Microbiologic Response to Periodontal Therapy and Multivariable Prediction of Clinical Outcome

Mombelli, Andrea; Almaghlouth, Adnan Ali; Cancela, José Antonio; Courvoisier, Delphine S.; Giannopoulou, Catherine

doi:10.1902/jop.2017.170286

Cited by 24 publications

(28 citation statements)

References 46 publications

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“…The organism is recognized as a member of the human periodontitis core microbiome [ 1 ], and is included in the orange complex cluster group of subgingival bacteria significantly associated with deep periodontal pockets [ 5 ]. Pre-treatment presence of subgingival P. micra in periodontitis patients is a significant predictor of post-treatment persistence of residual ≥5 mm periodontal pockets that bleed on probing [ 6 ]. Additionally, elevated subgingival levels of P. micra remaining after conventional mechanical-surgical treatment of severe periodontitis patients predisposes them to a significantly increased risk of further periodontal breakdown [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…P. micra is often poorly removed from periodontitis sites with conventional forms of periodontal therapy, such as repeated root surface debridement, periodontal access flap surgery, systematic maintenance care, and meticulous supragingival plaque control [ 6 , 7 , 8 , 9 , 12 ]. This may be due to marked adherence of P. micra to gingival crevicular epithelium [ 13 ], which is less likely to be affected by periodontal root instrumentation than tooth-associated microbial biofilms.…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic Resistance of Human Periodontal Pathogen Parvimonas micra Over 10 Years

2020

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance of Human Periodontal Pathogen Parvimonas micra Over 10 Years

2020

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“…Also, it is effective against anaerobes such as P. gingivalis and P. intermedia [ 24 ]. Studies have suggested that Metronidazole combined with Amoxicillin or Amoxicillin–Clavulanate potassium, it may be with great impact in the management of patients with aggressive periodontitis [ 23 ] [ 25 ] [ 26 ] [ 27 ] [ 28 ]. In our study, Metronidazole was mostly used in combination with Amoxicillin 12.1% and with Spiramycin in 10.2%.…”

Section: Discussionmentioning

confidence: 99%

Prescription of Antibiotics for Periodontal Disease among Dentists in the Region of Tirana

Abazi¹,

Mihani²

2018

Open Access Maced J Med Sci

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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.

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“…Critics point out that it is not a requirement for proper treatment and patients benefited from antibiotics irrespective of the knowledge of the bacterial status. [4][5][6] Especially the fact of being A. actinomycetemcomitans-positive or -negative did not change the effect of the antibiotics. 4 Proponents invoke that tests are a useful tool in finding the optimal and individualized treatment option to patients, in particular, when used on patients with (former classified) severe chronic or aggressive periodontitis who do not respond favorably to conventional mechanical therapy.…”

Section: Introductionmentioning

confidence: 88%

Clinical evaluation of a newly developed chairside test to determine periodontal pathogens

Arweiler

Marx

Laugisch

et al. 2019

Journal of Periodontology

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Background The subgingival microbiota as well as determination of markers such as associated pathogens is still in the focus of dental research. The aim of this controlled clinical trial was to determine clinical applicability of a newly developed chairside bacterial test (CST) for the most relevant periodontal pathogens. Methods Within 125 participants (100 with periodontitis, 25 healthy) two sulcus fluid samples each were collected and pooled for further analysis. Samples were analyzed with CST and results (positive signals for every pathogen/control) were visually detected by eye. As a reference quantitative polymerase chain reaction (qPCR) was performed. Results The detection limit of CST revealed 1.2 × 104 for Treponema denticola (T.d.) and Tannerella forsythia (T.f.), 2.5 × 104 for Porphyromonas gingivalis (P.g.), 5.3 × 103 for Prevotella intermedia (P.i.), and 5.8 × 104 for Aggregatibacter actinomycetemcomitans (A.a.). Based on this maximum potential of positive detections, the sensitivities of CST in reference to qPCR were: T.d. (91.3%); T.f. (86.3%); P.g. (83.8%); P.i. (85.7%), and A.a. (100%). In regard to the clinical diagnosis, the CST assay and the qPCR method reached a sensitivity of 87.82% and 94%, respectively. The specificity for both methods was 100%. Conclusion This newly developed CST can detect five typical periodontal pathogens with a somewhat lower sensitivity towards qPCR that can be classified as “good.”

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Microbiologic Response to Periodontal Therapy and Multivariable Prediction of Clinical Outcome

Abstract: Long-term microbiologic outcomes of periodontal therapy with adjunctive antibiotics either in T1 or T2 were similar. Detection of Pm before therapy was a predictor for persistence of sites with PD >4 mm and BOP at 12 months post-treatment.

Cited by 24 publications

References 46 publications

Antibiotic Resistance of Human Periodontal Pathogen Parvimonas micra Over 10 Years

Antibiotic Resistance of Human Periodontal Pathogen Parvimonas micra Over 10 Years

Prescription of Antibiotics for Periodontal Disease among Dentists in the Region of Tirana

Clinical evaluation of a newly developed chairside test to determine periodontal pathogens

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