Multiple periodontal abscesses after systemic antibiotic therapy

Abstract

Multiple periodontal abscesses were reported in medically compromised patients. We examined patients with a non-contributory medical history referred for the treatment of numerous periodontal abscesses. All patients had taken oral broad spectrum antibiotics 1 to 3 weeks prior to the outburst of the abscesses (8 patients: penicillin, 2 patients: tetracycline). The patients suffered from advanced periodontal disease, 82% of the examined sites showed probing depths greater than 3 mm, 56% attachment loss greater than 3 mm. Subgingival plaque samples were analysed from 2 different abscess sites. Bacteroides gingivalis (19/20), Fusobacterium nucleatum (13/20) and Streptococcus intermedius (13/20) were the most prevalent anaerobic microbiota. Strains resistant to the prescribed antibiotic were found in 55% (11/20) of the subgingival plaque samples. It was concluded that in patients with advanced periodontal disease, systemic antibiotic therapy without subgingival debridement may change the composition of the subgingival microbiota, thus favouring the outburst of multiple periodontal abscesses.

Clinical and microbiological characterization of periodontal abscesses

“…In this study, Fusobacterium spp., P. intermedia/nigrescens and P. gingivalis were found to be the most prevalent microorganisms associated with periodontal abscesses. This is in agreement with previous reports (Newman & Sims 1979, van Winkelhoff et al 1985, Topoll et al 1990). Other microorganisms have been isolated from periodontal abscesses.…”

Prevalence of β‐lactamase‐producing bacteria in human periodontitis

“…An increasing prevalence of β‐lactamase activity among oral bacterial isolates has been reported , which is largely thought to be the result of plasmid and transposon‐mediated conjugal transfer and dissemination of β‐lactamase‐encoding genes among microorganisms surviving following selective pressure from β‐lactam antibiotics . Beta‐lactamases may predispose systemic penicillin monotherapy, unprotected by β‐lactamase inhibitors, to oral cavity treatment failures, such as recalcitrant orofacial infections and periodontal surgical flap necrosis , as well as enhance periodontal abscess risk in untreated periodontitis subjects .…”

Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo‐periodontal lesions

“…○Surgical periodontal therapy: associated with the presence of foreign bodies such as membranes for regeneration or sutures ○Systemic antimicrobial intake, without subgingival debridement, in patients with severe periodontitis could also cause abscess formation, probably related to an overgrowth of opportunistic bacteria ○Use of other drugs: e.g., nifedipine …”