ABSTRACT
Abstract The aim was of this study was to determine the current weight of evidence for the existence of specific differences between the microbiota of healthy teeth and healthy implants, or of teeth with periodontitis and implants with peri-implantitis. A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE and Cochrane databases were searched up to February 2018 for studies comparing microbiological data of biofilm samples collected from healthy teeth and implants or from teeth with periodontitis and implants with peri-implantitis. The weight of evidence was defined in three categories (strong, moderate and mild/some), according to the difference in number of studies showing statistically significantly higher counts and/or proportions and/or abundance and/or prevalence of microorganisms in health or in disease. Of the 132 articles identified, 8 were included. A wide range of microorganisms were present in different conditions but no microorganisms showed strong, moderate or mild/some evidence for a specific association with either teeth or implants. The results of this systematic review indicated that there is insufficient evidence in the literature to support specific differences between microorganisms colonizing teeth and implants, either in health or in disease.
Subject(s)
Humans , Periodontitis/microbiology , Dental Implants/microbiology , Peri-Implantitis/microbiology , Gingiva/microbiology , Bacteria/isolation & purification , Case-Control Studies , Biofilms/growth & development , Dental Plaque/microbiology , MicrobiotaABSTRACT
ABSTRACT Objective: To identify and quantify the levels of three bacterial species that have recently been identified as potential "new" periodontal pathogens (Enterococcus faecalis, Staphylococcus aureus and Staphylococcus warneri) in subjects with periodontal health and generalized chronic periodontitis. Methods: Thirty adults with generalized chronic periodontitis and 10 periodontally healthy were included in this study. Nine subgingival biofilm samples were collected per subject and individually analyzed by checkerboard DNA-DNA hybridization technique. Results: The mean levels of E. faecalis and S. warneri were higher in chronic periodontitis than in periodontal health (p<0.05). Furthermore, a higher percentage of subjects with periodontitis were colonized by the three species evaluated in comparison with healthy subjects (p<0.05). This represented a difference of 40 percentage points between the two groups, for E. faecalis (present in 90% of individuals with periodontitis and 50% of the healthy individuals) and S. warneri (100% and 60%, respectively), and 26 percentage points for S. aureus (86% and 60%, respectively). Conclusion: E. faecalis and S. warneri have the potential to be periodontal pathogens. The role of S. aureus was less evident, since this species was more prevalent and at relatively higher levels in health than the other two species. These data might guide future studies on the role of these microorganisms in the etiology of periodontitis and help to establish more effective treatments for these infections.
RESUMO Objetivo: Identificar e quantificar os níveis de três espécies bacterianas que foram recentemente apontadas como possíveis "novos" patógenos periodontais (Enterococcus faecalis, Staphylococcus warneri e Staphylococcus aureus), em indivíduos periodontalmente saudáveis e com periodontite crônica generalizada. Métodos: A amostra foi composta por 30 indivíduos adultos com periodontite crônica generalizada e 10 periodontalmente saudáveis. Nove amostras de biofilme subgengival foram coletadas por indivíduo e analisadas individualmente pela técnica de checkerboard DNA-DNA hybridization. Resultados: Os níveis médios de E. faecalis e S. warneri foram maiores no grupo com periodontite crônica do que no de saúde periodontal (p<0,05). Além disso, um maior percentual de indivíduos com periodontite estavam colonizados pelas três espécies avaliadas em comparação com os indivíduos saudáveis (p<0,05). Essa diferença entre os dois grupos foi de 40 pontos percentuais para E. faecalis (presente em 90% dos indivíduos com periodontite e 50% dos saudáveis) e S. warneri (100% e 60%, respectivamente), e de 26 pontos percentuais para S. aureus (86% e 60%, respectivamente). Conclusão: E. faecalis e S. warneri tem potencial para serem patógenos periodontais. O papel do S. aureus foi menos evidente, uma vez que esta espécie estava mais prevalente e em níveis relativamente mais altos do que as outras duas espécies em saúde. Estes dados podem guiar futuros estudos sobre o papel dessas espécies na etiologia das periodontites e ajudar a estabelecer tratamentos mais eficazes para essas infecções.
ABSTRACT
Objective The aim of this systematic review was to compare the clinical effectiveness of systemic antibiotics administered in the active stage of periodontal treatment or after the healing phase. Material and Methods An electronic search was performed in the databases EMBASE, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL), in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. A manual search of the reference list of selected studies and of review articles was also performed up to November 2013. Randomized Clinical Trials (RCT) that evaluated the systemic administration of antibiotics as adjuvants to scaling and root planning (SRP) at different phases of periodontal treatment were included. Systematic reviews and studies that evaluated subjects with systemic diseases and those that used subantimicrobial doses of antibiotics were excluded. Results The initial search identified 1,039 articles, of which seven were selected, and only one met the inclusion criteria. This study showed that subjects taking metronidazole and amoxicillin at the initial phase of treatment exhibited statistically significantly greater reduction in pocket depth and gain in clinical attachment level in initially deep sites (PD≥7 mm) than subjects taking antibiotics after healing (p<0.05). This comparison was conducted 2 months after antibiotic intake, at the healing phase. Conclusion To date, only one short-term RCT has directly compared different moments of systemic antibiotics administration, as adjuncts to SRP, in the treatment of periodontitis. Although the results of this study suggested some benefits for antibiotics intake during the active phase of therapy, these findings need to be confirmed by larger placebo-controlled randomized clinical trials with longer follow-up periods. .