Persistence of Porphyromonas gingivalis is a negative predictor in patients with moderate to severe periodontitis after nonsurgical periodontal therapy

Abstract Nonsurgical periodontal therapy with adjunctive use of systemic antimicrobials (for 7–14 days) showed improved clinical, microbiological and immunological results over the mechanical protocol alone. Considering the increasing risk for antimicrobial resistance with longer antibiotic regimes, it is important to establish the optimal antibiotic protocol with a maximum antimicrobial benefit and minimum risk for adverse effects. The aim of the study was to evaluate the microbiological and inflammatory outcomes 12-months after a 3-/7-day systemic antibiotic protocol [amoxicillin (AMX) + metronidazole (MET)] adjunctive to subgingival debridement in severe periodontitis compared to mechanical treatment alone. From the initially treated 102 patients, 75 subjects (Placebo group: n = 26; 3-day AMX + MET group: n = 24; 7-day AMX + MET group: n = 25) completed the 12-month examination. Clinical parameters, eight periodontal pathogens and inflammatory markers were determined at baseline and 3-, 6-, 12-months after therapy using real-time PCR and ELISA respectively. After 6 months, several periodontopathogens were significantly more reduced in the two antibiotic groups compared to placebo (p < 0.05). After 1 year, both antibiotic protocols showed significant reductions and detection of the keystone pathogen P. gingivalis compared to placebo. Antibiotic protocols, smoking, disease severity, baseline-BOP, -CAL and -IL-1β, as well as detection of T. denticola at 12-months significantly influenced the residual number of deep sites. The present data indicate that the systemic use of both short and longer antibiotic protocols (AMX + MET) adjunctive to nonsurgical periodontal therapy lead to higher microbiological improvements compared to subgingival debridement alone. The two investigated antibiotic protocols led to comparable microbiological and inflammatory results.

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Severe periodontitis treated by nonsurgical periodontal therapy

International Journal of Medical and Dental Case Reports ◽

10.15713/ins.ijmdcr.40 ◽

2016 ◽

Vol 3 ◽

pp. 1-4

Author(s):

Shahabe Saquib Abullais ◽

Mohammad Yunis Saleem Bhat ◽

Anoop Gore ◽

Aashima Gupta

Keyword(s):

Periodontal Therapy ◽

Severe Periodontitis ◽

Nonsurgical Periodontal Therapy

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Effects of Lactobacillus Reuteri Lozenges (Prodentis) as Adjunctive Therapeutic Agent in Non-Surgical Therapy of Periodontitis

Balkan Journal of Dental Medicine ◽

10.2478/bjdm-2021-0003 ◽

2021 ◽

Vol 25 (1) ◽

pp. 41-45

Author(s):

Zerina Hadžić ◽

Enes Pašić ◽

Mirjana Gojkov Vukelić ◽

Sanja Hadžić

Keyword(s):

Porphyromonas Gingivalis ◽

Therapeutic Agent ◽

Lactobacillus Reuteri ◽

Aggregatibacter Actinomycetemcomitans ◽

Periodontal Therapy ◽

Periodontal Treatment ◽

Prevotella Intermedia ◽

Scaling And Root Planing ◽

Root Planing ◽

Nonsurgical Periodontal Therapy

SummaryBackground/Aim: This study aimed to evaluate the effects of Lactobacillus reuteri lozenges as an adjunctive therapeutic agent in combination with scaling and root planing in a randomized, clinical trial of volunteers with periodontitis stage IV.Material and Methods: The study included 40 patients diagnosed with periodontitis divided into 2 groups of 20 patients by random sample method. The first group of patients used Lactobacillus reuteri lozenges after nonsurgical periodontal therapy for a period of 40 days while the second group of patients was treated with non-surgical periodontal therapy without lozenges. Periodontal clinical parameters were registered for all patients before treatment and after 40 days. Samples of saliva from patients before and 40 days after treatment were analyzed by the PCR method for pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia. Assessments were made on day 0 before treatment for patients of both groups and after 40 days.Results: Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis show a statistically significant difference between the two study groups. Results were not statistically significant for Prevotella intermedia (P= 0.5598).Conclusions: The present study confirms the positive effects of L. reuteri lozenges after non-surgical periodontal therapy and the maintenance phase of periodontal treatment. Considering the beneficial effects of probiotics, L.reuteri could serve as a useful adjunct or maybe even as an alternative to periodontal treatment when scaling and root planing might be contraindicated or has to be postponed.

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09 / A Clinical and Microbiological Comparison of Er:YAG Laser and Mechanical Debridement For The Nonsurgical Periodontal Therapy: A Randomized Controlled Clinical Study

10.26226/morressier.5ac383212afeeb00097a4538 ◽

2018 ◽

Author(s):

Tuğba Zengin Çelik

Keyword(s):

Clinical Study ◽

Er:Yag Laser ◽

Periodontal Therapy ◽

Randomized Controlled ◽

Nonsurgical Periodontal Therapy ◽

Controlled Clinical Study

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Effect of nonsurgical periodontal therapy with additional photodynamic therapy on the level of MMP-9 and TIMP-1 in GCF in chronic periodontitis patients.

10.26226/morressier.5ac3831d2afeeb00097a3f0a ◽

2018 ◽

Author(s):

Ewa Dolińska

Keyword(s):

Photodynamic Therapy ◽

Chronic Periodontitis ◽

Periodontal Therapy ◽

Nonsurgical Periodontal Therapy

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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy: a randomized clinical trial

BMC Oral Health ◽

10.1186/s12903-020-01363-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Holger F. R. Jentsch ◽

Christian Flechsig ◽

Benjamin Kette ◽

Sigrun Eick

Keyword(s):

Test Group ◽

Nonparametric Tests ◽

Periodontal Therapy ◽

Periodontal Pocket ◽

Control Group ◽

Clinical Variables ◽

Air Polishing ◽

Probing Depth ◽

Nonsurgical Periodontal Therapy ◽

Attachment Level

Abstract Background This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. Methods Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. Results In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. Conclusions Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. Clinical relevance The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL.

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