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International Journal of Dentistry 2022To assess the clinical and microbiological efficacy of systemic quinolones adjunctive to mechanical therapy in periodontitis patients. systematic review of the... (Review)
Review
OBJECTIVES
To assess the clinical and microbiological efficacy of systemic quinolones adjunctive to mechanical therapy in periodontitis patients. systematic review of the scientific literature was carried out. The search scheme comprised the Scopus, PubMed/MEDLINE, SCIELO (Scientific Electronic Library Online), and LILACS (Literatura Latinoamericana del Caribe en Ciencias de la Salud) databases, together with the gray literature. MeSH terms and keywords were utilized to explore publications in all idioms. Only randomized clinical trials (RCTs) that met the selection criteria were included.
RESULTS
A total of 4 RCTs were selected. These RCTs found superior clinical and microbiological efficacy of adjunctive systemic moxifloxacin (MOX) and levofloxacin (LV) compared to subgingival debridement plus placebo. Improvements in PD and CAL were 2.4 ± 0.8 mm and 2.7 ± 0.9 mm for LV, and 1.5 ± 0.5 mm and 1.8 ± 0.5 mm for MOX, respectively. After six months of follow-up, adjunctive MOX reduced the presence of to imperceptible levels, while LV markedly reduced this microorganism. Some adverse events were reported in the LV group and none in the MOX group.
CONCLUSIONS
Adjunctive MOX and LV improve probing depth and clinical attachment level compared with subgingival debridement alone in patients with periodontitis. The efficacy of these quinolones against was also superior.
PubMed: 35637653
DOI: 10.1155/2022/4334269 -
Journal of Gastroenterology and... Sep 2022Eosinophilic esophagitis (EoE) is an atopic disease of the esophagus that has shown a significant increase in incidence and prevalence in the last 20 years. The... (Review)
Review
Eosinophilic esophagitis (EoE) is an atopic disease of the esophagus that has shown a significant increase in incidence and prevalence in the last 20 years. The etiology of EoE is unclear, and few studies explore the esophageal microbiota in EoE. The local microbiome has been implicated in the pathogenesis of several allergic and inflammatory diseases, such as asthma and eczema. In this study, we performed a systematic review to evaluate differences in the microbiota profile of patients with EoE compared with controls. MEDLINE, Embase, Cochrane Library, Scopus, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases were searched to identify studies investigating the microbiota composition in EoE. Three reviewers screened the articles for eligibility and quality. Seven articles underwent full-text review, and a narrative synthesis was undertaken. The microbiota of the mouth and esophagus are correlated. Patients with active EoE present increased esophageal microbial load and increased abundance in particular species, such as Haemophilus and Aggregatibacter. On the other hand, EoE patients present a decrease in Firmicutes. High microbial load and abundance of Haemophilus are observed in EoE patients, but little evidence exists to demonstrate their influence on inflammation and disease. Understanding microbial signatures in EoE might contribute to the development of novel therapeutic strategies.
Topics: Eosinophilic Esophagitis; Humans; Incidence; Inflammation; Microbiota
PubMed: 35730344
DOI: 10.1111/jgh.15921 -
Clinical Oral Investigations Mar 2022The aim of this study was to systematically update the evidence for associations between host genetic variants and subgingival microbial detection and counts.
OBJECTIVE
The aim of this study was to systematically update the evidence for associations between host genetic variants and subgingival microbial detection and counts.
MATERIALS AND METHODS
Following a previous systematic review (Nibali et al. J Clin Periodontol 43(11): 889-900, 15), an update of a systematic search of the literature was conducted in Ovid Medline, Embase, LILACS, and Cochrane Library for studies reporting data on host genetic variants and detection of microbes subgingivally published in the last 6 years.
RESULTS
A total of 19 studies were included in the review, from an initial search of 2797 titles. Studies consisted mainly of candidate gene studies and of one genome-wide analysis. A total of 62 studies were considered for summary findings, including 43 identified in the previous systematic review of studies published up to 2015. Meta-analyses were done when appropriate including both papers in the original review and in the update. Meta-analyses revealed lack of associations between IL1 composite genotype and subgingival detection of Aggregatibacter acinomycetemcomitans, Poprhyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia. Promising evidence is emerging from other genetic variants and from sub-analyses of data from genome-association studies. Among other studies with candidate-gene, target SNPs were mainly within the IL10, IL6, IL4, IL8, IL17A, and VDR gene.
CONCLUSIONS
IL1 composite genotype does not seem to be associated with subgingival microbial detection. Promising associations should be pursued by future studies, including studies employing -OMICS technologies.
CLINICAL RELEVANCE
A better knowledge of which host genetic variant predispose to subgingival microbial colonization and to the development of progression of periodontal disease could potentially help to better understand periodontal disease pathogenesis and help with its management.
Topics: Genotype; Gingiva; Gram-Negative Bacteria; Host Microbial Interactions; Humans; Interleukin-1
PubMed: 35122548
DOI: 10.1007/s00784-021-04233-8 -
Frontiers in Microbiology 2016To evaluate the variations in the detection of Porphyromonas gingivalis and/or Aggregatibacter actinomycetemcomitans before and after systemic administration of...
Detection of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans after Systemic Administration of Amoxicillin Plus Metronidazole as an Adjunct to Non-surgical Periodontal Therapy: A Systematic Review and Meta-Analysis.
OBJECTIVE
To evaluate the variations in the detection of Porphyromonas gingivalis and/or Aggregatibacter actinomycetemcomitans before and after systemic administration of amoxicillin plus metronidazole in association with non-surgical periodontal therapy (NSPT).
BACKGROUND
The adjunctive use of antibiotics has been advocated to improve the clinical outcomes of NSPT. However, no systematic review has investigated the microbiological benefit of this combination.
MATERIALS AND METHODS
An electronic search was conducted up to December 2015. Randomized clinical trials comparing the number of patients testing positive for P. gingivalis and/or A. actinomycetemcomitans before and after NSPT with (test group) or without (control group) amoxicillin plus metronidazole were included. The difference between groups in the variation of positive patients was calculated using the inverse variance method with a random effects model.
RESULTS
The frequency of patients positive for A. actinomycetemcomitans was decreased by 30% (p = 0.002) and by 25% (p = 0.01) in the test group compared to the control group at 3- and 6-month follow-up, respectively. Similar findings were observed when considering the frequency of patients positive for Porphyromonas gingivalis, with a reduction by 28% (p < 0.0001), 32% (p < 0.0001), and 34% (p = 0.03) in the test group compared to the control group at 3-, 6-, and 12-month follow-up, respectively.
CONCLUSION
The systemic administration of amoxicillin plus metronidazole as an adjunct to NSPT significantly decreased the number of patients positive for P. gingivalis and A. actinomycetemcomitans compared with periodontal therapy alone or with a placebo.
PubMed: 27594851
DOI: 10.3389/fmicb.2016.01277 -
Dental and Medical Problems 2021The adjunctive use of fluoroquinolone (FQ) agents in patients with periodontitis produces contradictory results. There has been no meta-analysis performed based on the... (Meta-Analysis)
Meta-Analysis Review
The adjunctive use of fluoroquinolone (FQ) agents in patients with periodontitis produces contradictory results. There has been no meta-analysis performed based on the evaluations of FQ use that would enable making appropriate clinical decisions. Our study aimed to evaluate, via a systematic review and metaanalysis conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, the clinical benefits, antimicrobial effects and safety profiles of the FQ agents administered to periodontitis patients under a conventional treatment regime. Relevant databases were searched for studies published up to May 2020, with the quality and risk of bias evaluations performed on the selected studies, and meta-analyses, funnel plots and heterogeneity tests carried out based on the obtained data. Any finding of p-value less than 0.05 was considered statistically significant. Quality and the risk of bias ranged from high to low. With acceptable heterogeneity and no reporting bias, the meta-analyses showed that local or systemic FQ use produced the following results: a reduced probing depth change (ΔPD) (p < 0.00001 at ≤3 months); reduced bleeding on probing (BOP) (p < 0.00001 at 3-6 months); reduced subgingival detection of Aggregatibacter actinomycetemcomitans for up to 12 months (p-values from <0.00001 to 0.001); and an insignificant number of adverse events (p ≥ 0.05) in patients subjected to a conventional therapy as compared to those subjected to an antibiotic-free therapy. Our study found evidence to show that FQ administration provides clinical benefits and ensures antibacterial effects in periodontitis patients subjected to a conventional therapy regime.
Topics: Anti-Bacterial Agents; Fluoroquinolones; Humans; Periodontitis
PubMed: 34176246
DOI: 10.17219/dmp/133512 -
Cerebrovascular Diseases Extra 2018To systematically review the current literature investigating the association between oral health and acquired brain injury. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To systematically review the current literature investigating the association between oral health and acquired brain injury.
METHODS
A structured search strategy was applied to PubMed, Embase, Web of Science, and CENTRAL electronic databases until March 2017 by 2 independent reviewers. The preferred reporting items for systematic review and meta-analysis guidelines were used for systematic review.
RESULTS
Even though the objective was to assess the association between oral health and acquired brain injury, eligible studies focused solely on different forms of stroke and stroke subtypes. Stroke prediction was associated with various factors such as number of teeth, periodontal conditions (even after controlling for confounding factors), clinical attachment loss, antibody levels to Aggregatibacter actinomycetemcomitans and Prevotella intermedia. The literature showed no consensus on the possible association between gingivitis and stroke. Patients with stroke generally had poorer oral hygiene practices and oral health. Dental prophylaxis and professional intervention reduced the incidence of stroke.
CONCLUSIONS
Overall, oral health and stroke were related. Periodontitis and tooth loss were independently associated with stroke. However, prevention and timely intervention may reduce the risk of stroke. Stroke was the main cerebral lesion studied in the literature, with almost no publications on other brain lesions.
Topics: Aggregatibacter actinomycetemcomitans; Bacteroidaceae Infections; Brain Injuries; Cerebrovascular Disorders; Dental Prophylaxis; Female; Gingivitis; Humans; Incidence; Male; Oral Health; Oral Hygiene; Pasteurellaceae Infections; Periodontal Diseases; Periodontitis; Prevotella intermedia; Stroke; Tooth Loss
PubMed: 29402871
DOI: 10.1159/000484989 -
Clinical Oral Investigations Mar 2022To investigate the global prevalence of the JP2 genotype of Aggregatibacter actinomycetemcomitans (Aa).
PURPOSE
To investigate the global prevalence of the JP2 genotype of Aggregatibacter actinomycetemcomitans (Aa).
METHODS
A comprehensive electronic search of databases, PUBMED, MEDLINE, EMBASE, BIOSIS, and SCOPUS, was conducted up to August 2021. All published articles and studies were considered, excluding animal studies, editorials, personal opinions, letters to editor, conference abstracts, posters, and those studies without full text. The primary objective of this systematic review was to determine the presence of the JP2 genotype of Aa in the world population.
RESULTS
A total of 295 articles were identified, of which 62 were preselected, and 51 were finally included in this review. Due to variable study designs and high heterogeneity, a meta-analysis was not conducted. A total of 9744 subjects were screened for the presence of the JP2 genotype of Aa worldwide, and only 621 cases were found positive.
CONCLUSIONS
A relatively high presence of JP2 genotype of Aa was found in subjects from South America, North America, and Africa. There were no studies estimating the presence of the JP2 genotype of Aa in the Oceania region. The heterogeneity and quality of the included publications suggest that caution should be exercised when interpreting the data and that there remains an important need for additional evidence.
CLINICAL RELEVANCE
Periodontitis is a highly prevalent inflammatory oral disorder with substantial aesthetic, functional, and psychological implications for patients. The JP2 genotype of Aa is implicated in the pathogenesis of periodontitis. To the best of our knowledge, there is a lack of systematic reviews estimating the presence of the JP2 genotype of Aa in the global population. We identified a relatively high presence of the JP2 genotype of Aa in specific geographic areas of the world, and we propose that cross-sectional and longitudinal studies are lacking in the Oceania region and need to be conducted to estimate the presence of the JP2 genotype of Aa in this region.
Topics: Aggregatibacter actinomycetemcomitans; Cross-Sectional Studies; Genotype; Humans; Periodontitis; Prevalence
PubMed: 35066686
DOI: 10.1007/s00784-021-04343-3 -
Journal of Periodontal & Implant Science Oct 2022The aim of this systematic review was to evaluate clinical and microbiological outcomes with the use of azithromycin as an adjunct to non-surgical subgingival... (Review)
Review
The aim of this systematic review was to evaluate clinical and microbiological outcomes with the use of azithromycin as an adjunct to non-surgical subgingival professional mechanical plaque removal (PMPR) in the treatment of grade C periodontitis. Online database searches using high-level MeSH terms in a PICO structure were conducted along with hand-searching of relevant periodontal journals. Titles and abstracts of identified studies were independently reviewed by both authors and the full texts of studies meeting the inclusion criteria were independently reviewed. In total, 122 studies were identified through searches, of which 6 were included in the qualitative analysis and 4 in the meta-analysis. Three studies included in the meta-analysis were deemed at low risk of bias and 1 at serious risk. There were conflicting results on whether azithromycin reduced the number of subgingival pathogens or detectable subgingival between the included studies. The meta-analysis revealed a statistically significant probing depth reduction difference in favour of azithromycin compared to the control at 3 months (weighted mean difference [WMD]=-0.39 mm; 95% confidence interval [CI], -0.66 to -0.13 mm; I²=0%) and 12 months (WMD=-1.32 mm; 95% CI, -1.71 to -0.93 mm; I²=0%). The clinical attachment level change was also statistically significant in favour of azithromycin compared to the control at 3 months (WMD=-0.61 mm; 95% CI, -1.13 to -0.10 mm; I²=71%) and 12 months (WMD=-0.88 mm; 95% CI, -1.32 to -0.44 mm; I²=0%). Based upon these results, azithromycin offers additional improvements in some clinical parameters when used in conjunction with subgingival PMPR in patients with aggressive periodontitis over control groups. These improvements appear to be maintained for up to 12 months after treatment completion. However, due to a lack of well-designed studies, the conclusions that can be drawn from the available evidence are limited. Trial Registration: International Prospective Register of Systematic Reviews Identifier: CRD42020168195.
PubMed: 36302643
DOI: 10.5051/jpis.2200340017 -
Medicine Apr 2020Periodontal bacteria is the major pathogens in the oral cavity and the main cause of adult chronic periodontitis, but their association with incidence and prognosis in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Periodontal bacteria is the major pathogens in the oral cavity and the main cause of adult chronic periodontitis, but their association with incidence and prognosis in cancer is controversial. The aim of this study was to evaluate the effect of periodontal bacteria infection on incidence and prognosis of cancer.
METHODS
A systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library databases was performed to obtain 39 studies comprising 7184 participants. The incidence of cancer was evaluated as odd ratios (OR) with a 95% confidence interval (95% CI) using Review Manager 5.2 software. Overall survival, cancer-specific survival and disease-free survival, which were measured as hazard ratios (HR) with a 95% CI using Review Manager 5.2 software.
RESULTS
Our results indicated that periodontal bacteria infection increased the incidence of cancer (OR = 1.25; 95%CI: 1.03-1.52) and was associated with poor overall survival (HR = 1.75; 95% CI: 1.40-2.20), disease-free survival (HR = 2.18; 95%CI: 1.24-3.84) and cancer-specific survival (HR = 1.85, 95%CI: 1.44-2.39). Subgroup analysis indicted that the risk of cancer was associated with Porphyromonas gingivalis (Pg) infection (OR = 2.16; 95%CI: 1.34-3.47) and Prevotella intermedia (Pi) infection (OR = 1.28; 95%CI: 1.01-1.63) but not Tannerella forsythia (Tf) (OR = 1.06; 95%CI: 0.8-1.41), Treponema denticola (Td) (OR = 1.30; 95%CI: 0.99-1.72), Aggregatibacter actinomycetemcomitans (Aa) (OR = 1.00; 95%CI: 0.48-2.08) and Fusobacterium nucleatum (Fn) (OR = 0.61; 95%CI: 0.32-1.16).
CONCLUSION
This meta-analysis revealed periodontal bacteria infection increased the incidence of cancer and predicted poor prognosis of cancer.
Topics: Aggregatibacter actinomycetemcomitans; Bacterial Infections; Chronic Periodontitis; Disease-Free Survival; Fusobacterium nucleatum; Humans; Incidence; Mouth; Neoplasms; Porphyromonas gingivalis; Prevotella intermedia; Prognosis; Risk Assessment; Treponema denticola
PubMed: 32282725
DOI: 10.1097/MD.0000000000019698 -
BMC Oral Health Jun 2017Orthodontic treatment was found to have an impact on the quantity and constitution of subgingival microbiota. However, contradictory findings regarding the effects of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Orthodontic treatment was found to have an impact on the quantity and constitution of subgingival microbiota. However, contradictory findings regarding the effects of fixed appliances on microbial changes were reported. The aim of this systematic review was to investigate the microbial changes in subgingival plaques of orthodontic patients.
METHODS
The PubMed, Cochrane Library, and EMBASE databases were searched up to November 20, 2016. Longitudinal studies observing microbial changes in subgingival plaques at different time points of orthodontic treatment are included. The methodological quality of the included studies was assessed by Methodological index for non-randomized studies (MINORS). The studies that reported the frequency of subgingival periodontopathogens were used for quantitative analysis. Other studies were analysed qualitatively to describe the microbial changes during orthodontic treatment.
RESULTS
Thirteen studies were selected, including two controlled clinical trials, three cohort studies and eight self-controlled studies. Four periodontopathogens, including Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi) and Tannerella forsythia (Tf), were analysed. Following orthodontic appliance placement, the frequencies of Pg and Aa showed no significant change (P = 0.97 and P = 0.77), whereas the frequency of Tf significantly increased (P < 0.01) during short-term observation (0-3 months). The frequency of Pi showed a tooth-specific difference, as it presented no significant difference (P = 0.25) at the site of the first molar but was significantly increased (P = 0.01) at the incisor. During long-term observation (> = 6 months), two studies reported that the levels of subgingival periodontopathogens exhibited a transient increase but decreased to the pretreatment levels afterwards. After removal of the orthodontic appliance, the four periodontopathogens showed no significant difference compared with before removal.
CONCLUSION
The levels of subgingival pathogens presented temporary increases after orthodontic appliance placement, and appeared to return to pretreatment levels several months later. This indicates that orthodontic treatment might not permanently induce periodontal disease by affecting the level of subgingival periodontal pathogen levels. Further studies of high methodological quality are required to provide more reliable evidence regarding this issue.
Topics: Dental Plaque; Gingiva; Humans; Orthodontic Appliances
PubMed: 28576147
DOI: 10.1186/s12903-017-0378-1