| 0219 Short-Time Effects of Systemic Antibiotics in Periodontal Disease Therapy | ||
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R. BUCHMANN1, G. CONRADS2, L. GERLAND3, U. NEHLMEYER3, and A. HERFORTH4, 1 Practice limited to Periodontics, Hamm, Germany, 2 Division of Oral Microbiology and Immunology, Aachen, Germany, 3 Private Practice, Unna, Germany, 4 Department of Periodontology, Duesseldorf, Germany Objectives: The hypothesis was tested that the time-course of subgingival recolonization during healing changes upon administration of systemic antibiotics as adjuncts to periodontal therapy. Methods: In 29 subjects (average age 49.3 ± 12.8 y) clinical and microbial parameters were assessed prior to and at day 2, 3, 4, 7, 10 and 21 after completion of full mouth scaling and root planning (SRP). 19 patients with aggressive periodontitis (AP) received either adjunctive antibiotic therapy with amoxicillin plus metronidazole (AP+AB) or were treated mechanically only (AP). 10 subjects with chronic periodontitis (CP) served as controls. In subgingival plaque samples Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis and Prevotella intermedia were identified with digoxigenin labeled 16S rRNA oligodeoxynucleotide probes and dot-blot hybridization (LCL biokey GmbH, Aachen) with concentrations semi-quantitatively determined in cells per sample. Statistical analysis was performed on a patient level. Results: In untreated periodontitis, subgingival prevalence of A. a. was 88.9 % in AP versus 60.0 % in CP. Posttherapy, immediate subgingival elimination of A. a. occurred in all 3 treatment groups at day 2. After 3 weeks, A. a. was prevalent in 22.2 % (AP+AB) and in 30 % (AP, CP). At baseline, subgingival cellcount in AP was 3.3- (P.i.), 5.7- (T.f.), 10.2- (A.a.) and 69.9-fold (P.g.) enhanced compared to CP. At day 7 of healing, the subgingival load of all four target pathogens in AP+AB dropped beyond the levels of AP and CP, and remained low until day 21. However, even with adjunctive systemic antibiotics, an elimination of pathogens was hardly recognized. All three treatment groups yielded statistically significant differences in clinical parameters before and after SRP. Conclusion: Mechanical periodontal therapy supported by systemic antibiotics rapidly lowers the total microbial load in the subgingival environment during healing, but has minor effect on the elimination of target isolates following therapy. | ||
| Seq #21 - Periodontal Research 11:00 AM-1:00 PM, Friday, 27 August 2004 Crowne Plaza Hotel SEDEF I | ||
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