Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis
This study evaluated a combined systemic and topical anti-infective periodontal treatment of 35 adults who had experienced ongoing periodontal breakdown following conventional surgical periodontics. The prescribed anti-infective therapy, based on microbiological testing, consisted of a single course...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/12/2/265 |
| _version_ | 1827759009984151552 |
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| author | Thomas E. Rams Jørgen Slots |
| author_facet | Thomas E. Rams Jørgen Slots |
| author_sort | Thomas E. Rams |
| collection | DOAJ |
| description | This study evaluated a combined systemic and topical anti-infective periodontal treatment of 35 adults who had experienced ongoing periodontal breakdown following conventional surgical periodontics. The prescribed anti-infective therapy, based on microbiological testing, consisted of a single course of metronidazole plus ciprofloxacin (23 patients), metronidazole plus amoxicillin/clavulanic acid (10 patients), and metronidazole plus ciprofloxacin followed by metronidazole plus amoxicillin/clavulanic acid (2 patients). In addition, the study patients received 0.1% povidone-iodine subgingival disinfection during non-surgical root debridement and daily patient administered oral irrigation with 0.1% sodium hypochlorite. At 1 and 5 years post-treatment, all study patients showed gains in clinical periodontal attachment with no further attachment loss, and significant decreases in pocket probing depth, bleeding on probing, and subgingival temperature. The greatest disease resolution occurred in patients who at baseline harbored predominantly major periodontal pathogens which post-antibiotics became non-detectable and substituted by non-periodontopathic viridans streptococci. The personalized and minimally invasive anti-infective treatment regimen described here controlled periodontitis disease activity and markedly improved the clinical and microbiological status of the refractory periodontitis patients. |
| first_indexed | 2024-03-11T09:14:40Z |
| format | Article |
| id | doaj.art-0da9122776784427a6bbfa1f0fced405 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T09:14:40Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-0da9122776784427a6bbfa1f0fced4052023-11-16T18:42:33ZengMDPI AGAntibiotics2079-63822023-01-0112226510.3390/antibiotics12020265Antimicrobial Chemotherapy for Recalcitrant Severe Human PeriodontitisThomas E. Rams0Jørgen Slots1Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA 19140, USADivision of Periodontology and Diagnostic Sciences, University of Southern California School of Dentistry, Los Angeles, CA 90089, USAThis study evaluated a combined systemic and topical anti-infective periodontal treatment of 35 adults who had experienced ongoing periodontal breakdown following conventional surgical periodontics. The prescribed anti-infective therapy, based on microbiological testing, consisted of a single course of metronidazole plus ciprofloxacin (23 patients), metronidazole plus amoxicillin/clavulanic acid (10 patients), and metronidazole plus ciprofloxacin followed by metronidazole plus amoxicillin/clavulanic acid (2 patients). In addition, the study patients received 0.1% povidone-iodine subgingival disinfection during non-surgical root debridement and daily patient administered oral irrigation with 0.1% sodium hypochlorite. At 1 and 5 years post-treatment, all study patients showed gains in clinical periodontal attachment with no further attachment loss, and significant decreases in pocket probing depth, bleeding on probing, and subgingival temperature. The greatest disease resolution occurred in patients who at baseline harbored predominantly major periodontal pathogens which post-antibiotics became non-detectable and substituted by non-periodontopathic viridans streptococci. The personalized and minimally invasive anti-infective treatment regimen described here controlled periodontitis disease activity and markedly improved the clinical and microbiological status of the refractory periodontitis patients.https://www.mdpi.com/2079-6382/12/2/265anti-infective agentsperiodontitisperiodontal pathogensmetronidazoleciprofloxacinamoxicillin |
| spellingShingle | Thomas E. Rams Jørgen Slots Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis Antibiotics anti-infective agents periodontitis periodontal pathogens metronidazole ciprofloxacin amoxicillin |
| title | Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis |
| title_full | Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis |
| title_fullStr | Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis |
| title_full_unstemmed | Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis |
| title_short | Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis |
| title_sort | antimicrobial chemotherapy for recalcitrant severe human periodontitis |
| topic | anti-infective agents periodontitis periodontal pathogens metronidazole ciprofloxacin amoxicillin |
| url | https://www.mdpi.com/2079-6382/12/2/265 |
| work_keys_str_mv | AT thomaserams antimicrobialchemotherapyforrecalcitrantseverehumanperiodontitis AT jørgenslots antimicrobialchemotherapyforrecalcitrantseverehumanperiodontitis |