Top

Published in:

01-10-2019 | Wound Debridement | Original Article

Microbiological dynamics of red complex bacteria following full-mouth air polishing in periodontally healthy subjects—a randomized clinical pilot study

Authors: Belinda Reinhardt, Astrid Klocke, Sarah H. Neering, Sabine Selbach, Ulrike Peters, Thomas F. Flemmig, Thomas Beikler

Published in: Clinical Oral Investigations | Issue 10/2019

Abstract

Objectives

Suppression of periodontal pathogens in the oral cavity of periodontally healthy individuals may lower the risk for periodontal or periimplant diseases. Therefore, the present study aimed to analyze the effect of supragingival debridement (SD) with adjunctive full mouth glycine powder air polishing (FM-GPAP) on the prevalence of periodontal pathogens in periodontally healthy individuals.

Materials and Methods

Eighty-seven systemically and periodontally healthy intraoral carriers of red complex bacteria, i.e., Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola or other periodontal pathogens including Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Eikenella corrodens were enrolled into the study and randomly assigned to receive SD with adjunctive FM-GPAP (test, n = 42) or SD alone (control, n = 45). In the first observation period, microbiological samples were obtained prior to, and 2, 5, and 9 days following intervention. If one of these periodontal pathogens could still not be identified, additional microbial sampling was performed after 6 and 12 weeks.

Results

The prevalence of red complex bacteria was significantly reduced in the test compared to the control group following treatment (p = 0.004) and at day 9 (p = 0.031). Intragroup comparison showed a significant (test, p < 0.001; control, p ≤ 0.01) reduction in the mean prevalence in both groups from BL through day 9 with an additional significant intergroup difference (p = 0.048) at day 9. However, the initial strong reduction returned to baseline values after 6 and 12 weeks.

Conclusion

In periodontally healthy carriers of periodontal pathogens, FM-GPAP as an adjunct to SD transiently enhances the suppression of red complex bacteria.

Clinical relevance

Whether the enhanced suppression of red complex bacteria by adjunctive FM-GPAP prevents the development of periodontitis in periodontally healthy carriers requires further investigations.

Zee KY (2009) Smoking and periodontal disease. Aust Dent J 54(Suppl 1):S44–S50. https://doi.org/10.1111/j.1834-7819.2009.01142.x CrossRefPubMed

Genco RJ, Borgnakke WS (2013) Risk factors for periodontal disease. Periodontol 2000 62:59–94. https://doi.org/10.1111/j.1600-0757.2012.00457.x CrossRefPubMed

Clark WB, Loe H (1993) Mechanisms of initiation and progression of periodontal disease. Periodontol 2000 2:72–82CrossRef

Darveau RP, Tanner A, Page RC (1997) The microbial challenge in periodontitis. Periodontol 2000 14:12–32CrossRef

Flemmig TF, Beikler T (2011) Control of oral biofilms. Periodontol 2000 55:9–15. https://doi.org/10.1111/j.1600-0757.2010.00383.x CrossRefPubMed

Pozhitkov AE, Leroux BG, Randolph TW, Beikler T, Flemmig TF, Noble PA (2015) Towards microbiome transplant as a therapy for periodontitis: an exploratory study of periodontitis microbial signature contrasted by oral health, caries and edentulism. BMC Oral Health 15:125CrossRef

Rafiei M, Kiani F, Sayehmiri K, Sayehmiri F, Tavirani M, Dousti M, Sheikhi A (2018) Prevalence of anaerobic bacteria (P.gingivalis) as major microbial agent in the incidence periodontal diseases by meta-analysis. J Dent (Shiraz) 19:232–242

Nadkarni MA, Chhour KL, Browne GV, Byun R, Nguyen KA, Chapple CC, Jacques NA, Hunter N (2015) Age-dependent changes in Porphyromonas gingivalis and Prevotella species/phylotypes in healthy gingiva and inflamed/diseased sub-gingival sites. Clin Oral Investig 19:911–919. https://doi.org/10.1007/s00784-014-1301-7 CrossRefPubMed

Aruni AW, Dou Y, Mishra A, Fletcher HM (2015) The Biofilm Community-Rebels with a Cause. Curr Oral Health Rep 2:48–56CrossRef

10.

Kinane DF, Galicia JC, Gorr SU, Stathopoulou PG, Benakanakere M (2008) P. gingivalis interactions with epithelial cells. Front Biosci 13:966–984CrossRef

11.

Lamont RJ, Hajishengallis G (2015) Polymicrobial synergy and dysbiosis in inflammatory disease. Trends Mol Med 21:172–183CrossRef

12.

Aas JA, Paster BJ, Stokes LN, Olsen I, Dewhirst FE (2005) Defining the normal bacterial flora of the oral cavity. J Clin Microbiol 43:5721–5732CrossRef

13.

Duran-Pinedo AE, Baker VD, Frias-Lopez J (2014) The periodontal pathogen Porphyromonas gingivalis induces expression of transposases and cell death of Streptococcus mitis in a biofilm model. Infect Immun 82:3374–3382CrossRef

14.

Bosshardt DD (2018) The periodontal pocket: pathogenesis, histopathology and consequences. Periodontol 2000 76:43–50. https://doi.org/10.1111/prd.12153 CrossRefPubMed

15.

Mineoka T, Awano S, Rikimaru T, Kurata H, Yoshida A, Ansai T, Takehara T (2008) Site-specific development of periodontal disease is associated with increased levels of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in subgingival plaque. J Periodontol 79:670–676. https://doi.org/10.1902/jop.2008.070398 CrossRefPubMed

16.

Yao ES, Lamont RJ, Leu SP, Weinberg A (1996) Interbacterial binding among strains of pathogenic and commensal oral bacterial species. Oral Microbiol Immunol 11:35–41CrossRef

17.

Kolenbrander PE, Andersen RN (1989) Inhibition of coaggregation between Fusobacterium nucleatum and Porphyromonas (Bacteroides) gingivalis by lactose and related sugars. Infect Immun 57:3204–3209PubMedPubMedCentral

18.

Kolenbrander PE, Palmer RJ Jr, Rickard AH, Jakubovics NS, Chalmers NI, Diaz PI (2006) Bacterial interactions and successions during plaque development. Periodontol 2000 42:47–79. https://doi.org/10.1111/j.1600-0757.2006.00187.x CrossRefPubMed

19.

Abusleme L, Dupuy AK, Dutzan N, Silva N, Burleson JA, Strausbaugh LD, Gamonal J, Diaz PI (2013) The subgingival microbiome in health and periodontitis and its relationship with community biomass and inflammation. ISME J 7:1016–1025CrossRef

20.

Riep B, Edesi-Neuss L, Claessen F, Skarabis H, Ehmke B, Flemmig TF, Bernimoulin JP, Gobel UB, Moter A (2009) Are putative periodontal pathogens reliable diagnostic markers? J Clin Microbiol 47:1705–1711CrossRef

21.

Beikler T, Abdeen G, Schnitzer S, Salzer S, Ehmke B, Heinecke A, Flemmig TF (2004) Microbiological shifts in intra- and extraoral habitats following mechanical periodontal therapy. J Clin Periodontol 31:777–783. https://doi.org/10.1111/j.1600-051X.2004.00557.x CrossRefPubMed

22.

Beikler T, Schnitzer S, Abdeen G, Ehmke B, Eisenacher M, Flemmig TF (2006) Sampling strategy for intraoral detection of periodontal pathogens before and following periodontal therapy. J Periodontol 77:1323–1332. https://doi.org/10.1902/jop.2006.050204 CrossRefPubMed

23.

Ximenez-Fyvie LA, Haffajee AD, Socransky SS (2000) Comparison of the microbiota of supra- and subgingival plaque in health and periodontitis. J Clin Periodontol 27:648–657CrossRef

24.

Carrouel F, Viennot S, Santamaria J, Veber P, Bourgeois D (2016) Quantitative molecular detection of 19 major pathogens in the interdental biofilm of periodontally healthy young adults. Front Microbiol 7:840CrossRef

25.

Tallarico M, Canullo L, Caneva M, Ozcan M (2017) Microbial colonization at the implant-abutment interface and its possible influence on periimplantitis: a systematic review and meta-analysis. J Prosthodont Res 61:233–241. https://doi.org/10.1016/j.jpor.2017.03.001 CrossRefPubMed

26.

Jervoe-Storm PM, Jepsen S, Johren P, Mericske-Stern R, Enkling N (2015) Internal bacterial colonization of implants: association with peri-implant bone loss. Clin Oral Implants Res 26:957–963. https://doi.org/10.1111/clr.12421 CrossRefPubMed

27.

Keller W, Bragger U, Mombelli A (1998) Peri-implant microflora of implants with cemented and screw retained suprastructures. Clin Oral Implants Res 9:209–217CrossRef

28.

Leonhardt A, Dahlen G, Renvert S (2003) Five-year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man. J Periodontol 74:1415–1422. https://doi.org/10.1902/jop.2003.74.10.1415 CrossRefPubMed

29.

Flemmig TF, Hetzel M, Topoll H, Gerss J, Haeberlein I, Petersilka G (2007) Subgingival debridement efficacy of glycine powder air polishing. J Periodontol 78:1002–1010. https://doi.org/10.1902/jop.2007.060420 CrossRefPubMed

30.

Pelka MA, Altmaier K, Petschelt A, Lohbauer U (2010) The effect of air-polishing abrasives on wear of direct restoration materials and sealants. J Am Dent Assoc 141:63–70CrossRef

31.

Petersilka G, Faggion CM Jr, Stratmann U, Gerss J, Ehmke B, Haeberlein I, Flemmig TF (2008) Effect of glycine powder air-polishing on the gingiva. J Clin Periodontol 35:324–332. https://doi.org/10.1111/j.1600-051X.2007.01195.x CrossRefPubMed

32.

Petersilka GJ (2011) Subgingival air-polishing in the treatment of periodontal biofilm infections. Periodontol 2000 55:124–142. https://doi.org/10.1111/j.1600-0757.2010.00342.x CrossRefPubMed

33.

Charles CJ, Charles AH (1994) Periodontal screening and recording. J Calif Dent Assoc 22:43–46PubMed

34.

Ainamo J, Barmes D, Beagrie G, Cutress T, Martin J, Sardo-Infirri J (1982) Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN). Int Dent J 32:281–291PubMed

35.

Saxer UPM, R H (1975) Motivation and education. SSO Schweiz Monatsschr Zahnheilkd 85:905–919PubMed

36.

Lange DEP, C H, Eenboom A, Promesberger A (1977) Clinical methods for the objective evaluation of oral hygiene. Dtsch Zahnarztl Z 32:44–47PubMed

37.

Ashimoto A, Chen C, Bakker I, Slots J (1996) Polymerase chain reaction detection of 8 putative periodontal pathogens in subgingival plaque of gingivitis and advanced periodontitis lesions. Oral Microbiol Immunol 11:266–273CrossRef

38.

Stubbs SL, Brazier JS, O'Neill GL, Duerden BI (1999) PCR targeted to the 16S-23S rRNA gene intergenic spacer region of Clostridium difficile and construction of a library consisting of 116 different PCR ribotypes. J Clin Microbiol 37:461–463PubMedPubMedCentral

39.

Quirynen M, De Soete M, Dierickx K, van Steenberghe D (2001) The intra-oral translocation of periodontopathogens jeopardises the outcome of periodontal therapy. A review of the literature. J Clin Periodontol 28:499–507CrossRef

40.

Leblebicioglu B, Kulekci G, Ciftci S, Keskin F, Badur S (2009) Salivary detection of periodontopathic bacteria and periodontal health status in dental students. Anaerobe 15:82–86. https://doi.org/10.1016/j.anaerobe.2008.12.005 CrossRefPubMed

41.

Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr (1998) Microbial complexes in subgingival plaque. J Clin Periodontol 25:134–144CrossRef

42.

Tan KH, Seers CA, Dashper SG, Mitchell HL, Pyke JS, Meuric V, Slakeski N, Cleal SM, Chambers JL, McConville MJ, Reynolds EC (2014) Porphyromonas gingivalis and Treponema denticola exhibit metabolic symbioses. PLoS Pathog 10:e1003955CrossRef

43.

Tanner A, Maiden MF, Macuch PJ, Murray LL, Kent RL Jr (1998) Microbiota of health, gingivitis, and initial periodontitis. J Clin Periodontol 25:85–98CrossRef

44.

Thurnheer T, Belibasakis GN, Bostanci N (2014) Colonisation of gingival epithelia by subgingival biofilms in vitro: role of “red complex” bacteria. Arch Oral Biol 59:977–986. https://doi.org/10.1016/j.archoralbio.2014.05.023 CrossRefPubMed

45.

Hajishengallis G, Liang S, Payne MA, Hashim A, Jotwani R, Eskan MA, McIntosh ML, Alsam A, Kirkwood KL, Lambris JD, Darveau RP, Curtis MA (2011) Low-abundance biofilm species orchestrates inflammatory periodontal disease through the commensal microbiota and complement. Cell Host Microbe 10:497–506CrossRef

46.

Nussbaum G, Shapira L (2011) How has neutrophil research improved our understanding of periodontal pathogenesis? J Clin Periodontol 38(Suppl 11):49–59. https://doi.org/10.1111/j.1600-051X.2010.01678.x CrossRefPubMed

47.

van Winkelhoff AJ, Rams TE, Slots J (1996) Systemic antibiotic therapy in periodontics. Periodontol 2000 10:45–78CrossRef

48.

Jepsen K, Jepsen S (2016) Antibiotics/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced periodontitis. Periodontol 2000 71:82–112. https://doi.org/10.1111/prd.12121 CrossRefPubMed

49.

Badersten A, Nilveus R, Egelberg J (1981) Effect of nonsurgical periodontal therapy. I. Moderately advanced periodontitis. J Clin Periodontol 8:57–72CrossRef

50.

Wilder-Smith P, Arrastia AM, Schell MJ, Liaw LH, Grill G, Berns MW (1995) Effect of ND:YAG laser irradiation and root planing on the root surface: structural and thermal effects. J Periodontol 66:1032–1039. https://doi.org/10.1902/jop.1995.66.12.1032 CrossRefPubMed

51.

Flemmig TF, Arushanov D, Daubert D, Rothen M, Mueller G, Leroux BG (2012) Randomized controlled trial assessing efficacy and safety of glycine powder air polishing in moderate-to-deep periodontal pockets. J Periodontol 83:444–452. https://doi.org/10.1902/jop.2011.110367 CrossRefPubMed

52.

Mussano F, Rovasio S, Schierano G, Baldi I, Carossa S (2013) The effect of glycine-powder airflow and hand instrumentation on peri-implant soft tissues: a split-mouth pilot study. Int J Prosthodont 26:42–44CrossRef

53.

Eick S, Pfister W (2004) Efficacy of antibiotics against periodontopathogenic bacteria within epithelial cells: an in vitro study. J Periodontol 75:1327–1334. https://doi.org/10.1902/jop.2004.75.10.1327 CrossRefPubMed

54.

Matsunaga T, Nakayuki A, Saito Y, Kato A, Noiri Y, Ebisu S, Azakami H (2011) Genomic recombination through plasmid-encoded recombinase enhances hemolytic activity and adherence to epithelial cells in the periodontopathogenic bacterium Eikenella corrodens. Biosci Biotechnol Biochem 75:748–751. https://doi.org/10.1271/bbb.100866 CrossRefPubMed

55.

Longo PL, Nunes AC, Umeda JE, Mayer MP (2013) Gene expression and phenotypic traits of Aggregatibacter actinomycetemcomitans in response to environmental changes. J Periodontal Res 48:766–772. https://doi.org/10.1111/jre.12067 CrossRefPubMed

56.

Ebersole JL, Dawson DR 3rd, Morford LA, Peyyala R, Miller CS, Gonzalez OA (2013) Periodontal disease immunology: ‘double indemnity’ in protecting the host. Periodontol 2000 62:163–202CrossRef

57.

Periasamy S, Kolenbrander PE (2009) Mutualistic biofilm communities develop with Porphyromonas gingivalis and initial, early, and late colonizers of enamel. J Bacteriol 191:6804–6811CrossRef

58.

Bollen CM, Quirynen M (1996) Microbiological response to mechanical treatment in combination with adjunctive therapy: a review of the literature. J Periodontol 67:1143–1158. https://doi.org/10.1902/jop.1996.67.11.1143 CrossRefPubMed

59.

Fang H, Han M, Li QL, Cao CY, Xia R, Zhang ZH (2016) Comparison of full-mouth disinfection and quadrant-wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta-analysis. J Periodontal Res 51:417–430. https://doi.org/10.1111/jre.12326 CrossRefPubMed

60.

Eberhard J, Jepsen S, Jervoe-Storm PM, Needleman I, Worthington HV (2015) Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults. Cochrane Database Syst Rev:CD004622. https://doi.org/10.1002/14651858.CD004622.pub3

Title: Microbiological dynamics of red complex bacteria following full-mouth air polishing in periodontally healthy subjects—a randomized clinical pilot study
Authors: Belinda Reinhardt
Astrid Klocke
Sarah H. Neering
Sabine Selbach
Ulrike Peters
Thomas F. Flemmig
Thomas Beikler
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Wound Debridement
Periodontal Pathogens
Published in: Clinical Oral Investigations / Issue 10/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02821-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Microbiological dynamics of red complex bacteria following full-mouth air polishing in periodontally healthy subjects—a randomized clinical pilot study

Abstract

Objectives

Materials and Methods

Results

Conclusion

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and Methods

Results

Conclusion

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 10/2019

The effects of extended curing time and radiant energy on microhardness and temperature rise of conventional and bulk-fill resin composites

Is the caregivers’ oral health related to dental caries in children or adolescents? A systematic review

Following in the footsteps of Hippocrates—interrelation between the incidence of odontogenic abscess and meteorological parameters

When to intervene in the caries process? An expert Delphi consensus statement

Nuclear morphological changes in gingival epithelial cells of patients with periodontitis

Influence of buffy coat–derived putative endothelial progenitor cells on tumor growth and neovascularization in oral squamous cell carcinoma xenografts