ADJUNCTIVE USE OF ANTIBIOTICS IN PERIODONTAL THERAPY

Abstract

Periodontal diseases are infectious diseases with a mixed microbial aetiology and marked inflammatory response leading to destruction of underlying tissue. Periodontal therapy aims to eliminate pathogens associated with the disease and attain periodontal health. Periodontitis is generally treated by nonsurgical mechanical debridement and regular periodontal maintenance care. Periodontal surgery may be indicated for some patients to improve access to the root surface; however, mechanical debridement alone may not be helpful in all cases. In such cases, adjunctive systemic antibiotic therapy remains the treatment of choice. It can reach microorganisms at the base of the deep periodontal pockets and furcation areas via serum, and also affects organisms residing within gingival epithelium and connective tissue. This review aims to provide an update on clinical issues regarding when and how to prescribe systemic antibiotics in periodontal therapy. The points discussed are the mode of antibiotic action, susceptible periodontal pathogens, antibiotic dosage, antibiotic use in treatment of periodontal disease, and mechanism of bacterial resistance to each antibiotic.

Keywords

• Systemic antibiotics; periodontal disease; treatment; aggressive periodontitis; chronic periodontitis

Periodontal Tedavide Kullanılan Antibiyotikler

Abstract

Periodontal hastalıklar periodontal dokuların doku yıkımına yol açan, karışık mikrobiyal etyolojisi ve belirgin inflamatuvar yanıt ile karakterize enfeksiyöz hastalıklardır. Periodontal tedavinin amacı, hastalık ile ilişkili patojenlerin ortadan kaldırılması ve periodontal sağlığın elde edilmesidir. Periodontitis tedavisi genellikle cerrahi olmayan mekanik debridman ve düzenli periodontal bakım ile yapılır. Periodontal cerrahi bazı hastalarda kök yüzeyine erişimi artırmak için endike olabilir; ancak, yalnız mekanik debridman tüm durumlarda yarar sağlamayabilir. Bu tür durumlarda, ilave antibiyotik tedavisi düşünülebilir. Böylece, serum ile derin periodontal cepler ve furkasyon alanlarının tabanında mikroorganizmalara ulaşım ve aynı zamanda dişeti epiteli ve bağ dokusu içinde bulunan organizmalara etki sağlanır. Bu derlemede, periodontal hastalıkta ne zaman ve hangi durumlarda sistemik antibiyotik reçete edilmesi gerektiği üzerine güncel klinik yaklaşımlar değerlendirilmiştir. Etki mekanizmaları, duyarlı periodontal patojenler, dozaj, periodontal hastalıkların tedavisinde kullanımı ve her antibiyotik için bakteri direnç mekanizması tartışılmıştır.

Keywords

• Sistemik antibiyotikler, periodontal hastalık, tedavi, agresif periodontitis, kronik periodontitis

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