Should Antibiotics Be Prescribed to Treat Chronic Periodontitis?

Walters, John D.; Lai, Pin‐Chuang

doi:10.1016/j.cden.2015.06.011

Cited by 32 publications

(30 citation statements)

References 69 publications

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“…Current periodontitis treatment involves surgical‐ and non‐surgical mechanical therapies, which are usually effective in relieving local inflammation. Systemic or local administration of antibiotics may be used to treat severe and refractory manifestations of the disease . These treatment strategies are often only temporarily effective and recurrence of the disease is common, possibly due to the re‐emergence of pathogens such as P gingivalis .…”

Section: Discussionmentioning

confidence: 99%

“…Systemic or local administration of antibiotics may be used to treat severe and refractory manifestations of the disease. [46][47][48] These treatment strategies are often only temporarily effective and recurrence of the disease is common, 49,50 possibly due to the re-emergence of pathogens such as P gingivalis. 51 Our previous work demonstrated that SAPP represses expression of gingipains and fimbrial proteins in P gingivalis in vitro.…”

Section: Discussionmentioning

confidence: 99%

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Characterization and development of SAPP as a specific peptidic inhibitor that targets Porphyromonas gingivalis

Lamont

Chazin

et al. 2018

Molecular Oral Microbiology

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SUMMARY Porphyromonas gingivalis is a keystone bacterium in the oral microbial communities that elicits a dysbiosis between the microbiota and the host. Therefore, inhibition of this organism in dental plaques has been one of strategies for preventing and treating chronic periodontitis. We previously identified a Streptococcal ArcA derived Anti-P. gingivalils Peptide (SAPP) that in vitro, is capable of repressing the expression of several virulence genes in the organism. This leads to a significant reduction in P. gingivalis virulence potential, including its ability to colonize on the surface of Streptococcus gordonii, to invade human oral epithelial cells, and to produce gingipains. In this study, we showed that SAPP had minimal cytotoxicity to human oral keratinocytes and gingival fibroblasts. We observed that SAPP directly bound to the cell surface of P. gingivalis, and that alterations in the sequence at the N-terminus of SAPP diminished its abilities to interact with P. gingivalis cells and repressed the expression of virulence genes. Most strikingly, we demonstrated using an ex-vivo assay that besides its inhibitory activity against P. gingivalis colonization, SAPP could also reduce the levels of several other oral Gram-negative bacteria strongly associated with periodontitis in multispecies biofilms. Our results provide a platform for the development of SAPP-targeted therapeutics against chronic periodontitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Characterization and development of SAPP as a specific peptidic inhibitor that targets Porphyromonas gingivalis

Lamont

Chazin

et al. 2018

Molecular Oral Microbiology

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“…; Teeuw et al. ; Walters and Lai ). P. gingivalis, a predominant causative factor of periodontitis, has been reported to accelerate atherosclerosis in animal models (Hayashi et al.…”

Section: Introductionmentioning

confidence: 99%

TRPV4 is a regulator inP. gingivalislipopolysaccharide‐induced exacerbation of macrophage foam cell formation

et al. 2019

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Porphyromonas gingivalis (P.g), a major causative agent of periodontitis, has been linked to atherosclerosis, a chronic inflammatory vascular disease. Recent studies have suggested a link between periodontitis and arterial stiffness, a risk factor for atherosclerosis. However, the mechanisms by which P.g infection contributes to atherogenesis remain elusive. The formation of lipid‐laden macrophage “foam cells” is critically important to development and progression of atherosclerosis. We have obtained evidence that TRPV 4 (transient receptor potential channel of the vanilloid subfamily 4), a mechanosensitive channel, is a regulator of macrophage foam cell formation both in response to P.g‐derived lipopolysaccharide (Pg LPS ) or to an increase in matrix stiffness. Importantly, we found that TRPV 4 activity (Ca 2+ influx) was increased in response to Pg LPS . Genetic deletion or chemical antagonism of TRPV 4 channels blocked Pg LPS ‐triggered exacerbation of oxidized LDL (ox LDL )‐mediated foam cell formation. Mechanistically, we found that (1) T RPV 4 regulated ox LDL uptake but not its cell surface binding in macrophages; (2) reduced foam cell formation in TRPV 4 null cells was independent of expression of CD 36, a predominant receptor for ox LDL , and (3) co‐localization of TRPV 4 and CD 36 on the macrophage plasma membrane was sensitive to the increased level of matrix stiffness occurring in the presence of Pg LPS . Altogether, our results suggest that TRPV 4 channels play an essential role in P.g‐induced exacerbation of macrophage foam cell generation through a mechanism that modulates uptake of ox LDL .

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“…Antibiotics are indicated for treating odontogenic infections, oral nonodontogenic infections, as prophylaxis against focal and local infection, and the spread of infection . The most common oral infections are pulpitis and periapical periodontitis, for which antibiotics are not required . However, studies have shown that antibiotics are often prescribed for these conditions .…”

Section: Introductionmentioning

confidence: 99%

“…3 The most common oral infections are pulpitis and periapical periodontitis, for which antibiotics are not required. 4,5 However, studies have shown that antibiotics are often prescribed for these conditions. 5,6 The awareness of dentists regarding the rational use of antibiotics and their antibiotic prescribing behaviors are important.…”

Section: Introductionmentioning

confidence: 99%

Managing knowledge for health care quality: An investigation of rational antibiotic use among Thai dentists

Pisarnturakit

Sooampon

2019

Health Planning & Management

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Summary Objectives Because of the irrational use of antibiotics, antimicrobial resistance is now a global concern that requires developing effective strategies against. The aim of this study was to assess the knowledge gap that causes the irrational use of antibiotics among Thai dentists. Methods Thai dentists were asked to complete an online questionnaire regarding their knowledge, perception, and attitude towards rationale antibiotic use. The survey was conducted during November to December 2018. Results Online questionnaires were completed by 588 dentists. Most respondents had a positive perception and were aware of the rational use of antibiotics. However, the use of antibiotics without proper indication and the lack of pharmacological knowledge were found. A mobile application was considered the most preferable approach to manage knowledge for rational drug use. Conclusion Irrational drug use among Thai dentists can be caused by lack of knowledge, attitude, and the perception of each dentist. Policy makers should promote self‐learning through knowledge management strategies that can complement the pharmacology courses taught in dental school.

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Should Antibiotics Be Prescribed to Treat Chronic Periodontitis?

Cited by 32 publications

References 69 publications

Characterization and development of SAPP as a specific peptidic inhibitor that targets Porphyromonas gingivalis

Characterization and development of SAPP as a specific peptidic inhibitor that targets Porphyromonas gingivalis

TRPV4 is a regulator inP. gingivalislipopolysaccharide‐induced exacerbation of macrophage foam cell formation

Managing knowledge for health care quality: An investigation of rational antibiotic use among Thai dentists

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