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

Yıl 2019, Cilt: 6 Sayı: 2, 169 - 176, 01.08.2019

Emre Yaprak , Uğur Arslan Tamer Ataoğlu

https://doi.org/10.15311/selcukdentj.560942

Cited By: 1

Öz

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

Destekleyen Kurum

Selçuk Üniversitesi Bilimsel Araştırma Projeleri

Proje Numarası

07102014

Teşekkür

Bu çalışma sorumlu yazar olan Emre Yaprak'ın doktora tezinden elde edilen verilerden üretilmiştir. Çalışmamızı finansal olarak desteklediği için Selçuk Üniversitesi Bilimsel Araştırma Projeleri (BAP) birimine teşekkür ederiz.

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

Öz

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 3^rd and 6^th
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

Anahtar Kelimeler

periodontitis, amoxicillin, metronidazole, Real-Time PCR

Proje Numarası

07102014

Kaynakça

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