26288001 PMCID: PMC4950860 DOI: 10.1097/mib.0000000000000557] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Oral manifestations are common in Crohn's disease (CD). Here we characterized the subgingival microbiota in pediatric patients with CD initiating therapy and after 8 weeks to identify microbial community features associated with CD and therapy. METHODS Pediatric patients with CD were recruited from The Children's Hospital of Pennsylvania. Healthy control subjects were recruited from primary care or orthopedics clinic. Subgingival plaque samples were collected at initiation of therapy and after 8 weeks. Treatment exposures included 5-ASAs, immunomodulators, steroids, and infliximab. The microbiota was characterized by 16S rRNA gene sequencing. The study was repeated in separate discovery (35 CD, 43 healthy) and validation cohorts (43 CD, 31 healthy). RESULTS Most subjects in both cohorts demonstrated clinical response after 8 weeks of therapy (discovery cohort 88%, validation cohort 79%). At week 0, both antibiotic exposure and disease state were associated with differences in bacterial community composition. Seventeen genera were identified in the discovery cohort as candidate biomarkers, of which 11 were confirmed in the validation cohort. Capnocytophaga, Rothia, and TM7 were more abundant in CD relative to healthy controls. Other bacteria were reduced in abundance with antibiotic exposure among CD subjects. CD-associated genera were not enriched compared with healthy controls after 8 weeks of therapy. CONCLUSIONS Subgingival microbial community structure differed with CD and antibiotic use. Results in the discovery cohort were replicated in a separate validation cohort. Several potentially pathogenic bacterial lineages were associated with CD but were not diminished in abundance by antibiotic treatment, suggesting targets for additional surveillance.
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Affiliation(s)
- Judith Kelsen
- *Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; †Department of Microbiology; and ‡Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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15
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Fonseca DC, Cortelli JR, Cortelli SC, Miranda Cota LO, Machado Costa LC, Moreira Castro MV, Oliveira Azevedo AM, Costa FO. Clinical and Microbiologic Evaluation of Scaling and Root Planing per Quadrant and One-Stage Full-Mouth Disinfection Associated With Azithromycin or Chlorhexidine: A Clinical Randomized Controlled Trial. J Periodontol 2015; 86:1340-51. [DOI: 10.1902/jop.2015.150227] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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16
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Villa O, Wohlfahrt JC, Mdla I, Petzold C, Reseland JE, Snead ML, Lyngstadaas SP. Proline-Rich Peptide Mimics Effects of Enamel Matrix Derivative on Rat Oral Mucosa Incisional Wound Healing. J Periodontol 2015; 86:1386-95. [PMID: 26252748 DOI: 10.1902/jop.2015.150207] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Proline-rich peptides have been shown to promote periodontal regeneration. However, their effect on soft tissue wound healing has not yet been investigated. The aim of this study is to evaluate the effect of enamel matrix derivative (EMD), tyrosine-rich amelogenin peptide (TRAP), and a synthetic proline-rich peptide (P2) on acute wound healing after a full-thickness flap procedure in an incisional rat model. METHODS This experimental study has a split-mouth, randomized, placebo-controlled design. Test and control wounds were created on the palatal mucosa of 54 Sprague-Dawley rats. Wounds were histologically processed, and reepithelialization, leukocyte infiltration, and angiogenesis were assessed at days 1, 3, and 7 post-surgery. RESULTS EMD and P2 significantly promoted early wound closure at day 1 (P <0.001 and P = 0.004, respectively). EMD maintained a significant acceleration of reepithelialization at day 3 (P = 0.004). Wounds treated by EMD and P2 showed increased angiogenesis during the first 3 days of healing (P = 0.03 and 0.001, respectively). Leukocyte infiltration was decreased in EMD-treated wounds at day 1 (P = 0.03), and P2 and TRAP induced a similar effect at days 3 (P = 0.002 and P <0.0001, respectively) and 7 (P = 0.005 and P <0.001). CONCLUSION EMD and P2 promoted reepithelialization and neovascularization in full-thickness surgical wounds on rat oral mucosa.
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Affiliation(s)
- Oscar Villa
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Johan C Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, University of Oslo
| | | | - Christiane Petzold
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Janne E Reseland
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Malcolm L Snead
- Herman Ostrow School of Dentistry, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, CA
| | - Staale P Lyngstadaas
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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17
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Alzoman HA, Diab HM. Effect of gallium aluminium arsenide diode laser therapy on Porphyromonas gingivalis in chronic periodontitis: a randomized controlled trial. Int J Dent Hyg 2015; 14:261-266. [PMID: 26250477 DOI: 10.1111/idh.12169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this randomized, controlled trial was to evaluate the effects of 685-nm gallium aluminium arsenide (GaAlAs) diode laser therapy (1.6 J cm-2 ) as an adjunct to scaling and root planing in the treatment of chronic periodontitis. METHODS Thirty-two patients aged 35-60 years old who had chronic periodontitis met the eligibility criteria. They were randomly assigned to two equal groups: scaling and root planing were performed in the SRP group, while scaling, root planing and laser irradiation of periodontal pockets were performed in the SRP + DL group. Subgingival plaque samples were subjected to polymerase chain reaction (PCR) to detect P. gingivalis-colonized sites, and common clinical indices were evaluated before and 2 months after treatment. Clinical examination included gingival index (GI), plaque index (PI), probing depth (PD), clinical attachment level (CAL) and gingival bleeding index (GBI), all of which were recorded. RESULTS Data from 30 patients [19 women and 11 men; mean age, 48.4 (5.4) years old] were analysed. There were statistically significant improvements in GI, PD, CAL and GBI for the SRP + DL group compared to SRP group but no significant difference in PI between the groups. Additionally, the percentage of P. gingivalis-positive sites in the SRP + DL group decreased from 80% (12/15) to 20% (3/15) after laser irradiation (P < 0.05). No significant changes were noted in the SRP group. CONCLUSION GaAlAs diode laser irradiation of diseased periodontal pockets at 685 nm and 1.6 J cm-2 seemed to be an effective adjuvant to mechanical instrumentation to treat chronic periodontitis.
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Affiliation(s)
- H A Alzoman
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - H M Diab
- Department of Periodontology, Faculty of Dentistry, Tanta University, Tanta, Egypt.,Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
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18
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Cortelli SC, Costa FO, Rodrigues E, Cota LOM, Cortelli JR. Periodontal Therapy Effects on Nitrite Related to Oral Bacteria: A 6-Month Randomized Clinical Trial. J Periodontol 2015; 86:984-94. [PMID: 25811847 DOI: 10.1902/jop.2015.140678] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Nitrite is a biologic factor relevant to oral and systemic homeostasis. Through an oral bacteria reduction process, it was suggested that periodontal therapy and chlorhexidine (CHX) rinse could affect nitrite levels, leading to negative effects, such as an increase in blood pressure. This 6-month randomized clinical trial evaluated the effects of periodontal therapeutic protocols on salivary nitrite and its relation to subgingival bacteria. METHODS One hundred patients with periodontitis were allocated randomly to debridement procedures in four weekly sections (quadrant scaling [QS]) or within 24 hours (full-mouth scaling [FMS]) in conjunction with a 60-day CHX (QS + CHX and FMS + CHX), placebo (QS + placebo and FMS + placebo), or no mouthrinse (QS + none and FMS + none) use. Real-time polymerase chain reaction determined total bacterial, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Streptococcus oralis, and Actinomyces naeslundii levels. Salivary nitrite concentration was determined with Griess reagent. Data were analyzed statistically at baseline and 3 and 6 months by analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests (P <0.05). RESULTS Nitrite concentrations did not tend to change over time. Regarding CHX use, there was a negative correlation between nitrite and total bacterial load at 6 months (FMS + CHX) and one positive correlation between P. gingivalis and nitrite at baseline (QS + CHX). Independently of rinse type, in the FMS group, nitrite correlated negatively with several microbial parameters and also with a higher percentage of deep periodontal pockets. CONCLUSIONS The relationship between nitrite and bacterial levels appears weak. Short-term scaling exhibited a greater influence on nitrite concentrations then long-term CHX use.
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Affiliation(s)
- Sheila C Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubaté, Taubaté, São Paulo, Brazil.,Dental School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernando O Costa
- Periodontal Department, Dental School, Federal University of Minas Gerais
| | - Edson Rodrigues
- Biochemistry Department, Institute of Biosciences, University of Taubaté
| | - Luis O M Cota
- Periodontal Department, Dental School, Federal University of Minas Gerais
| | - Jose R Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubaté, Taubaté, São Paulo, Brazil
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19
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Javed F, Romanos GE. Does Photodynamic Therapy Enhance Standard Antibacterial Therapy in Dentistry? Photomed Laser Surg 2013; 31:512-8. [DOI: 10.1089/pho.2012.3329] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fawad Javed
- Eng. A.B. Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Georgios E. Romanos
- Department of Dental Medicine, School of Dental Medicine, Stony Brook University, Stony Brook, New York
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