Review Article


DOI :10.17096/jiufd.90144   IUP :10.17096/jiufd.90144    Full Text (PDF)

ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY

Ece BarçaEmine ÇifcibaşıSerdar Çintan

Periodontal diseases are infectious diseases with a mixed microbial aetiology and marked inflammatory response leading to destruction of underlying tissue. Periodontal therapy aims to eliminate pathogens associated with the disease and attain periodontal health. Periodontitis is generally treated by nonsurgical mechanical debridement and regular periodontal maintenance care. Periodontal surgery may be indicated for some patients to improve access to the root surface; however, mechanical debridement alone may not be helpful in all cases. In such cases, adjunctive systemic antibiotic therapy remains the treatment of choice. It can reach microorganisms at the base of the deep periodontal pockets and furcation areas via serum, and also affects organisms residing within gingival epithelium and connective tissue. This review aims to provide an update on clinical issues regarding when and how to prescribe systemic antibiotics in periodontal therapy. The points discussed are the mode of antibiotic action, susceptible periodontal pathogens, antibiotic dosage, antibiotic use in treatment of periodontal disease, and mechanism of bacterial resistance to each antibiotic.

DOI :10.17096/jiufd.90144   IUP :10.17096/jiufd.90144    Full Text (PDF)

PERİODONTAL TEDAVİDE KULLANILAN ANTİBİYOTİKLER

Ece BarçaEmine ÇifcibaşıSerdar Çintan

Periodontal hastalıklar periodontal dokuların doku yıkımına yol açan, karışık mikrobiyal etyolojisi ve belirgin inflamatuvar yanıt ile karakterize enfeksiyöz hastalıklardır. Periodontal tedavinin amacı, hastalık ile ilişkili patojenlerin ortadan kaldırılması ve periodontal sağlığın elde edilmesidir. Periodontitis tedavisi genellikle cerrahi olmayan mekanik debridman ve düzenli periodontal bakım ile yapılır. Periodontal cerrahi bazı hastalarda kök yüzeyine erişimi artırmak için endike olabilir; ancak, yalnız mekanik debridman tüm durumlarda yarar sağlamayabilir. Bu tür durumlarda, ilave antibiyotik tedavisi düşünülebilir. Böylece, serum ile derin periodontal cepler ve furkasyon alanlarının tabanında mikroorganizmalara ulaşım ve aynı zamanda dişeti epiteli ve bağ dokusu içinde bulunan organizmalara etki sağlanır. Bu derlemede, periodontal hastalıkta ne zaman ve hangi durumlarda sistemik antibiyotik reçete edilmesi gerektiği üzerine güncel klinik yaklaşımlar değerlendirilmiştir. Etki mekanizmaları, duyarlı periodontal patojenler, dozaj, periodontal hastalıkların tedavisinde kullanımı ve her antibiyotik için bakteri direnç mekanizması tartışılmıştır.


PDF View

References

  • Saglie FR, Carranza FA Jr, Newman MG, Cheng L, Lewin KJ. Identification of tissue-invading bacteria in human periodontal disease. J Periodontol Res 1982;17(5):452–455. google scholar
  • Marsh PD. Dental plaque: biological significance of a biofilm and community life-style. J Clin Periodontol 2005;32(Suppl 6):7–15. google scholar
  • Eick S, Seltmann T, Pfister W. Efficacy of antibiotics to strains of periodontopathogenic bacteria within a single species biofilm - an in vitro study. J Clin Periodontol 2004;31(5):376–383. google scholar
  • Aas JA, Paster BJ, Stokes LN, Olsen I, Dewhirst FE. Defining the normal bacterial flora of the oral cavity. J Clin Microbiol 2005;43(11):5721-5732. google scholar
  • Walker CB. The acquisition of antibiotic resistance in the periodontal microflora. Periodontol 2000 1996;10:79-88. google scholar
  • Slots J, Rams TE. New views on periodontal microbiota in special patient categories. J Clin Periodontol 1991;18(6):411-420. google scholar
  • Schenkein HA, Van Dyke TE. Early-onset periodontitis: systemic aspects of etiology and pathogenesis. Periodontol 2000 1994;6(1):7-25. google scholar
  • Johnson BD, Engel D. Acute necrotizing ulcerative gingivitis. A review of diagnosis, etiology and treatment. J Periodontol 1986;57(3):141-150. google scholar
  • Slots J, Rams TE. Antibiotics in periodontal therapy: advantages and disadvantages. J Clin Periodontol 1990;17(7 Pt 2):479-493. google scholar
  • Haffajee AD, Socransky SS, Gunsolley JC. Systemic anti-infective periodontal therapy. A systematic review. Ann Periodontol 2003;8(1):115-181. google scholar
  • Pallasch TJ. Pharmacokinetic principles of antimicrobial therapy. Periodontol 2000 1996;10(1):5-11. google scholar
  • van Winkelhoff AJ, Rams TE, Slots J. Systemic antibiotic therapy in periodontitis. Periodontol 2000 1996;10(1):45-78. google scholar
  • Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontol 2000 2002;28(1):12-55. google scholar
  • Van Winkelhoff AJ, Van der Velden U, Clement M, De Graaff J. Intra-oral distribution of black-pigmented Bacteriodes species in periodontitis patients. Oral Microbiol Immunol 1988;3(2):83-85. google scholar
  • Walker CB. Selected antimicrobial agents: mechanism of action, side effects and drug interactions. Periodontol 2000 1996;10(1):12-28. google scholar
  • Loesche WJ, Grossman N, Giordano J. Metronidazole in periodontitis (IV). The effect of patient compliance on treatment parameters. J Clin Periodontol 1993;20(2):96-104. google scholar
  • Pavicic MJ, van Winkelhoff AJ, de Graaff J. In vitro susceptibilities of Actinobacilus actinomycetemcomitans to a number of antimicrobial combinations. Antimicrob Agents Chemother 1992;36(12):2634-2638. google scholar
  • Slots J, Schonfeld SE. Actinobacillus actinomycetemcomitans in localized juvenile periodontitis. In: Hamada S, Holt SC, McGhee, JR, (Ed). Periodontal disease: pathogens& host immune responses. Tokyo: Quintessence Publishing Co.;1991,p.53-64. google scholar
  • Goodson JM. Antimicrobial strategies for treatment of periodontal diseases. Periodontol 2000 1994;5(1):142-68. google scholar
  • Herrera D, Alonso B, Leon R, Roldan S, Sanz M. Antimicrobial therapy in periodontitis: the use of systemic antimicrobials against the subgingival biofilm. J Clin Periodontol 2008;35(8 Suppl):45-66. google scholar
  • Herrera D, Sanz M, Jepsen S, Needleman I, Roldan S. A systematic review on the effect of systemic antimicrobials as an adjunct to scaling and root planning in periodontitis patients. J Clin Periodontol 2002;29(Suppl 3):136-159. google scholar
  • Lindhe J, Palmer R. Group C summary. J Clin Periodontol 2002;29(Suppl 3):160-162. google scholar
  • Sanz M, Teughels W. Innovations in non-surgical periodontal therapy: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008;35(8 Suppl):3-7. google scholar
  • Sampaio E, Rocha M, Figueiredo LC, Faveri M, Duarte PM, Gomes Lira EA, Feres M. Clinical and microbiological effects of azithromycin in the treatment of generalized chronic periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol 2011;38(9):838–846. google scholar
  • Silva MP, Feres M, Sirotto TA, Soares GM, Mendes JA, Faveri M, Figueiredo LC. Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol 2011;38(9):828–837. google scholar
  • Mestnik MJ, Feres M, Figueiredo LC, Duarte PM, Lira EA, Faveri M. Short-term benefits of the adjunctive use of metronidazole plus amoxicillin in the microbial profile and in the clinical parameters of subjects with generalized aggressive periodontitis. J Clin Periodontol 2010;37(4):353–365. google scholar
  • Yek EC, Cintan S, Topcuoglu N, Kulekci G, Issever H, Kantarci A. Efficacy of amoxicillin and metronidazole combination for the management of generalized aggressive periodontitis. J Periodontol 2010;81(7):964–974. google scholar
  • Griffiths GS, Ayob R, Guerrero A, Nibali L, Suvan J, Moles DR, Tonetti MS. Amoxicillin and metronidazole as an adjunctive treatment in generalized aggressive periodontitis at initial therapy or re-treatment: a randomized controlled clinical trial. J Clin Periodontol 2011;38(1):43–49. google scholar
  • Guerrero A, Griffiths GS, Nibali L, Suvan J, Moles DR, Laurell L, Tonetti MS. Adjunctive benefits of systemic amoxicillin and metronidazole in non-surgical treatment of generalized aggressive periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol 2005;32(10):1096–1107. google scholar
  • Heller D, Varela VM, Silva-Senem MX, Torres MC, Feres-Filho EJ, Colombo AP. Impact of systemic antimicrobials combined with anti-infective mechanical debridement on the microbiota of generalized aggressive periodontitis: a 6-month RCT. J Clin Periodontol 2011;38(4):355–364. google scholar
  • Varela VM, Heller D, Silva-Senem MX, Torres MC, Colombo AP, Feres-Filho EJ. Systemic antimicrobials adjunctive to a repeated mechanical and antiseptic therapy for aggressive periodontitis: a 6-month randomized controlled trial. google scholar
  • J Periodontol 2011;82(8):1121–1130. google scholar
  • Aimetti M, Romano F, Guzzi N, Carnevale G. Full-mouth disinfection and systemic antimicrobial therapy in generalized aggressive periodontitis: a randomized, placebo-controlled trial. J Clin Periodontol 2012;39(3):284–294. google scholar
  • Bonito AJ, Lux L, Lohr KN. Impact of local adjuncts to scaling and root planing in periodontal disease therapy: a systematic review. J Periodontol 2005;76(8):1227–1236. google scholar
  • Pradeep AR, Sagar SV, Daisy H. Clinical and microbiologic effects of subgingivally delivered 0.5% azithromycin in the treatment of chronic periodontitis. J Periodontol 2008;79(11):2125-2135. google scholar
  • Oteo A, Herrera D, Figuero E, O'Connor A, Gonzalez I, Sanz M. Azithromycin as an adjunct to scaling and root planing in the treatment of Porphyromonas gingivalis-associated periodontitis: a pilot study. J Clin Periodontol 2010;37(11):1005–1015. google scholar
  • Onan U, Isik G, Firatli E. Periodontal tedavide kullanılan kemoterapötikler II: antibiyotikler, antibakteriyel ajanlar ve hassasiyet giderici ilaçlar. İstanbul Üniv Diş Hek Fak Derg 1992;26(1):42-47. google scholar

Citations

Copy and paste a formatted citation or use one of the options to export in your chosen format


EXPORT



APA

Barça, E., Çifcibaşı, E., & Çintan, S. (2015). ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY. European Oral Research, 49(3), 55-62. https://doi.org/10.17096/jiufd.90144


AMA

Barça E, Çifcibaşı E, Çintan S. ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY. European Oral Research. 2015;49(3):55-62. https://doi.org/10.17096/jiufd.90144


ABNT

Barça, E.; Çifcibaşı, E.; Çintan, S. ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY. European Oral Research, [Publisher Location], v. 49, n. 3, p. 55-62, 2015.


Chicago: Author-Date Style

Barça, Ece, and Emine Çifcibaşı and Serdar Çintan. 2015. “ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY.” European Oral Research 49, no. 3: 55-62. https://doi.org/10.17096/jiufd.90144


Chicago: Humanities Style

Barça, Ece, and Emine Çifcibaşı and Serdar Çintan. ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY.” European Oral Research 49, no. 3 (Dec. 2024): 55-62. https://doi.org/10.17096/jiufd.90144


Harvard: Australian Style

Barça, E & Çifcibaşı, E & Çintan, S 2015, 'ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY', European Oral Research, vol. 49, no. 3, pp. 55-62, viewed 22 Dec. 2024, https://doi.org/10.17096/jiufd.90144


Harvard: Author-Date Style

Barça, E. and Çifcibaşı, E. and Çintan, S. (2015) ‘ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY’, European Oral Research, 49(3), pp. 55-62. https://doi.org/10.17096/jiufd.90144 (22 Dec. 2024).


MLA

Barça, Ece, and Emine Çifcibaşı and Serdar Çintan. ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY.” European Oral Research, vol. 49, no. 3, 2015, pp. 55-62. [Database Container], https://doi.org/10.17096/jiufd.90144


Vancouver

Barça E, Çifcibaşı E, Çintan S. ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY. European Oral Research [Internet]. 22 Dec. 2024 [cited 22 Dec. 2024];49(3):55-62. Available from: https://doi.org/10.17096/jiufd.90144 doi: 10.17096/jiufd.90144


ISNAD

Barça, Ece - Çifcibaşı, Emine - Çintan, Serdar. ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY”. European Oral Research 49/3 (Dec. 2024): 55-62. https://doi.org/10.17096/jiufd.90144



TIMELINE


Submitted09.09.2014
Accepted13.03.2015
Published Online21.10.2015

SHARE




Istanbul University Press aims to contribute to the dissemination of ever growing scientific knowledge through publication of high quality scientific journals and books in accordance with the international publishing standards and ethics. Istanbul University Press follows an open access, non-commercial, scholarly publishing.