Effectiveness of Systematic Periodontal Treatment in Male HIV-Infected Patients after 9 Years: A Case Series.

OBJECTIVE: To investigate effectiveness of systematic periodontal treatment in the long term in HIV-infected patients undergoing highly active antiretroviral treatment. METHODS: Longitudinal, prospective, open-label case series over a period of nine years. Periodontal treatment was performed by scaling and root planing and supportive periodontal care (SPC) at regular intervals. To measure effectiveness, reductions of pocket probing depths were defined as primary study endpoint. RESULTS: During the study period, there was a proportional increase in periodontal pockets ≥4 mm of +53% and in pockets ≥ 6 mm of +100%. Mean pocket depth reductions on patient's level were, however, 0.4 mm nine years after scaling and root planing and supportive periodontal care (p=0.180). No teeth were lost during the observation period. CONCLUSIONS: In terms of best evidence available, it is concluded that systematic periodontal treatment including SPC is effective in virologically controlled HIV infection and can be performed in dental practice safely.

Influence of highly-active antiretroviral therapy on the subgingival biofilm in HIV-infected patients.

AIM: Highly-active antiretroviral therapy (HAART) has been associated with alterations in subgingival biofilm and periodontal disease. The purpose of the present study was to investigate the association between different HAART regimens and the prevalence of periodontal pathogens in HIV-infected patients with chronic periodontitis. METHODS: Subgingival periodontal pathogens were determined by a DNA chip microarray in a case series in 14 HIV-infected patients receiving HAART with different drug combinations: protease inhibitor (PI)-based HAART versus non-nucleoside reverse transcriptase inhibitor (NNRTI)-based HAART. A statistical analysis was conducted to determine whether specific HAART regimens were associated with 10 periodontal pathogens using odds ratios (OR). RESULTS: At baseline and after treatment, the patients did not show significant clinical and immunological differences. In general, the highest OR for the prevalence of periodontal pathogens were found in the PI HAART group for Actinomyces viscosus (A. viscosus) (OR: 303), Campylobacter rectus (OR: 90), and Treponema denticola (OR: 25). In the NNRTI HAART group, higher OR were documented for Fusobacterium nucleatum (OR: 56) and Eikenella corrodens (OR: 25). The association between A. viscosus and PI HAART was statistically significant (P = 0.03). CONCLUSIONS: The results demonstrated statistical associations between subgingival bacteria and antiretroviral drug therapies. Further investigation on the clinical significance and underlying mechanisms are needed to support these findings.