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Casarin RCV, Salmon CR, Stolf CS, Paz HES, Rangel TP, Domingues RR, Pauletti BA, Paes-Leme AF, Araújo C, Santamaria MP, Ruiz KS, Monteiro MF. Salivary annexin A1: A candidate biomarker for periodontitis. J Clin Periodontol 2023; 50:942-951. [PMID: 36935103 DOI: 10.1111/jcpe.13803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 02/03/2023] [Accepted: 02/28/2023] [Indexed: 03/20/2023]
Abstract
AIM To compare the salivary proteomic profile of periodontitis-affected (PA) parents and their offspring to periodontally healthy (PH) dyads in the pursuit of possible biomarkers for early diagnosis of this disease. MATERIALS AND METHODS Unstimulated saliva samples collected from 17 pairs of PA or PH individuals and their children were submitted to mass spectrometric analyses followed by proteomic analyses. Primary PA fibroblasts were triggered towards having an inflammatory response, and an immunoenzymatic assay of its supernatant was performed to validate the obtained data. RESULTS ANXA1, KRT4, GSTP1, HPX, A2M and KRT13 were lower in PA parents and their children, and IGHG1, CSTB, KRT9, SMR3B, IGHG4 and SERPINA1 were higher. ANXA1 presented the highest fold change, 7.1 times less produced in children of PA parents, and was selected as a potential biomarker for periodontitis. The in vitro assay also showed lower ANXA1 production by cells of PA patients. CONCLUSION Before any clinical sign of periodontal loss, descendants of PA patients have an altered proteomic profile compared to PH individuals, presenting a lower abundance of ANXA1. This protein is suggested as a potential biomarker for periodontitis.
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Affiliation(s)
- Renato C V Casarin
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Cristiane R Salmon
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Camila S Stolf
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Hélvis E S Paz
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Thiago P Rangel
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Romênia R Domingues
- Laboratory of Mass Spectrometry, Brazilian Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), São Paulo, Brazil
| | - Bianca A Pauletti
- Laboratory of Mass Spectrometry, Brazilian Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), São Paulo, Brazil
| | - Adriana F Paes-Leme
- Laboratory of Mass Spectrometry, Brazilian Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), São Paulo, Brazil
| | - Cassia Araújo
- Periodontics Division, Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University, São Paulo, Brazil
| | - Mauro P Santamaria
- Periodontics Division, Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University, São Paulo, Brazil
| | - Karina S Ruiz
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Mabelle F Monteiro
- Periodontics Division, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
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Herrera D, van Winkelhoff AJ, Matesanz P, Lauwens K, Teughels W. Europe's contribution to the evaluation of the use of systemic antimicrobials in the treatment of periodontitis. Periodontol 2000 2023. [PMID: 37314038 DOI: 10.1111/prd.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 06/15/2023]
Abstract
This narrative review celebrates Europe's contribution to the current knowledge on systemically administered antimicrobials in periodontal treatment. Periodontitis is the most frequent chronic noncommunicable human disease. It is caused by dysbiotic bacterial biofilms and is commonly treated with subgingival instrumentation. However, some sites/patients do not respond adequately, and its limitations and shortcomings have been recognized. This has led to the development of alternative or adjunctive therapies. One is the use of antimicrobials to target bacteria in subgingival biofilms in the periodontal pocket, which can be targeted directly through the pocket entrance with a locally delivered antibiotic or systemically by oral, intravenous, or intramuscular methods. Since the early 20th century, several studies on systemic antibiotics have been undertaken and published, especially between 1990 and 2010. Europe's latest contribution to this topic is the first European Federation of Periodontology, S3-level Clinical Practice Guideline, which incorporates recommendations related to the use of adjuncts to treat stage I-III periodontitis. Understanding the etiopathogenesis of periodontal diseases, specifically periodontitis, has influenced the use of systemic periodontal antibiotic therapy. Randomized clinical trials and systematic reviews with meta-analyses have demonstrated the clinical advantages of adjunctive systemic antimicrobials. However, current recommendations are restrictive due to concerns about antibiotic misuse and the increase in microbial antibiotic resistance. European researchers have contributed to the use of systemic antimicrobials in the treatment of periodontitis through clinical trials and by providing rational guidelines. Nowadays, European researchers are exploring alternatives and directing clinical practice by providing evidence-based guidelines to limit the use of systemic antimicrobials.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Arie Jan van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Katalina Lauwens
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Mamaklıoğlu D, Karched M, Kuru L, Kuru B, Asikainen S, Doğan B. Different Scaling And Root Planing Strategies In Turkish Patients With Aggressive Periodontitis: A Randomized Controlled Clinical Trial. Int J Dent Hyg 2022; 20:347-363. [PMID: 35143714 DOI: 10.1111/idh.12592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 01/06/2022] [Accepted: 02/06/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study is to compare clinical, cytokine and microbiological responses after quadrant-based scaling and root planing (Q-SRP), full-mouth SRP (FM-SRP) and full-mouth disinfection (FMD) in patients with generalized aggressive periodontitis (GAgP), which is currently termed as generalized stage III grade C periodontitis. METHODS Forty-two patients with GAgP were randomly assigned into groups as Q-SRP, FM-SRP or FMD with chlorhexidine. Clinical parameters were recorded and gingival crevicular fluid (GCF) and subgingival plaque samples collected at baseline, 3 and 6 months after treatment. GCF levels of interleukin (IL)-1β and IL-17 were analysed using ELISA. Quantities of six bacterial species were determined using qPCR. RESULTS Clinical parameters improved significantly in all groups at 3 and 6 months (p<0.05). Percentage of sites with probing depth >6 mm was lower in the FMD than Q-SRP group at 3 and 6 months (p<0.05). FMD showed significantly higher percentage of pocket closure compared to Q-SRP and FM-SRP at both 3 and 6 months after treatment (p<0.05). The IL-1β levels decreased only in the FMD group (p<0.05), whereas no changes were found in IL-17 levels in any group. The levels of five out of six bacterial species decreased at 3 and/or 6 months only in the FMD group (p<0.05). CONCLUSIONS The FMD treatment appears to offer superior outcome than Q-SRP and could be the first choice for patients with GAgP.
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Affiliation(s)
- Dilek Mamaklıoğlu
- Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Maribasappa Karched
- Oral Microbiology Research Laboratory, Faculty of Dentistry, Kuwait University, Kuwait
| | - Leyla Kuru
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Bahar Kuru
- Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Sirkka Asikainen
- Oral Microbiology Research Laboratory, Faculty of Dentistry, Kuwait University, Kuwait.,Oral Microbiology, Umea University, Umea, Sweden
| | - Başak Doğan
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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The effect of drug dose and duration of adjuvant Amoxicillin-plus-Metronidazole to full-mouth scaling and root planing in periodontitis: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:5671-5685. [PMID: 33751238 DOI: 10.1007/s00784-021-03869-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/01/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim is to explore the optimal drug dose and duration of adjunctive Amoxicillin-plus-Metronidazole (AMX/MET) to full-mouth scaling and planing (FMSRP) in periodontitis. METHODS An electronic search in four databases and manual search in four journals were conducted for randomised clinical trials comparing AMX/MET adjunct to FMSRP with FMSRP alone for at least 3 months. RESULTS Eleven studies were eligible and included. The primary outcome was clinical attachment level (CAL) gain, the secondary outcomes were periodontal pocket depth (PPD) reduction and adverse events. Our results showed a beneficial effect of adjunctive AMX/MET with higher drug dose to FMSRP for CAL gain and PPD reduction at 3 months, and the benefit remained stable at 6 months. However, minimal difference among three-seven-and ten-day drug duration was observed. In addition, the risk difference of adverse events was minimal between two groups. CONCLUSION FMSRP adjunct to a high drug dose of 500/500 mg of AMX/MET showed a significant and stable improvement on 6-month follow-up period. No decision for drug duration could be made due to limited evidence. CLINICAL RELEVANCE On 6-month follow-up, higher dose of AMX/MET adjunct to FMSRP could provide a stable clinical effect. No recommendation for drug duration could be made.
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Mendes CL, Assis PD, Annibal H, Oliveira LJRD, Albuquerque MSD, Soares MDL, Lago MC, Braz R. Metronidazole and amoxicillin association in aggressive periodontitis: A systematic review and meta-analysis. Saudi Dent J 2020; 32:269-275. [PMID: 32874066 PMCID: PMC7452018 DOI: 10.1016/j.sdentj.2020.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Cácio Lopes Mendes
- Department of Restorative Dentistry, University of Pernambuco, Camaragibe, PE, Brazil
| | - Paulo de Assis
- Department of Restorative Dentistry, University of Pernambuco, Camaragibe, PE, Brazil
| | - Hermínia Annibal
- Department of Restorative Dentistry, University of Pernambuco, Camaragibe, PE, Brazil
| | | | | | | | - Maria Catarina Lago
- Department of Restorative Dentistry, University of Pernambuco, Camaragibe, PE, Brazil
| | - Rodivan Braz
- Biomaterials Research Center, University of Pernambuco, Camaragibe, PE, Brazil
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Kaufmann ME, Wiedemeier DB, Zellweger U, Solderer A, Attin T, Schmidlin PR. Gingival recession after scaling and root planing with or without systemic metronidazole and amoxicillin: a re-review. Clin Oral Investig 2020; 24:1091-1100. [PMID: 31938962 DOI: 10.1007/s00784-020-03198-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 01/03/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Gingival recessions inevitably occur during healing after scaling and root planing, but synoptic data on this topic is still lacking. This review compared the recession formation with and without the administration of systemic antibiotics. OBJECTIVES To evaluate the formation of recession with and without the administration of antibiotics during the healing after scaling and root planing. MATERIALS AND METHODS This study re-analyzed publications that reported clinical attachment levels (CAL) and probing pocket depths (PD) up to January 2019, including the pivotal review by Zandbergen and co-workers (2013). Whereas these studies traditionally focused on PD and CAL, the present analysis compared recession formation (ΔREC) after adjunctive systemic administration of amoxicillin (amx) and metronidazole (met) during scaling and root planing (SRP) and SRP alone. The mean increase in ΔREC, if not reported, was calculated from CAL and PD values and statistically analyzed. Recession formation was compared after 3 and 6 months after therapy. Results were separately reported for chronic periodontitis (CP) as well as aggressive periodontitis (AP) cases. RESULTS Recessions increased consistently between baseline and follow-up. In the AP group, median ΔREC was 0.20 mm after 3 months, irrespective of whether antibiotics were administered or not. After 6 months, median ΔREC increased to 0.35 mm after AB and remained stable at 0.20 mm with SRP alone. In the CP group, after 3 months with and without antibiotics, median ΔREC accounted for 0.30 mm and 0.14 mm, respectively. After 6 months, median ΔREC accounted for 0.28 mm (with AB) and 0.20 mm (without AB). The quantitative assessment by meta-analyses also yielded small values (≤ 0.25 mm) for the estimated differences in recession formation between AB and noAB; however, none of them reached statistical significance. CONCLUSIONS Although a slight tendency towards higher recession formation after SRP in combination with AB could be observed in many studies, quantitative meta-analyses showed no clinically relevant difference in recession formation due to the administration of AB. In general, the description and discussion of recessions in the literature seems not to be a major focus so far. CLINICAL RELEVANCE Since the preservation of gingival tissues is important by preventive and therapeutic means, e.g., when avoiding postoperative root sensitivity or performing regenerative surgery, these aspects should not be neglected. We thus suggest to report REC measurements along with PD and CAL values for more direct recession formation (ΔREC) assessments in the future.
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Affiliation(s)
- Manuela E Kaufmann
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11 8032, Zurich, Switzerland.
| | - Daniel B Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | - Alex Solderer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11 8032, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11 8032, Zurich, Switzerland
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11 8032, Zurich, Switzerland
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Pretzl B, Sälzer S, Ehmke B, Schlagenhauf U, Dannewitz B, Dommisch H, Eickholz P, Jockel-Schneider Y. Administration of systemic antibiotics during non-surgical periodontal therapy-a consensus report. Clin Oral Investig 2018; 23:3073-3085. [PMID: 30374830 DOI: 10.1007/s00784-018-2727-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/18/2018] [Indexed: 12/16/2022]
Abstract
AIM The aim of this meta-review was to evaluate whether there is a meaningful clinical benefit regarding the use of systemic adjunctive antibiotics in the treatment of patients with periodontitis. Additionally, a consensus regarding possible recommendations for future administration of antibiotics should be reached. METHODS A structured literature search was performed by two independent investigators focusing on systematic reviews (SR) covering adjunctive systemic antibiosis during non-surgical periodontal therapy. Additionally, recent randomized clinical trials (RCT, July 2015 to July 2017) were searched systematically to update the latest SR. Results were summarized and discussed in a plenary to reach a consensus. RESULTS Mostly, systematic reviews and RCTs showed a significant positive effect of adjunctive systematic antibiosis compared to controls. These positive effects gain clinical relevance in patients with severe periodontal disease aged 55 years and younger. CONCLUSION Systemic antibiotics as an adjunct to non-surgical periodontal therapy should be sensibly administered and restrictively used. Only certain groups of periodontitis patients show a significant and clinically relevant benefit after intake of systemic antibiosis during periodontal therapy. CLINICAL RELEVANCE Avoiding antibiotic resistance and possible side effects on the human microbiome should be a focus of dentists and physicians. Thus, a sensible administration of antibiotics is mandatory. This manuscript suggests guidelines for a reasonable use.
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Affiliation(s)
- B Pretzl
- Department of Conservative Dentistry, Section of Periodontology, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, 69120, Heidelberg, Germany.
| | - S Sälzer
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Schleswig-Holstein, 24105, Kiel, Germany
| | - B Ehmke
- Department of Periodontology, University Hospital Münster, 48149, Münster, Germany
| | - U Schlagenhauf
- Divison of Periodontology, University Hospital of Julius-Maximilians-University, 97070, Würzburg, Germany
| | - B Dannewitz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, 60596, Frankfurt, Germany
| | - H Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - P Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, 60596, Frankfurt, Germany
| | - Y Jockel-Schneider
- Divison of Periodontology, University Hospital of Julius-Maximilians-University, 97070, Würzburg, Germany
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