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

Eick, Sigrun; Nydegger, Jasmin; Bürgin, Walter; Salvi, Giovanni E.; Sculean, Anton; Ramseier, Christoph A.

doi:10.1007/s00784-018-2392-3

Cited by 38 publications

(45 citation statements)

References 52 publications

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“…In the Department of Periodontology, School of Dental Medicine, University of Bern, patients diagnosed with AP generally received antibiotics during nonsurgical periodontal therapy (i.e., hygienic phase). Retrospective analysis of our patients revealed that the prevalence of A. actinomycetemcomitans was higher in patients diagnosed with AP than in those diagnosed with CP [4]. Following periodontal therapy, especially surgical treatment, A. actinomycetemcomitans was less frequently detected in patients with AP than in those with CP [4].…”

Section: Introductionmentioning

confidence: 72%

JP2 Genotype of Aggregatibacter actinomycetemcomitans in Caucasian Patients: A Presentation of Two Cases

2020

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Aggregatibacter actinomycetemcomitans is a key pathogen that has been associated with periodontal disease. Its most important virulence factor is a leukotoxin capable of inactivating immune cells. The JP2 genotype of Aggregatibacter actinomycetemcomitans shows enhanced leukotoxic activity and is mostly present in individuals of North and West African origin with severe periodontitis. In this paper, two cases of Caucasians diagnosed with the JP2 genotype are presented. A 50-year-old female patient had three approximal sites with ≥ 6 mm clinical attachment loss (CAL) and eight sites with probing depth (PD) ≥ 5 mm. Microbiological diagnostics revealed A. actinomycetemcomitans JP2 genotype, but not Porphyromonas gingivalis. This JP2 genotype was highly leukotoxic to monocytic cells. The second case was a 55-year-old female patient with CAL of > 5 mm at all molars and PD of up to 12 mm. A. actinomycetemcomitans JP2 was identified, but not P. gingivalis. Her husband originated from North-Africa. In him, no A. actinomycetemcomitans was detected, but their 17-year-old daughter was diagnosed with periodontitis and was found to be positive for the JP2 genotype. Both patients were successfully treated with adjunctive antibiotics and the JP2 genotype was eliminated. In summary, here, the microbiological diagnosis was key for the treatment with adjunctive antibiotics.

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Section: Introductionmentioning

confidence: 72%

JP2 Genotype of Aggregatibacter actinomycetemcomitans in Caucasian Patients: A Presentation of Two Cases

2020

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“…While it was shown in previous studies that microbiological testing itself could lead to more antibiotic prescription, all authors are in agreement that clinicians should not empirically and not indiscriminately select antibiotic treatment regimens, especially for patients with mild‐to‐moderate periodontitis …”

Section: Introductionmentioning

confidence: 97%

“…‒ Studies presenting trends in antibiotic use and presenting some inappropriate prescriptions of second choice antibiotics and emerging antibiotic resistance emphasize that specific microbiological diagnostic tests can be supportive for clinical practitioners . Furthermore, a recent study presented clinical findings that (appear to) support the use of microbiological testing to strengthen the clinical decision for either using or not using systemic antibiotics in conjunction with non‐surgical periodontal therapy . Considering World Health Organization (WHO) and European Union (EU) statements (summarized in ref.…”

Section: Introductionmentioning

confidence: 99%

“…10 Furthermore, a recent study presented clinical findings that (appear to) support the use of microbiological testing to strengthen the clinical decision for either using or not using systemic antibiotics in conjunction with non-surgical periodontal therapy. 11 Considering World Health Organization (WHO) and European Union (EU) statements 12 (summarized in ref. 13) that resistance to common bacteria has reached alarming levels and also dentists have to reconsider their antibiotic use and adopt proactive and rational strategies (such as 1) avoidance of unnecessary use of any antibiotic, 2) use of narrow-spectrum antibiotics whenever possible, and 3) avoidance of broad-spectrum or combination antibiotics besides in cases of severe infections that do not respond otherwise); microbiological diagnosis is advised before selecting antibiotics against infectious diseases in general and periodontal diseases in particular.…”

Section: Introductionmentioning

confidence: 99%

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Clinical evaluation of a newly developed chairside test to determine periodontal pathogens

Arweiler

Marx

Laugisch

et al. 2019

Journal of Periodontology

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Background The subgingival microbiota as well as determination of markers such as associated pathogens is still in the focus of dental research. The aim of this controlled clinical trial was to determine clinical applicability of a newly developed chairside bacterial test (CST) for the most relevant periodontal pathogens. Methods Within 125 participants (100 with periodontitis, 25 healthy) two sulcus fluid samples each were collected and pooled for further analysis. Samples were analyzed with CST and results (positive signals for every pathogen/control) were visually detected by eye. As a reference quantitative polymerase chain reaction (qPCR) was performed. Results The detection limit of CST revealed 1.2 × 104 for Treponema denticola (T.d.) and Tannerella forsythia (T.f.), 2.5 × 104 for Porphyromonas gingivalis (P.g.), 5.3 × 103 for Prevotella intermedia (P.i.), and 5.8 × 104 for Aggregatibacter actinomycetemcomitans (A.a.). Based on this maximum potential of positive detections, the sensitivities of CST in reference to qPCR were: T.d. (91.3%); T.f. (86.3%); P.g. (83.8%); P.i. (85.7%), and A.a. (100%). In regard to the clinical diagnosis, the CST assay and the qPCR method reached a sensitivity of 87.82% and 94%, respectively. The specificity for both methods was 100%. Conclusion This newly developed CST can detect five typical periodontal pathogens with a somewhat lower sensitivity towards qPCR that can be classified as “good.”

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“…The management of AgP remains a challenge for the clinicians due to lack of standardized protocols for effective disease control (Akrivopouloua, Green, Donos, Nair, & Ready, ). The traditional management of this disease consists on mechanical debridement with or without surgery, and generally supplemented with antimicrobial drugs (Deas & Mealey, ; Eick et al, ). There is a great need of new more specific treatment strategies as well as new tools for an early identification of risk individuals.…”

Section: Introductionmentioning

confidence: 99%

High salivary levels of JP2 genotype of Aggregatibacter actinomycetemcomitans is associated with clinical attachment loss in Moroccan adolescents

Ennibi

Claesson

Akkaoui

et al. 2019

Clinical & Exp Dental Res

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It has previously been shown that the presence of Aggregatibacter actinomycetemcomitans in subgingival plaque is significantly associated with increased risk for clinical attachment loss. The highly leukotoxic JP2 genotype of this bacterium is frequently detected in adolescents with aggressive forms of periodontitis. The aims of the study were to quantify the levels of JP2 and non‐JP2 genotypes of A. actinomycetemcomitans in saliva of Moroccan adolescents with the JP2 genotype earlier detected in the subgingival plaque. The salivary concentrations of inflammatory proteins were quantified and linked to the clinical parameters and microbial findings. Finally, a mouth rinse with leukotoxin‐neutralizing effect was administrated and its effect on the levels the biomarkers and A. actinomycetemcomitans examined. The study population consisted of 22 adolescents that previously were found to be positive for the JP2 genotype in subgingival plaque. Periodontal registration and sampling of stimulated saliva was performed at baseline. A mouth rinse (active/placebo) was administrated, and saliva sampling repeated after 2 and 4 weeks rinse. The salivary levels of JP2 and non‐JP2 were analyzed by quantitative PCR and inflammatory proteins by ELISA. Both the JP2 and the non‐JP2 genotype were detected in all individuals with significantly higher levels of the non‐JP2. Enhanced levels of the JP2 genotype of A. actinomycetemcomitans was significantly correlated to the presence of attachment loss (≥3 mm). Salivary concentrations of inflammatory biomarkers did not correlate to periodontal condition or levels of A. actinomycetemcomitans . The use of active or placebo leukotoxin‐neutralizing mouth rinse did not significantly interfered with the levels of these biomarkers. Saliva is an excellent source for detection of A. actinomycetemcomitans on individual basis, and high levels of the JP2 genotype were significantly associated with the presence of clinical attachment loss.

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

Abstract: 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.

Cited by 38 publications

References 52 publications

JP2 Genotype of Aggregatibacter actinomycetemcomitans in Caucasian Patients: A Presentation of Two Cases

JP2 Genotype of Aggregatibacter actinomycetemcomitans in Caucasian Patients: A Presentation of Two Cases

Clinical evaluation of a newly developed chairside test to determine periodontal pathogens

High salivary levels of JP2 genotype of Aggregatibacter actinomycetemcomitans is associated with clinical attachment loss in Moroccan adolescents

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