CHANGES IN ORAL MICROBIOME DURING NON-SURGICAL THERAPY OF PATIENTS WITH SEVERE PERIODONTITIS
Authors:
J. Myšák 1; Š. Podzimek 1; T. Janatová 1; J. Dušková 1; J. Janata 2; L. Najmanová 2
Authors place of work:
Oddělení parodontologie, Stomatologická klinika, 1. lékařská fakulta Univerzity Karlovy, a Všeobecná fakultní nemocnice, Praha
1; Mikrobiologický ústav, Akademie věd ČR, v. v. i., Praha
2
Published in the journal:
Česká stomatologie / Praktické zubní lékařství, ročník 121, 2021, 3, s. 67-74
Category:
Summary
Introduction, aim: Periodontitis, which is one of the most common diseases in the adult population, is almost as common cause of tooth loss in people over the age of 35 as it is due to tooth decay. The aim of this study was to evaluate the utility of new-generation sequencing methods as a tool for complex characterization of subgingival bacterial biofilm in patients with advanced periodontitis and for monitoring the dynamics of changes in the composition of subgingival bacterial biofilm during therapy. We assume that next-generation sequencing methods will provide a new quality of monitoring the course of treatment and offer periodontologists a tool for objective evaluation of the effectiveness of the chosen therapeutic procedure and choice of further treatment.
Methods: The study included 43 patients with a diagnosis of advanced periodontitis. Patients were divided into two subgroups and treated with one of two standard approved methods – deep scaling and root planing only (subgroup A – 20 patients) and deep scaling and root planing supplemented with antibiotic therapy (subgroup B – 23 patients) – and their periodontal status was assessed by periodontal indices BOP (bleeding on probing), CAL (clinical attachment loss) a PPD (periodontal pocket depth) before treatment and two weeks, three months and 18 months after therapy. A set of four samples was taken from each deepest periodontal pocket at equal time intervals to determine the microbiome composition.
Results: During treatment, there was a significant decrease in the periodontal indices PPD, BOP and CAL in both subgroups of patients. There was also a significant decrease in the periodontal risk index R/G during treatment. In addition, the subgroup of patients treated with deep scaling and root planing with antibiotics (subgroup B) had a significantly higher decrease in R/G index 14 days after treatment compared to subgroup A treated with deep scaling and root planing alone. Three months and 18 months after treatment, the periodontal risk index R/G values were similar in both subgroups of patients.
Conclusion: Taxonomic characterization of the microbiome expressed in the form of R/G index allows to monitor dynamic changes during treatment, in contrast to mere monitoring of clinical parameters shows clear differences between groups with and without antibiotics at 14 days after deep scaling and root planing therapy. However, given the clinical parameters of the two groups, which do not differ significantly after three or 18 months, it is appropriate to carefully consider whether antibiotic support for deep scaling and root planing is beneficial, as there is a significant risk of developing and spreading resistance. The use of antibiotics in periodontology should be based on detailed clinical, microbiological and general medical examination.
Keywords:
severe periodontitis – oral microbiome – antibiotics – deep scaling – root planing
Zdroje
1. Schätzle M, Löe H, Bürgin W, Anerud A, Boysen H, Lang NP. Clinical course of chronic periodontitis. I. Role of gingivitis. J Clin Periodontol. 2003; 30(10): 887–901.
2. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999; 4(1): 1–6.
3. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H, Herrera D, Kao RT, Kebschull M, Kinane DF, Kirkwood KL, Kocher T, Kornman KS, Kumar PS, Loos BG, Machtei E, Meng H, Mombelli A, Needleman I, Offenbacher S, Seymour GJ, Teles R, Tonetti MS. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018; 89(Suppl. 1): S173–S182.
4. Armitage GC, Cullinan MP. Comparison of the clinical features of chronic and aggressive periodontitis. Periodontol 2000. 2010; 53: 12–27.
5. Hernández M, Dutzan N, García-Sesnich J, Abusleme L, Dezerega A, Silva N, González FE, Vernal R, Sorsa T, Gamonal J. Host-pathogen interactions in progressive chronic periodontitis. J Dent Res. 2011; 90(10): 1164–1170.
6. Bosshardt DD. The periodontal pocket: pathogenesis, histopathology and consequences. Periodontol 2000. 2018; 76(1): 43–50.
7. Scannapieco FA, Dasanayake AP, Chhun N. Does periodontal therapy reduce the risk for systemic diseases? Dent Clin North Am. 2010; 54(1): 163–181.
8. Socransky SS, Haffajee AD, Smith C, Dibart S. Relation of counts of microbial species to clinical status at the sampled site. J Clin Periodontol. 1991; 18(10): 766–775.
9. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent Jr RL. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998; 25(2): 134–144.
10. Kumar PS, Griffen AL, Barton JA, Paster BJ, Moeschberger ML, Leys EJ. New bacterial species associated with chronic periodontitis. J Dent Res. 2003; 82(5): 338–344.
11. Kumar PS, Griffen AL, Moeschberger ML, Leys EJ. Identification of candidate periodontal pathogens and beneficial species by quantitative 16S clonal analysis. J Clin Microbiol. 2005; 43(8): 3944–3955.
12. Kumar PS, Leys EJ, Bryk JM, Martinez FJ, Moeschberger ML, Griffen AL. Changes in periodontal health status are associated with bacterial community shifts as assessed by quantitative 16S cloning and sequencing. J Clin Microbiol. 2006; 4(10): 3665–3673.
13. Keijser BJF, Zaura E, Huse SM, Vossen van der JMBM, Schuren FHJ, Montijn RC, ten Cate JM, Crielaard W. Pyrosequencing analysis of the oral microflora of healthy adults. J Dent Res. 2008; 87(11): 1016–1020.
14. Zaura E, Keijser BJF, Huse SM, Crielaard W. Defining the healthy "core microbiome" of oral microbial communities. BMC Microbiol. 2009; 9: 259.
15. Dewhirst FE, Chen T, Izard J, Paster BJ, Tanner ACR, Yu WH, Lakshmanan A, Wade WG. The human oral microbiome. J Bacteriol. 2010; 192(19): 5002–5017.
16. Griffen AL, Beall CJ, Campbell JH, Firestone ND, Kumar PS, Yang ZK, Podar M, Leys EJ. Distinct and complex bacterial profiles in human periodontitis and health revealed by 16S pyrosequencing. ISME J. 2012; 6(6): 1176–1185.
17. Najmanova L, Sabova L, Lenartova M, Janatova T, Mysak J, Vetrovsky T, Tesinska B, Balikova Novotna G, Koberska M, Broukal Z, Duskova J, Podzimek S, Janata J. R/G value – a numeric index of individual periodontal health and oral microbiome dynamics. Front Cell Infect Microbiol. 2021; doi: 10.3389/fcimb.2021.602643
18. Prakasam A, Elavarasu SS, Natarajan RK. Antibiotics in the management of aggressive periodontitis. J Pharm Bioallied Sci. 2012; 4(Suppl. 2): S252–S255.
19. Aral K, Aral CA, Kapila Y. Six–month clinical outcomes of non-surgical periodontal treatment with antibiotics on apoptosis markers in aggressive periodontitis. Oral Dis. 2019; 25(3): 839–847.
20. Isola G. Antibiotics and antimicrobials for treatment of the oral microbiota: myths and facts in research and clinical practice. Antibiotics (Basel). 2020; 9(2): 95.
21. Mendes CL, de Assis P, Annibal H, de Oliveira LJR, de Albuquerque MS, de Lima Soares M, Lago MC, Braz R. Metronidazole and amoxicillin association in aggressive periodontitis: A systematic review and meta-analysis. Saudi Dent J. 2020; 32(6): 269–275.
22. Rams TE, Sautter JD, van Winkelhoff AJ. Comparative in vitro resistance of human periodontal bacterial pathogens to tinidazole and four other antibiotics. Antibiotics (Basel). 2020; 9(2): 68.
23. Araujo CF, Andere NMRB, dos Santos NCC, Mathias–Santamaria IF, Reis AA, de Oliveira LD, Jardini MAN, Casarin RCV, Santamaria MP. Two different antibiotic protocols as adjuncts to one-stage full-mouth ultrasonic debridement to treat generalized aggressive periodontitis: A pilot randomized controlled clinical trial. J Periodontol. 2019; 90(12): 1431–1440.
24. Kaner D, Christan C, Dietrich T, Bernimoulin JP, Kleber BM, Friedmann A. Timing affects the clinical outcome of adjunctive systemic antibiotic therapy for generalized aggressive periodontitis. J Periodontol. 2007; 78(7): 1201–1208.
25. Abdallaoui-Maan L, Bouziane A. Effects of timing of adjunctive systemic antibiotics on the clinical outcome of periodontal therapy: A systematic review. Clin Exp Dent. 2020; 12(3): e300–e309.
26. Johnson JD, Chen R, Lenton PA, Zhang G, Hinrichs JE, Rudney JD. Persistence of extracrevicular bacterial reservoirs after treatment of aggressive periodontitis. J Periodontol. 2008; 79(12): 2305–2312.
27. Lenartova M, Tesinska B, Janatova T, Hrebicek O, Mysak J, Janata J, Najmanova L. The oral microbiome in periodontal health. Front Cell Infect Microbiol. 2021; doi: 10.3389/fcimb.2021.629723
28. Eick S, Nydegger J, Bürgin W, Salvi GE, Sculean A, Ramseier C. Microbiological analysis and the outcomes of periodontal treatment with or without adjunctive systemic antibiotics – a retrospective study. Clin Oral Investig. 2018; 22(9): 3031–3041.
29. 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. 2019; 23(7): 3073–3085.
Štítky
Maxillofacial surgery Orthodontics Dental medicineČlánok vyšiel v časopise
Czech Dental Journal
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