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Article: Local antibiotic therapy guided by microbiological diagnosis: Treatment of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans persisting after mechanical therapy

TitleLocal antibiotic therapy guided by microbiological diagnosis: Treatment of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans persisting after mechanical therapy
Authors
KeywordsA. Actinomycetemcomitans
Amoxicillin
Eradication
Metronidazole
P. Gingivalis
Periodontal Therapy
Persistence
Tetracycline
Issue Date2002
PublisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CPE
Citation
Journal Of Clinical Periodontology, 2002, v. 29 n. 8, p. 743-749 How to Cite?
AbstractBackground: The aim of this study was to determine the distribution patterns of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in periodontitis patients after standard mechanical periodontal therapy, and to evaluate the effect of additional local antibiotic therapy, given to all teeth with cultural evidence of these bacteria. Methods: 17 patients were included. 852 separate subgingival microbial samples were taken from the mesial and distal aspect of every tooth in 17 subjects at baseline. 46 of these samples, from 10 positive subjects, showed cultural evidence for P. gingivalis. 82 samples, from 5 subjects, were A. actinomycetemcomitans-positive. Three subjects showed no evidence for persistence of A. actinomycetemcomitans or P. gingivalis. In the other 14 subjects, all A. actinomycetemcomitans- or P. gingivalis-positive teeth were treated with tetracycline fibers (ACTISITE®). Subgingival microbial samples were again taken from two sites of every tooth, 1 month after fiber removal. 89% of the initially P. gingivalis-positive sites were now negative, but 16 previously negative sites now tested positive. 77% of the initially A. actinomycetemcomitans-positive sites were now negative, but 5 previously negative sites now tested positive. The teeth with persisting P. gingivalis or A. actinomycetemcomitans were again treated with fibers. Two sites of every tooth were once more sampled after 1 month. At this time, 5 subjects still showed cultural evidence of P. gingivalis at a total of 19 sites, and 4 subjects were positive for A. actinomycetemcomitans in a total of 27 sites. These 9 patients were finally submitted to systemic antibiotic therapy (3 x 250 mg metronidazole plus 3 x 375 mg amoxicillin/d for 7 days). Despite of all efforts, P. gingivalis was again detected 3 months later in isolated sites in 3 subjects, and A. actinomycetemcomitans could be cultivated from one single site. Conclusions: Therapy with tetracycline fibers guided by microbiological diagnosis effectively reduced P. gingivalis and A. actinomycetemcomitans locally, but was unable to completely eradicate the target organisms. Additional systemic antibiotic therapy further reduced P. gingivalis and A. actinomycetemcomitans. The observed persistence patterns suggest that reemergence of A. actinomycetemcomitans was due to recolonization, whereas the strikingly reproducible local reemergence of P. gingivalis in some sites indicated failed eradication. © Blackwell Munksgaard, 2002.
Persistent Identifierhttp://hdl.handle.net/10722/154205
ISSN
2015 Impact Factor: 3.915
2015 SCImago Journal Rankings: 1.848
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMombelli, Aen_US
dc.contributor.authorSchmid, Ben_US
dc.contributor.authorRutar, Aen_US
dc.contributor.authorLang, NPen_US
dc.date.accessioned2012-08-08T08:23:52Z-
dc.date.available2012-08-08T08:23:52Z-
dc.date.issued2002en_US
dc.identifier.citationJournal Of Clinical Periodontology, 2002, v. 29 n. 8, p. 743-749en_US
dc.identifier.issn0303-6979en_US
dc.identifier.urihttp://hdl.handle.net/10722/154205-
dc.description.abstractBackground: The aim of this study was to determine the distribution patterns of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in periodontitis patients after standard mechanical periodontal therapy, and to evaluate the effect of additional local antibiotic therapy, given to all teeth with cultural evidence of these bacteria. Methods: 17 patients were included. 852 separate subgingival microbial samples were taken from the mesial and distal aspect of every tooth in 17 subjects at baseline. 46 of these samples, from 10 positive subjects, showed cultural evidence for P. gingivalis. 82 samples, from 5 subjects, were A. actinomycetemcomitans-positive. Three subjects showed no evidence for persistence of A. actinomycetemcomitans or P. gingivalis. In the other 14 subjects, all A. actinomycetemcomitans- or P. gingivalis-positive teeth were treated with tetracycline fibers (ACTISITE®). Subgingival microbial samples were again taken from two sites of every tooth, 1 month after fiber removal. 89% of the initially P. gingivalis-positive sites were now negative, but 16 previously negative sites now tested positive. 77% of the initially A. actinomycetemcomitans-positive sites were now negative, but 5 previously negative sites now tested positive. The teeth with persisting P. gingivalis or A. actinomycetemcomitans were again treated with fibers. Two sites of every tooth were once more sampled after 1 month. At this time, 5 subjects still showed cultural evidence of P. gingivalis at a total of 19 sites, and 4 subjects were positive for A. actinomycetemcomitans in a total of 27 sites. These 9 patients were finally submitted to systemic antibiotic therapy (3 x 250 mg metronidazole plus 3 x 375 mg amoxicillin/d for 7 days). Despite of all efforts, P. gingivalis was again detected 3 months later in isolated sites in 3 subjects, and A. actinomycetemcomitans could be cultivated from one single site. Conclusions: Therapy with tetracycline fibers guided by microbiological diagnosis effectively reduced P. gingivalis and A. actinomycetemcomitans locally, but was unable to completely eradicate the target organisms. Additional systemic antibiotic therapy further reduced P. gingivalis and A. actinomycetemcomitans. The observed persistence patterns suggest that reemergence of A. actinomycetemcomitans was due to recolonization, whereas the strikingly reproducible local reemergence of P. gingivalis in some sites indicated failed eradication. © Blackwell Munksgaard, 2002.en_US
dc.languageengen_US
dc.publisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CPEen_US
dc.relation.ispartofJournal of Clinical Periodontologyen_US
dc.subjectA. Actinomycetemcomitansen_US
dc.subjectAmoxicillinen_US
dc.subjectEradicationen_US
dc.subjectMetronidazoleen_US
dc.subjectP. Gingivalisen_US
dc.subjectPeriodontal Therapyen_US
dc.subjectPersistenceen_US
dc.subjectTetracyclineen_US
dc.titleLocal antibiotic therapy guided by microbiological diagnosis: Treatment of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans persisting after mechanical therapyen_US
dc.typeArticleen_US
dc.identifier.emailLang, NP:nplang@hkucc.hku.hken_US
dc.identifier.authorityLang, NP=rp00031en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1034/j.1600-051X.2002.290811.xen_US
dc.identifier.pmid12390571-
dc.identifier.scopuseid_2-s2.0-0036676042en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036676042&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume29en_US
dc.identifier.issue8en_US
dc.identifier.spage743en_US
dc.identifier.epage749en_US
dc.identifier.isiWOS:000178791100011-
dc.publisher.placeDenmarken_US
dc.identifier.scopusauthoridMombelli, A=7006180872en_US
dc.identifier.scopusauthoridSchmid, B=7102654027en_US
dc.identifier.scopusauthoridRutar, A=6602283506en_US
dc.identifier.scopusauthoridLang, NP=7201577367en_US

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