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Published in: Clinical Oral Investigations 9/2018

01-12-2018 | Original Article

Microbiological analysis and the outcomes of periodontal treatment with or without adjunctive systemic antibiotics—a retrospective study

Authors: Sigrun Eick, Jasmin Nydegger, Walter Bürgin, Giovanni E. Salvi, Anton Sculean, Christoph Ramseier

Published in: Clinical Oral Investigations | Issue 9/2018

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Abstract

Objectives

The purpose of this retrospective study was to assess the impact of microbiological diagnostics on the outcomes of periodontal treatment with or without adjunctive use of systemic antibiotics.

Materials and methods

Patient files were screened for microbiological analysis before (T1) and after non-surgical periodontal therapy (T2). Medical history, diagnosis, clinical data, and results of the microbiological analysis were extracted from the patient’s file. After descriptive statistics, logistic regression analysis was performed to model the presence of 90 and 50% reductions of numbers of sites with probing depths (PD) of ≥ 5 mm at T2 (90%-PD5 and 50%-PD5), respectively, against the presence of bacterial species, clinical diagnosis, and adjunctive use of systemic antibiotics.

Results

Eighteen patients diagnosed with aggressive periodontitis (AP, 17 with adjunctive antibiotics) and 84 with chronic periodontitis (CP, 31 with adjunctive antibiotics) were included in the analysis. Logistic modeling of bacteria at T1 to 90%-PD5 failed to show any statistical significance. Using 50%-PD5, presence of all Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola and in particular of T. denticola at T1 was associated with good response to therapy. Modeling of bacterial presence to 90-%PD5 and to 50-%PD5 at T2 found an association with absence of T. forsythia (90-%PD5 and 50-%PD5) and of T. denticola and Campylobacter rectus (50%-PD5). Modeling bacteria at T1, antibiotic group and oral hygiene at T2 on 50%-PD5 revealed odds ratio (OR) of the adjunctive antibiotic group between 2.70 and 52.4, of the oral hygiene between 3.27 and 4.11, and of the bacteria at T1 up to 28.6 (Porphyromonas gingivalis, T. forsythia, or T. denticola).

Conclusion

Microbiological analysis of the most important species associated with periodontal diseases appears to support a clinically based decision for the adjunctive use of systemic antibiotics.

Clinical relevance

The present findings appear to support the use microbiological testing to strengthen the clinical decision making process for either using or not using systemic antibiotics in conjunction with non-surgical periodontal therapy.
Literature
2.
go back to reference Apatzidou DA, Kinane DF (2010) Nonsurgical mechanical treatment strategies for periodontal disease. Dent Clin N Am 54:1–12CrossRef Apatzidou DA, Kinane DF (2010) Nonsurgical mechanical treatment strategies for periodontal disease. Dent Clin N Am 54:1–12CrossRef
3.
go back to reference Sgolastra F, Severino M, Petrucci A, Gatto R, Monaco A (2014) Effectiveness of metronidazole as an adjunct to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta-analysis. J Periodontal Res 49:10–19CrossRef Sgolastra F, Severino M, Petrucci A, Gatto R, Monaco A (2014) Effectiveness of metronidazole as an adjunct to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta-analysis. J Periodontal Res 49:10–19CrossRef
4.
go back to reference Zandbergen D, Slot DE, Cobb CM, Van der Weijden FA (2013) The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontol 84:332–351CrossRef Zandbergen D, Slot DE, Cobb CM, Van der Weijden FA (2013) The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontol 84:332–351CrossRef
10.
go back to reference Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr (1998) Microbial complexes in subgingival plaque. J Clin Periodontol 25:134–144CrossRef Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr (1998) Microbial complexes in subgingival plaque. J Clin Periodontol 25:134–144CrossRef
16.
go back to reference D'Ercole S, Catamo G, Tripodi D, Piccolomini R (2008) Comparison of culture methods and multiplex PCR for the detection of periodontopathogenic bacteria in biofilm associated with severe forms of periodontitis. New Microbiol 31:383–391PubMed D'Ercole S, Catamo G, Tripodi D, Piccolomini R (2008) Comparison of culture methods and multiplex PCR for the detection of periodontopathogenic bacteria in biofilm associated with severe forms of periodontitis. New Microbiol 31:383–391PubMed
20.
go back to reference Eick S, Pfister W (2002) Comparison of microbial cultivation and a commercial PCR based method for detection of periodontopathogenic species in subgingival plaque samples. J Clin Periodontol 29:638–644CrossRef Eick S, Pfister W (2002) Comparison of microbial cultivation and a commercial PCR based method for detection of periodontopathogenic species in subgingival plaque samples. J Clin Periodontol 29:638–644CrossRef
22.
go back to reference SAS Institute Inc. (2013) SAS/STAT® user’s guide. Version 9.4. SAS Institute Inc., Cary SAS Institute Inc. (2013) SAS/STAT® user’s guide. Version 9.4. SAS Institute Inc., Cary
23.
go back to reference Yang JL, Wang MS, Cheng AC, Pan KC, Li CF, Deng SX (2008) A simple and rapid method for extracting bacterial DNA from intestinal microflora for ERIC-PCR detection. World J Gastroenterol 14:2872–2876CrossRef Yang JL, Wang MS, Cheng AC, Pan KC, Li CF, Deng SX (2008) A simple and rapid method for extracting bacterial DNA from intestinal microflora for ERIC-PCR detection. World J Gastroenterol 14:2872–2876CrossRef
24.
39.
go back to reference Feres M, Soares GM, Mendes JA, Silva MP, Faveri M, Teles R, Socransky SS, Figueiredo LC (2012) Metronidazole alone or with amoxicillin as adjuncts to non-surgical treatment of chronic periodontitis: a 1-year double-blinded, placebo-controlled, randomized clinical trial. J Clin Periodontol 39:1149–1158. https://doi.org/10.1111/jcpe.12004 CrossRefPubMed Feres M, Soares GM, Mendes JA, Silva MP, Faveri M, Teles R, Socransky SS, Figueiredo LC (2012) Metronidazole alone or with amoxicillin as adjuncts to non-surgical treatment of chronic periodontitis: a 1-year double-blinded, placebo-controlled, randomized clinical trial. J Clin Periodontol 39:1149–1158. https://​doi.​org/​10.​1111/​jcpe.​12004 CrossRefPubMed
44.
go back to reference Wiksten JE, Pitkaranta A, Blomgren K (2016) Metronidazole in conjunction with penicillin neither prevents recurrence nor enhances recovery from peritonsillar abscess when compared with penicillin alone: a prospective, double-blind, randomized, placebo-controlled trial. J Antimicrob Chemother 71:1681–1687. https://doi.org/10.1093/jac/dkw038 CrossRefPubMed Wiksten JE, Pitkaranta A, Blomgren K (2016) Metronidazole in conjunction with penicillin neither prevents recurrence nor enhances recovery from peritonsillar abscess when compared with penicillin alone: a prospective, double-blind, randomized, placebo-controlled trial. J Antimicrob Chemother 71:1681–1687. https://​doi.​org/​10.​1093/​jac/​dkw038 CrossRefPubMed
Metadata
Title
Microbiological analysis and the outcomes of periodontal treatment with or without adjunctive systemic antibiotics—a retrospective study
Authors
Sigrun Eick
Jasmin Nydegger
Walter Bürgin
Giovanni E. Salvi
Anton Sculean
Christoph Ramseier
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 9/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2392-3

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