Adjunctive moxifloxacin in the treatment of generalized aggressive periodontitis patients: clinical and microbiological results of a randomized, triple-blind and placebo-controlled clinical trial.

AIM: The aim of the present study was to evaluate the clinical and microbiological efficacy of moxifloxacin (MOX) in one-stage scaling and root planing (SRP) in treating generalized aggressive periodontitis (GAgP). MATERIALS AND METHODS: Forty subjects were randomly allocated to two treatment groups. The two treatment groups consisted of SRP combined with systemically administered MOX at the dosage of 400 mg once daily for 7 days or SRP + placebo once daily for 7 days. Subgingival plaque samples were analysed for cultivable bacteria. RESULTS: Both groups resulted in significant reduction of probing depth (PD) and clinical attachment level (CAL) compared with baseline (p < 0.0001), and this difference was maintained at 6 months from baseline in both groups. However, subjects receiving MOX showed the greatest improvements CAL, and PD. Subjects in both groups at 6 months displayed the greatest reduction from baseline in frequency of sites with PD ≥ 6 mm (p < 0.001), favouring the MOX group. Adjunctive antibiotic protocol reduced subgingival Aggregatibacter actinomycetemcomitans to undetectable levels, after 3 and 6 months, and there was a significant reduction in the levels of Porphyromonas gingivalis and Tannerella forsythia in the MOX group compared to the placebo group. CONCLUSIONS: The results from this study suggest that moxifloxacin as and adjunct to one-stage full-mouth SRP leads to a better clinical and microbiological advantages compared to mechanical treatment.

Association between the presence of Treponema denticola and reduced levels of antiatherogenic high density lipoprotein in periodontitis.

OBJECTIVE: Dyslipidemia, a disorder in the levels of cholesterol or lipoproteins in the plasma, is a feature of atherosclerosis, leading to cardiovascular disease. The objective of this study was to evaluate whether Tanerella forsythia and Treponema denticola are related to reduced levels of antiatherogenic high density lipoprotein (HDL). METHOD AND MATERIALS: In this cross-sectional study, 108 patients were invited to participate. The diagnosis of chronic periodontitis and the diagnosis of adipose tissue disorders were made based on criteria previously defined. The presence of T forsythia and T denticola was detected by polymerase chain reaction. RESULTS: A total of 61 women and 19 men with chronic periodontitis, and 18 women and 10 men without periodontitis were studied. The serum levels of total cholesterol and low density lipoprotein were similar in both groups. Inversely, the levels of triglycerides (TG) were higher in periodontitis patients compared to subjects without periodontitis (178 mg/dL vs 165 mg/dL; P < .05), and the levels of HDL were lower (44 mg/dL vs 50 mg/dL; P < .05), respectively. The presence of T denticola was associated with low levels of HDL in periodontitis patients after adjustment for possible confounders (OR, 3.03; 95% CI, 1.2-7.2). CONCLUSION: Higher levels of TG and lower levels of HDL were associated with the presence of T denticola in chronic periodontitis. These results may suggest that the presence of T denticola could reduce the antiatherogenic potency of HDL and may increase the risk for cardiovascular disease in patients with chronic periodontitis.

Coexistence of Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola in the Red Bacterial Complex in Chronic Periodontitis Subjects / Coexistencia de Porphyromonas gingivalis, Tannerella forsythia y Treponema denticola en el Complejo Rojo Bacteriano en Sujetos con Periodontitis Crónica

Previous reports showed that periodontitis is associated with different microorganisms rather than individual periodontopathogens in the dental biofilm. The purpose of the current study was to evaluate the coexistence and relationship among Porphyromonas gingivalis, Tanerella forsythia, and Treponema denticola in the red complex, noting its association with the severity of periodontitis. In this cross sectional study, 96 subjects, aged 33 to 82 years (with 18 residual teeth) with chronic periodontitis who attended the dental clinics of the Universidad de Antioquia in Medellín, Colombia were invited to participate. The presence or absence of bleeding on probing and plaque were registered. Probing depth and clinical attachment level were measured at all approximal, buccal and lingual surfaces. Microbial sampling on periodontitis patients was performed on pockets >5 mm. The presence of P. gingivalis, T. forsythia, and T. denticola was detected by PCR using primers designed to target the respective 16S rRNA gene sequences. The coexistence of the three periodontopathogens was the most frequent (25 subjects). A statistically significant association between the three bacteria was observed (P. gingivalis and T. forsythia, P<0.0001; P. gingivalis and T. denticola, P=0.001; T. forsythia and T. denticola, P<0.0001). Similarly, the logistic regression analysis showed a significant association among periodontopathogens. The most relevant was observed between P. gingivalis and T. forsythia (OR=6.1). In conclusion, the present study found a significant association in the coexistence of P. gingivalis, T. forsythia and T. denticola, and they related strongly to clinical parameters of inflammation and periodontal destruction.

Reportes previos mostraron que la periodontitis se asocia con diferentes microorganismos en lugar de periodontopatógenos particulares en la biopelícula dental. El objetivo del presente estudio fue evaluar la coexistencia y relación entre Porphyromonas gingivalis, Tanerella forsythia y Treponema denticola en el complejo rojo, señalando su vinculación con la severidad de la periodontitis. En este estudio transversal, 96 sujetos de 33 a 82 años (con 18 dientes residuales) con periodontitis crónica que asistieron a las clínicas dentales de la Universidad de Antioquia en Medellín, Colombia fueron invitados a participar. Se registraron la presencia o ausencia de sangrado al sondaje y placa. La profundidad de sondaje y nivel de inserción clínica se midieron en todas las superficies proximales, bucal y lingual. El muestreo microbiano en pacientes con periodontitis se realizó en los bolsillos mayores a 5 mm. La presencia de P. gingivalis, T. forsythia, y T. denticola se detectó por PCR usando las bolsas periodontales diseñadas para dirigirse a las respectivas secuencias de genes 16S RNAr. La coexistencia de los tres periodontopatógenos fue la más frecuente (25 sujetos). Se observó una asociación estadísticamente significativa entre las tres bacterias (P. gingivalis y T. forsythia, P<0,0001; P. gingivalis y T. denticola, P=0,001; T. forsythia y T. denticola, P<0,0001). Del mismo modo, el análisis de regresión logística mostró una asociación significativa entre periodontopatógenos; la más relevantes se observó entre P. gingivalis y T. forsythia (OR=6,1). El presente estudio encontró una asociación significativa en la coexistencia de P. gingivalis, T. forsythia y T. denticola, y estuvieron fuertemente relacionadas a los parámetros clínicos de la inflamación y destrucción periodontal.