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Query: UMLS:C0031099 (periodontitis)
 12,489 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The activity of various antibacterial agents (amoxicillin, josamycin, doxycycline and metronidazole) was established in vitro using a rapid micromethod. The activity of these agents, which are widely used in oral medicine, was evaluated against microorganisms responsible for periodontitis and bucco-dental infections. Their action against alpha-hemolytic streptococci (including pneumococci) which make up the majority of the indigenous oral flora was also tested. Amoxicillin was found to be effective against all the strains tested. Doxycycline was active against periodontal bacteria, but not against 50% of the streptococcal flora. Josamycin was found to be effective against streptococci, but appeared without effect on Eikenella corrodens and Actinobacillus actinomycetemcomitans. Metronidazole, inactive against streptococci, displayed greater activity towards the strict anaerobes. The use of these antibiotics for the treatment of bucco-dental infections, especially periodontitis, is discussed. For periodontitis and periodontal suppurations, antimicrobial agents present a valuable adjunct to local treatments such as scaling or rootplaning. This may prevent more serious infections such as endocarditis that can develop after tooth extraction.
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PMID:Evaluation of the activity of four antimicrobial agents using an in vitro rapid micromethod against oral streptococci and various bacterial strains implicated in periodontitis. 214 28

Periodontitis is a common condition in dogs. Treatment of periodontitis consists of mechanical removal of plaque and calculus by scaling, root planing, and polishing the teeth. Antimicrobial therapy can provide additional improvement in severe or refractory cases of periodontitis when combined with dental prophylaxis if ongoing plaque control is not provided. The ability of various antimicrobials to reach therapeutic levels in the periodontal tissues differs greatly. The efficacy of antimicrobials against common periodontal pathogens also varies greatly. Choosing an appropriate antibiotic to treat periodontitis should be based on these considerations. Amoxicillin-clavulanate, clindamycin, and nitroimidazoles, such as metronidazole and tinidazole, seem to be particularly effective based on pharmacokinetic and clinical studies.
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PMID:Systemic antimicrobials in the treatment of periodontitis in dogs. 821 Aug 2

The recognition that periodontal diseases are primarily caused by specific microorganisms has led researchers to explore the possibility that antibiotics may enhance the effect of mechanical debridement procedures such as scaling and surgery. For some selected periodontal diseases, this has proven to be true. This paper will review systemically-administered antibiotics and the clinical studies and case reports supporting their use. In periodontal therapy, the tetracyclines are the most commonly-used antibiotics in the United States. Tetracycline hydrochloride, minocycline, and doxycycline have been shown to inhibit in vitro most putative periodontal pathogens. Several studies support the use of tetracyclines in the treatment of localized juvenile periodontitis. Penicillins such as amoxicillin are effective in vitro against most periodontal pathogens but have limited efficacy due to the presence of beta-lactamases in gingival fluid. Amoxicillin/clavulanate potassium (Au) has proven effective in treating adult refractory periodontitis characterized by a Gram-positive flora. Metronidazole is an effective adjunct in adult periodontitis associated with high numbers of "black-pigmented Bacteroides" ad spirochetes. A combination of metronidazole and amoxicillin produces a synergistic effect against A. actinomycetemcomitans and has been shown to be effective at eliminating this organism. Clindamycin is an effective adjunct in the treatment of adult refractory periodontitis associated with a predominantly Gram-negative flora. The use of macrolides, quinolones, and combinations of antibiotics is discussed. Clinical studies do not support the use of systemically-administered antibiotics in routine adult periodontitis. Clinical studies do, however, support the use of antibiotics in the treatment of specific periodontal diseases.
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PMID:Current status of systemic antibiotic usage in destructive periodontal disease. 841 Jun 16

The aerobic and anaerobic flora from gingival pockets of 49 dogs with severe gingivitis and periodontitis were cultured. The susceptibility of each isolate to four antimicrobial agents currently approved for veterinary use in the USA (amoxicillin-clavulanic acid; clindamycin; cefadroxil; and enrofloxacin) was determined. Amoxicillin-clavulanic acid (Clavamox Pfizer Animal Health) had the highest in-vitro susceptibility against all isolates (96%), all aerobes (94%) and all anaerobes (100%) tested. For gram-negative aerobes, enrofloxacin (Baytril, Bayer Corp.) had the highest in-vitro susceptibility activity. For bacteria associated with treatment of gingivitis, which typically are mixed aerobic/anaerobic and gram-positive/gram-negative organisms, the antimicrobial of choice for clinical use based on these susceptibility tests is amoxicillin-clavulanic acid.
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PMID:Antimicrobial susceptibility of subgingival bacterial flora in dogs with gingivitis. 969 43

The successful management of multi-space orofacial odontogenic infections involves identification of the source of the infection, the anatomical spaces encountered, the predominant microorganisms that are found during the various stages of odontogenic fascial space infection, the impact of the infectious process on defense systems, the ability to use and interpret laboratory data and imaging studies, and a thorough understanding of contemporary antibiotic and supportive care. The therapeutic goals, when managing multi-space odontogenic infections, are to restore form and/or function while limiting patient disability and preventing recurrence. Odontogenic infections are commonly the result of pericoronitis, carious teeth with pulpal exposure, periodontitis, or complications of dental procedures. The second and third molars are frequently the etiology of these multi-space odontogenic infections. Of the two teeth, the third molar is the more frequent source of infection. Diagnostic imaging modalities are selected based on the patient's history, clinical presentation, physical findings and laboratory results. Periapical and panoramic x-rays are reliable initial screening instruments used in determining etiology. Magnetic resonance imaging and computed tomography are ideal imaging studies that permit assessment of the soft tissue involvement to include determining fluid collections, distinguishing abscess from cellulitis, and offering insight as to airway patency. Antibiotics are administered to assist the host immune system's effort to control and eliminate invading microorganisms. Early infections, first three (3) days of symptoms, are primarily caused by aerobic streptococci which are sensitive to penicillin. Amoxicillin is classified as an extended spectrum penicillin. The addition of clavulanic acid to amoxicillin (Augmentin) increases the spectrum to staphylococcus and other anaerobes by conferring beta-lactamase resistance. In late infections, more than three (3) days of symptoms, the predominant microorganisms are anaerobes, predominantly Peptostreptococcus, Fusobacterium, or Bacteroides, that are resistant to penicillin. Clindamycin is an attractive alternative drug for first line therapy in the treatment of these infections. The addition of metronidazole to penicillin is also an excellent treatment choice. Alternatively, Unasyn (Ampicillin/Sublactam), should be considered. The mainstay of management of these infections remains appropriate culture for bacterial identification, timely and aggressive incision and drainage, and removal of the etiology. It is usually preferable to drain multi-space infections involving the submandibular, submental, masseteric, pterygomandibular, temporal, and/or lateral pharyngeal masticator spaces, as early as possible from an extraoral approach. Trismus and airway management are important considerations and may preclude the selection of other surgical approaches. The patients with multi-space infections should be hospitalized and patient care provided by experienced clinicians capable of management of airway problems, in administration of parenteral antibiotics and fluids, utilization of interpretation of laboratory and diagnostic imaging studies, and control of possible surgical complications.
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PMID:Management of complex multi-space odontogenic infections. 1257 6

Most infections of the oral cavity are primary, odontogenic infections, with dental caries, gingivitis, and periodontitis the most common. Treating these infections will encompass odontologic, antimicrobial, surgical or combined treatment. Antimicrobial treatment includes the use of betalactams, macrolydes, tetracyclins, metronidazole, clindamycin, or combined treatment. The most commonly used ones are administered orally. PK/ PD parameters predict THE clinical and microbiological efficacy of the antibiotic. The three indices that are generally used to measure clinical efficacy are: T >MIC (time during which the concentration is above the minimum inhibitory concentration), Cmax/ MIC (ratio between peak concentration and the minimum inhibitory concentration) and AUC/ MIC (ratio between the area under the curve and the minimum inhibitory concentration). Amoxicillin/ clavulanic acid is one of the antibiotics recommended for the treatment of odontogenic infections due to its wide spectrum, low incidence of resistance, pharmacokinetic profile, tolerance and dosage.
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PMID:Treatment options in odontogenic infection. 1558 Jan 34

Severe periodontitis treatment, where massive alveolar bone loss occurs, involves bone defect filling and intensive systemic log-term antibiotics administration. This study aims at developing novel injectable drug delivery systems (nanohydroxyapatite microspheres) with the drug releasing capability for periodontitis treatment and simultaneously initiating the osteointegration process. Materials were characterized by XRD, SEM, inverted stand optical microscope analysis, and mercury porosimetry method. Amoxicillin, amoxicillin + clavulanic acid, and erythromycin were the antibiotics used. Release properties during 28 days from the hydroxyapatite (HA) granules, and two types of nanoHA microspheres were investigated. Biocompatibility was assessed by cytotoxicity assays. HA granules were inadequate, releasing all antibiotic during the first hours. The concentration of antibiotics released in the first days from HA-2 was higher than from HA-1 microspheres, because of the increased porosity and surface area. The release profiles (fast initial release followed by long-term sustained release) of effective doses of antibiotics make these systems good alternatives for antibiotics delivery. Osteoblasts proliferated well on both types of microspheres, being cell growth enhanced in the presence of antibiotics. Erythromycin presented the most beneficial effect. Combining the sustained antibiotic release with the osteoconduction, resorbability, and potential use as injectable bone filling material of porous HA microspheres, these systems provided a forth fold beneficial effect.
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PMID:Nanohydroxyapatite microspheres as delivery system for antibiotics: release kinetics, antimicrobial activity, and interaction with osteoblasts. 1725 59

The occurrence of bacterial strains resistant to different antimicrobials is a growing problem in Latin American countries. The aim was to measure the antimicrobial susceptibility of Fusobacterium nucleatum, Prevotella intermedia and Prophyromona gingivalis, isolated from chronic periodontitis patients. Twenty-five patients diagnosed with generalized- moderate or advanced- chronic periodontitis were consecutively recruited from patients attending the Periodontal Specialist Program, Javeriana University, according to specific criteria, including no recent antibiotic consumption. All patients filled out a questionnaire on antibiotic intake. The deepest periodontal pocket in each quadrant was sampled. Pooled samples were mixed, diluted and plated on enriched brucella agar plates. After anaerobic incubation, identification of the target bacteria was performed, based on colony morphology, gram staining, aerotolerance and biochemical reactions (RapID Ana II, Remel, U.S.A.). Following identification, the bacteria were subjected to antimicrobial testing, using amoxicillin, tetracycline, doxycicline, azithromycin and metronidazole (E-test, AbBiodisk, Sweden). The minimal inhibitory concentrations obtained were compared with a reference standard to determine antimicrobial resistance. Amoxicillin-resistant species were tested for beta-lactamase production. Forty-four percent of the patients used antibiotics without any medical prescription, 40% used antibiotics at least once a year. The presence of eleven species was confirmed after a series of biochemical tests: four Fusobacterium nucleatum, five Prevotella intermedia and two Prophyromona gingivalis. All strains were resistant to metronidazole, five were resistant to tetracycline and azithromicin, and two strains were resistant to doxycicline and amoxicillin. The strains resistant to amoxicillin were positive for beta-lactamase production, Antimicrobial resistance, particularly against metronidazole, was a common phenomenon for the bacterial isolates analyzed in this Colombian sample.
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PMID:Antibiotic resistance of periodontal pathogens obtained from frequent antibiotic users. 1983 85

Inappropriate prescribing of antibiotics by health care professionals is a worldwide concern. This study evaluated the knowledge and practices of dental practitioners in the city of Shiraz, Islamic Republic of Iran regarding their therapeutic use of antibiotics for patients with dentoalveolar infections. Of 219 (48.6%) dentists responding to the questionnaire more than 40% would prescribe antibiotics for localized fluctuant swelling and for problems for which antibiotics are not required according to good practice guidelines (acute pulpitis, chronic apical infection, periodontal abscess, chronic gingivitis, chronic periodontitis, pericoronitis and dry socket). A majority correctly prescribed antibiotics for acute periapical infection (77.2%), cellulitis (75.3%) and acute ulcerated gingivitis (63.0%). Amoxicillin was the most frequently prescribed antibiotic for all clinical conditions but there was a wide variation in dosage, frequency and duration for all antibiotics used. Guidelines on rational antibiotic use are needed for dental practitioners in the Islamic Republic of Iran.
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PMID:Study of antibiotic prescribing among dental practitioners in Shiraz, Islamic Republic of Iran. 2225 11

Peripheral giant cell reparative granuloma is a reactive and rare lesion of oral cavity with unknown etiology which is derived from periosteum and periodontal ligament and occurs frequently in young adults. Inflammation or trauma is underlying causative factor of reactive proliferation. In the present case report, a 35 year-old male with aggressive periodontitis and peripheral giant cell reparative granuloma is presented. The patient applied to our clinic with a complaining about a big nodule at his palate. The lesion was pedunculated and localized at his right maxilla between #16 and #17 which arose from distal aspect of #16, and the surface of the lesion was hyperkeratotic and the lesion was measured 22 x 30 mm at the largest diameter. He also had severe generalized aggressive periodontitis and hypertension. Amoxicillin clavulanate 625 mg, three times a day, metronidazole 500 mg three times a day and 0.2% chlorhexidine digluconate oral rinse, twice a day for a week, were prescribed to the patient. Then, scaling and root planing were performed along with systemic antibiotic treatment and he scheduled for surgery. The lesion was excised completely and #16 was extracted. After the healing period, periodontal surgery was planned for the treatment of aggressive periodontitis. Obtained tissue specimen was sent for histopathological examination. The diagnosis of peripheral giant cell reparative granuloma was confirmed with histopathological examination. No intra- and post-operative complications were seen.
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PMID:Peripheral giant cell reparative granuloma of maxilla in a patient with aggressive periodontitis. 2528 27


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