Effect of adjunctive amoxicillin/metronidazole treatment on the recolonization levels of subgingival Tannerella forsythia, Prevotella intermedia and Fusobacterium nucleatum in periodontitis patients
Abstract
Amaç: Periodontitis
tedavisinde cerrahi olmayan periodontal tedavi ile eş zamanlı antibiyotik
uygulamaları kabul görmüş bir yaklaşımdır. Bununla beraber, bakteri
rekolonizasyonu tedavi kazanımlarının idamesini güçleştiren bir durumdur. Bu
çalışmanın amacı, periodontitis tedavisinde amoksisilin ve metronidazol
kombinasyonunun tedavi sonrası 6 aylık dönemde klinik ve mikrobiyolojik
etkilerinin değerlendirilmesidir.
Gereç ve Yöntemler: Yirmi iki
periodontitis hastası test (n=12) ve kontrol (n=10) gruplarına ayrıldı. Test
grubu diştaşı temizliği ve kök yüzeyi düzleştirmesi işlemlerine ilaveten eş
zamanlı amoksisilin ve metronidazol tedavisi alır iken, kontol grubuna yalnızca
diştaşı temizliği ve kök yüzeyi düzleştirmesi uygulandı. Klinik
değerlendirmeler başlangıçta ve 1, 3 ve 6. takip aylarında gerçekleştirildi. Fusobacterium
nucleatum, Tannerella forsythia ve
Prevotella intermedia seviyeleri gerçek zamanlı polimeraz zincir reaksiyonu yöntemi ile
belirlendi.
Bulgular: Her iki
grupta da bütün takip aylarında başlangıca göre anlamlı düzelmeler gözlendi.
Bununla beraber, test grubunda 3. ve 6. aylarda kontrol grubunda göre daha
fazla düzeyde klinik iyileşmeler tespit edildi. Her iki grupta da incelenen
bakterilerin miktarlarında belirli düşüşler görülse de, yalnızca T. forsythia seviyeleri tüm takip
aylarında test grubunda kontrol grubuna göre anlamlı seviyelerde düşüş
gösterdi.
Sonuçlar: Bu
çalışmanın sonuçları, diştaşı temizliği ve kök yüzeyi düzleştirmesine ilaveten
uygulanan amoksisilin/metronidazole tedavisinin ilave klinik faydalar ortaya
koyduğunu göstermektedir. Ayrıca, destekleyici antibiyotik tedavisi T. forsythia rekolonizasyonunu
baskılamıştır.
Anahtar Kelimeler: periodontitis; amoksisilin; metronidazol; Real-Time
PCR
Supporting Institution
Selçuk Üniversitesi Bilimsel Araştırma Projeleri
Project Number
07102014
Thanks
Bu çalışma sorumlu yazar olan Emre Yaprak'ın doktora tezinden elde edilen verilerden üretilmiştir. Çalışmamızı finansal olarak desteklediği için Selçuk Üniversitesi Bilimsel Araştırma Projeleri (BAP) birimine teşekkür ederiz.
References
- Referans1 Meng H, Xu L, Li Q, Han J, Zhao Y. Determinants of host susceptibility in aggressive periodontitis. Periodontol 2000 2007;43:133-159.
- Referans2 Marsh PD. Dental plaque: biological significance of a biofilm and community life-style. J Clin Periodontol 2005;32:7-15.
- Referans3 Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol 1998;25:134-144.
- Referans4 Bradshaw DJ, Marsh PD, Watson GK, Allison C. Role of Fusobacterium nucleatum and coaggregation in anaerobe survival in planktonic and biofilm oral microbial communities during aeration. Infect Immun 1998;66:4729-4732.
- Referans5 Sharma A. Virulence mechanisms of Tannerella forsythia. Periodontol 2000 2010;54:106-116.
- Referans6 Sharma A, Inagaki S, Sigurdson W, Kuramitsu HK. Synergy between Tannerella forsythia and Fusobacterium nucleatum in biofilm formation. Oral Microbiol Immun 2005;20:39-42.
- Referans7 Huang RJ, Li MY, Gregory RL. Bacterial interactions in dental biofilm. Virulence 2011;2:435-444.
- Referans8 Mombelli A. Maintenance therapy for teeth and implants. Periodontol 2000 2019;79:190-199.
- Referans9 Suvan JE. Effectiveness of mechanical nonsurgical pocket therapy. Periodontol 2000 2005;37:48-71.
- Referans10 Mombelli A. Microbial colonization of the periodontal pocket and its significance for periodontal therapy. Periodontol 2000 2018;76:85-96.
- Referans11 Slots J, Ting M. Systemic antibiotics in the treatment of periodontal disease. Periodontol 2000 2002;28:106-176.
- Referans12 Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol 1988;59:493-503.
- Referans13 Feres M, Figueiredo LC, Soares GMS, Faveri M. Systemic antibiotics in the treatment of periodontitis. Periodontol 2000 2015;67:131-186.
- Referans14 Schlagenhauf U, Burgemeister S. Adjunctive use of amoxicillin/metronidazole in aggressive periodontitis refractory to mechanical/surgical therapy. Clinical results after 1 year. J Dent Res 2002;81:B249-B249.
- Referans15 Rabelo CC, Feres M, Goncalves C, et al. Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta-analysis. J Clin Periodontol 2015;42:647-657.
- Referans16 Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol 2018;45:S1-S8.
- Referans17 Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4:1-6.
- Referans18 Guerrero A, Griffiths GS, Nibali L, et al. Adjunctive benefits of systemic amoxicillin and metronidazole in non-surgical treatment of generalized aggressive periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol 2005;32:1096-1107.
- Referans19 Xajigeorgiou C, Sakellari D, Slini T, Baka A, Konstantinidis A. Clinical and microbiological effects of different antimicrobials on generalized aggressive periodontitis. J Clin Periodontol 2006;33:254-264.
- Referans20 Mombelli A, Brochut P, Plagnat D, Casagni F, Giannopoulou C. Enamel matrix proteins and systemic antibiotics as adjuncts to non-surgical periodontal treatment: clinical effects. J Clin Periodontol 2005;32:225-230.
- Referans21 Ehmke B, Moter A, Beikler T, Milian E, Flemmig TF. Adjunctive antimicrobial therapy of periodontitis: Long-term effects on disease progression and oral colonization. J Periodontol 2005;76:749-759.
- Referans22 Gomi K, Yashima A, Nagano T, Kanazashi M, Maeda N, Arai T. Effects of full-mouth scaling and root planing in conjunction with systemically administered azithromycin. J Periodontol 2007;78:422-429.
- Referans23 Goodson JM, Haffajee AD, Socransky SS, et al. Control of periodontal infections: A randomized controlled trial I. The primary outcome attachment gain and pocket depth reduction at treated sites. J Clin Periodontol 2012;39:526-536.
- Referans24 Lopez NJ, Socransky SS, Da Silva I, Japlit MR, Haffajee AD. Effects of metronidazole plus amoxicillin as the only therapy on the microbiological and clinical parameters of untreated chronic periodontitis. J Clin Periodontol 2006;33:648-660.
- Referans25 Varela VM, Heller D, Silva-Senem MX, Torres MCMB, Colombo APV, Feres EJ. Systemic Antimicrobials Adjunctive to a Repeated Mechanical and Antiseptic Therapy for Aggressive Periodontitis: A 6-Month Randomized Controlled Trial. J Periodontol 2011;82:1121-1130.
- Referans26 Ribeiro ED, Bittencourt S, Zanin ICJ, et al. Full-Mouth Ultrasonic Debridement Associated With Amoxicillin and Metronidazole in the Treatment of Severe Chronic Periodontitis. J Periodontol 2009;80:1254-1264.
- Referans27 Paster BJ, Dewhirst FE. Molecular microbial diagnosis. Periodontol 2000 2009;51:38-44.
- Referans28 Boutaga K, Van Winkelhoff AJ, Vandenbroucke-Grauls CMJE, Savelkoul PHM. The additional value of real-time PCR in the quantitative detection of periodontal pathogens. J Clin Periodontol 2006;33:427-433.
- Referans29 Casarin RCV, Ribeiro ED, Sallum EA, Nociti FH, Goncalves RB, Casati MZ. The Combination of Amoxicillin and Metronidazole Improves Clinical and Microbiologic Results of One-Stage, Full-Mouth, Ultrasonic Debridement in Aggressive Periodontitis Treatment. J Periodontol 2012;83:988-998.
- Referans30 Cionca N, Giannopoulou C, Ugolotti G, Mombelli A. Microbiologic Testing and Outcomes of Full-Mouth Scaling and Root Planing With or Without Amoxicillin/Metronidazole in Chronic Periodontitis. J Periodontol 2010;81:15-23.
- Referans31 Yek EC, Cintan S, Topcuoglu N, Kulekci G, Issever H, Kantarci A. Efficacy of Amoxicillin and Metronidazole Combination far the Management of Generalized Aggressive Periodontitis. J Periodontol 2010;81:964-974.
- Referans32 Matto J, Asikainen S, Vaisanen ML, et al. Beta-lactamase production in Prevotella intermedia, Prevotella nigrescens, and Prevotella pallens genotypes and in vitro susceptibilities to selected antimicrobial agents. Antimicrob Agents Chemother 1999;43:2383-2388.
- Referans33 Duncan MJ. Genomics of oral bacteria. Crit Rev Oral Biol M 2003;14:175-187.
- Referans34 McGowan K, McGowan T, Ivanovski S. Optimal dose and duration of amoxicillin-plus-metronidazole as an adjunct to non-surgical periodontal therapy: A systematic review and meta-analysis of randomized, placebo-controlled trials. J Clin Periodontol 2018;45:56-67.
Effect of adjunctive amoxicillin/metronidazole treatment on subgingival Tannerella forsythia, Prevotella intermedia and Fusobacterium nucleatum recolonization in periodontitis patients
Abstract
Background: The use of antibiotics adjunctive to non-surgical
periodontal treatment is an accepted approach in the treatment of
periodontitis. However, bacterial recolonization is a major drawback which complicates
the maintenance of therapeutic acquisitions. The aim of this study was to
evaluate the clinical and microbiological effects of adjunctive amoxicillin and
metronidazole combination in the treatment of periodontitis during 6 months
follow-up.
Methods: Twenty-two periodontitis patients were assigned as
test (n=12) and control (n=10) groups. While test group received amoxicillin
and metronidazole combination as an adjunct to scaling and root planing,
control group treated with scaling and root planing alone. Clinical
examinations and subgingival dental plaque sampling were conducted at baseline
and 1, 3 and 6. months during the follow-up. Fusobacterium nucleatum, Tannerella forsythia and Prevotella intermedia levels were
determined using real time polymerase chain reaction method.
Results: Both groups exhibited significant improvements in
each follow-up period when compared to baseline. However, clinical improvements
in test group were more prominent than control group as 3rd and 6th
months. While some decrease was notable in the counts of all investigated bacteria
in both groups, only T. forsythia
levels significantly reduced at all follow-up months in test group comparing
with controls.
Conclusions: The results of this study indicated that
amoxicillin/metronidazole treatment adjunctive to scaling and root planing
provided additional clinical benefits and suppressed the T. forsythia recolonization.
Keywords: periodontitis; amoxicillin; metronidazole; Real-Time
PCR
Project Number
07102014
References
- Referans1 Meng H, Xu L, Li Q, Han J, Zhao Y. Determinants of host susceptibility in aggressive periodontitis. Periodontol 2000 2007;43:133-159.
- Referans2 Marsh PD. Dental plaque: biological significance of a biofilm and community life-style. J Clin Periodontol 2005;32:7-15.
- Referans3 Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol 1998;25:134-144.
- Referans4 Bradshaw DJ, Marsh PD, Watson GK, Allison C. Role of Fusobacterium nucleatum and coaggregation in anaerobe survival in planktonic and biofilm oral microbial communities during aeration. Infect Immun 1998;66:4729-4732.
- Referans5 Sharma A. Virulence mechanisms of Tannerella forsythia. Periodontol 2000 2010;54:106-116.
- Referans6 Sharma A, Inagaki S, Sigurdson W, Kuramitsu HK. Synergy between Tannerella forsythia and Fusobacterium nucleatum in biofilm formation. Oral Microbiol Immun 2005;20:39-42.
- Referans7 Huang RJ, Li MY, Gregory RL. Bacterial interactions in dental biofilm. Virulence 2011;2:435-444.
- Referans8 Mombelli A. Maintenance therapy for teeth and implants. Periodontol 2000 2019;79:190-199.
- Referans9 Suvan JE. Effectiveness of mechanical nonsurgical pocket therapy. Periodontol 2000 2005;37:48-71.
- Referans10 Mombelli A. Microbial colonization of the periodontal pocket and its significance for periodontal therapy. Periodontol 2000 2018;76:85-96.
- Referans11 Slots J, Ting M. Systemic antibiotics in the treatment of periodontal disease. Periodontol 2000 2002;28:106-176.
- Referans12 Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol 1988;59:493-503.
- Referans13 Feres M, Figueiredo LC, Soares GMS, Faveri M. Systemic antibiotics in the treatment of periodontitis. Periodontol 2000 2015;67:131-186.
- Referans14 Schlagenhauf U, Burgemeister S. Adjunctive use of amoxicillin/metronidazole in aggressive periodontitis refractory to mechanical/surgical therapy. Clinical results after 1 year. J Dent Res 2002;81:B249-B249.
- Referans15 Rabelo CC, Feres M, Goncalves C, et al. Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta-analysis. J Clin Periodontol 2015;42:647-657.
- Referans16 Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol 2018;45:S1-S8.
- Referans17 Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4:1-6.
- Referans18 Guerrero A, Griffiths GS, Nibali L, et al. Adjunctive benefits of systemic amoxicillin and metronidazole in non-surgical treatment of generalized aggressive periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol 2005;32:1096-1107.
- Referans19 Xajigeorgiou C, Sakellari D, Slini T, Baka A, Konstantinidis A. Clinical and microbiological effects of different antimicrobials on generalized aggressive periodontitis. J Clin Periodontol 2006;33:254-264.
- Referans20 Mombelli A, Brochut P, Plagnat D, Casagni F, Giannopoulou C. Enamel matrix proteins and systemic antibiotics as adjuncts to non-surgical periodontal treatment: clinical effects. J Clin Periodontol 2005;32:225-230.
- Referans21 Ehmke B, Moter A, Beikler T, Milian E, Flemmig TF. Adjunctive antimicrobial therapy of periodontitis: Long-term effects on disease progression and oral colonization. J Periodontol 2005;76:749-759.
- Referans22 Gomi K, Yashima A, Nagano T, Kanazashi M, Maeda N, Arai T. Effects of full-mouth scaling and root planing in conjunction with systemically administered azithromycin. J Periodontol 2007;78:422-429.
- Referans23 Goodson JM, Haffajee AD, Socransky SS, et al. Control of periodontal infections: A randomized controlled trial I. The primary outcome attachment gain and pocket depth reduction at treated sites. J Clin Periodontol 2012;39:526-536.
- Referans24 Lopez NJ, Socransky SS, Da Silva I, Japlit MR, Haffajee AD. Effects of metronidazole plus amoxicillin as the only therapy on the microbiological and clinical parameters of untreated chronic periodontitis. J Clin Periodontol 2006;33:648-660.
- Referans25 Varela VM, Heller D, Silva-Senem MX, Torres MCMB, Colombo APV, Feres EJ. Systemic Antimicrobials Adjunctive to a Repeated Mechanical and Antiseptic Therapy for Aggressive Periodontitis: A 6-Month Randomized Controlled Trial. J Periodontol 2011;82:1121-1130.
- Referans26 Ribeiro ED, Bittencourt S, Zanin ICJ, et al. Full-Mouth Ultrasonic Debridement Associated With Amoxicillin and Metronidazole in the Treatment of Severe Chronic Periodontitis. J Periodontol 2009;80:1254-1264.
- Referans27 Paster BJ, Dewhirst FE. Molecular microbial diagnosis. Periodontol 2000 2009;51:38-44.
- Referans28 Boutaga K, Van Winkelhoff AJ, Vandenbroucke-Grauls CMJE, Savelkoul PHM. The additional value of real-time PCR in the quantitative detection of periodontal pathogens. J Clin Periodontol 2006;33:427-433.
- Referans29 Casarin RCV, Ribeiro ED, Sallum EA, Nociti FH, Goncalves RB, Casati MZ. The Combination of Amoxicillin and Metronidazole Improves Clinical and Microbiologic Results of One-Stage, Full-Mouth, Ultrasonic Debridement in Aggressive Periodontitis Treatment. J Periodontol 2012;83:988-998.
- Referans30 Cionca N, Giannopoulou C, Ugolotti G, Mombelli A. Microbiologic Testing and Outcomes of Full-Mouth Scaling and Root Planing With or Without Amoxicillin/Metronidazole in Chronic Periodontitis. J Periodontol 2010;81:15-23.
- Referans31 Yek EC, Cintan S, Topcuoglu N, Kulekci G, Issever H, Kantarci A. Efficacy of Amoxicillin and Metronidazole Combination far the Management of Generalized Aggressive Periodontitis. J Periodontol 2010;81:964-974.
- Referans32 Matto J, Asikainen S, Vaisanen ML, et al. Beta-lactamase production in Prevotella intermedia, Prevotella nigrescens, and Prevotella pallens genotypes and in vitro susceptibilities to selected antimicrobial agents. Antimicrob Agents Chemother 1999;43:2383-2388.
- Referans33 Duncan MJ. Genomics of oral bacteria. Crit Rev Oral Biol M 2003;14:175-187.
- Referans34 McGowan K, McGowan T, Ivanovski S. Optimal dose and duration of amoxicillin-plus-metronidazole as an adjunct to non-surgical periodontal therapy: A systematic review and meta-analysis of randomized, placebo-controlled trials. J Clin Periodontol 2018;45:56-67.
Details
| Primary Language | English |
|---|---|
| Subjects | Dentistry |
| Journal Section | Research |
| Authors | |
| Project Number | 07102014 |
| Publication Date | August 1, 2019 |
| Submission Date | May 6, 2019 |
| Published in Issue | Year 2019 Volume: 6 Issue: 2 |
Selcuk Dental Journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).