Effect of adjunctive amoxicillin/metronidazole treatment on the recolonization levels of subgingival Tannerella forsythia, Prevotella intermedia and Fusobacterium nucleatum in periodontitis patients

Amaç: Periodontitis tedavisinde cerrahi olmayan periodontal tedavi ile eş zamanlı antibiyotik uygulamaları kabul görmüş bir yaklaşımdır. Bununla beraber, bakteri rekolonizasyonu tedavi kazanımlarının idamesini güçleştiren bir durumdur. Bu çalışmanın amacı, periodontitis tedavisinde amoksisilin ve metronidazol kombinasyonunun tedavi sonrası 6 aylık dönemde klinik ve mikrobiyolojik etkilerinin değerlendirilmesidir.Gereç ve Yöntemler: Yirmi iki periodontitis hastası test (n=12) ve kontrol (n=10) gruplarına ayrıldı. Test grubu diştaşı temizliği ve kök yüzeyi düzleştirmesi işlemlerine ilaveten eş zamanlı amoksisilin ve metronidazol tedavisi alır iken, kontol grubuna yalnızca diştaşı temizliği ve kök yüzeyi düzleştirmesi uygulandı. Klinik değerlendirmeler başlangıçta ve 1, 3 ve 6. takip aylarında gerçekleştirildi. Fusobacterium nucleatum, Tannerella forsythia ve Prevotella intermedia seviyeleri gerçek zamanlı polimeraz zincir reaksiyonu yöntemi ile belirlendi.Bulgular: Her iki grupta da bütün takip aylarında başlangıca göre anlamlı düzelmeler gözlendi. Bununla beraber, test grubunda 3. ve 6. aylarda kontrol grubunda göre daha fazla düzeyde klinik iyileşmeler tespit edildi. Her iki grupta da incelenen bakterilerin miktarlarında belirli düşüşler görülse de, yalnızca T. forsythia seviyeleri tüm takip aylarında test grubunda kontrol grubuna göre anlamlı seviyelerde düşüş gösterdi.Sonuçlar: Bu çalışmanın sonuçları, diştaşı temizliği ve kök yüzeyi düzleştirmesine ilaveten uygulanan amoksisilin/metronidazole tedavisinin ilave klinik faydalar ortaya koyduğunu göstermektedir. Ayrıca, destekleyici antibiyotik tedavisi T. forsythia rekolonizasyonunu baskılamıştır.Anahtar Kelimeler: periodontitis; amoksisilin; metronidazol; Real-Time PCR

Anahtar Kelimeler:

periodontitis, amoksisilin, metronidazol, Real-Time PCR

Effect of adjunctive amoxicillin/metronidazole treatment on subgingival Tannerella forsythia, Prevotella intermedia and Fusobacterium nucleatum recolonization in periodontitis patients

Background: The use of antibiotics adjunctive to non-surgical periodontal treatment is an accepted approach in the treatment of periodontitis. However, bacterial recolonization is a major drawback which complicates the maintenance of therapeutic acquisitions. The aim of this study was to evaluate the clinical and microbiological effects of adjunctive amoxicillin and metronidazole combination in the treatment of periodontitis during 6 months follow-up.Methods: Twenty-two periodontitis patients were assigned as test (n=12) and control (n=10) groups. While test group received amoxicillin and metronidazole combination as an adjunct to scaling and root planing, control group treated with scaling and root planing alone. Clinical examinations and subgingival dental plaque sampling were conducted at baseline and 1, 3 and 6. months during the follow-up. Fusobacterium nucleatum, Tannerella forsythia and Prevotella intermedia levels were determined using real time polymerase chain reaction method.Results: Both groups exhibited significant improvements in each follow-up period when compared to baseline. However, clinical improvements in test group were more prominent than control group as 3rd and 6th months. While some decrease was notable in the counts of all investigated bacteria in both groups, only T. forsythia levels significantly reduced at all follow-up months in test group comparing with controls.Conclusions: The results of this study indicated that amoxicillin/metronidazole treatment adjunctive to scaling and root planing provided additional clinical benefits and suppressed the T. forsythia recolonization.Keywords: periodontitis; amoxicillin; metronidazole; Real-Time PCR

Keywords:

periodontitis, amoxicillin, metronidazole, Real-Time PCR,

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