The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 21 , ISSUE 4 ( April, 2020 ) > List of Articles

REVIEW ARTICLE

Antibiotics for Periodontal Infections: Biological and Clinical Perspectives

Simpy Amit Mahuli, Ali M Zorair, Mohammed Abdurabu Jafer, Alnomari Sultan

Keywords : Antibiotic, Periodontitis, Plaque control, Periodontal pathogen

Citation Information : Mahuli SA, Zorair AM, Jafer MA, Sultan A. Antibiotics for Periodontal Infections: Biological and Clinical Perspectives. J Contemp Dent Pract 2020; 21 (4):372-376.

DOI: 10.5005/jp-journals-10024-2797

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: The review is to highlight the use of antibiotics in periodontal infections and prevent indiscriminate use of antibiotics. Background: Periodontitis is the most common disease of the periodontal attachment apparatus, and its etiological factor can be related to the existence of virulent microorganisms in the dental plaque biofilm which harbors millions of microorganisms. In addition, the pathogenesis of this disease is greatly influenced by the host immune response that leads to the cyclic destruction and healing pattern. Review results: Periodontitis is mostly treated through mechanical debridement using surgical and nonsurgical therapy. However, many times, this treatment does not render desired results due to poor patient compliance, altered immune response, or other host-related factors. This leads to the administration of antibiotics as an adjunct to mechanical debridement. Antibiotics are useful in eliminating periodontopathic microbes, but these agents should be cautiously used and prescribed only if indicated. Conclusion: Indiscriminate use of antibiotics can lead to unforeseen adverse effects as well as the development of resistant strains of microorganisms. Clinical significance: Hence, it is crucial for the dentists to know the indications, contraindications, undesirable effects, correct choice, and dosage of the antimicrobial agent before prescribing it to their patients thereby ensuring the success of periodontal therapy. Thus, the clinician should keep in mind that the antibiotics are merely adjuncts to mechanical therapy and not its replacement.


PDF Share
  1. Nolte WA. Oral ecology. In: Nolte WA, ed. Oral microbiology. 2nd ed., St. Louis: Mosby; 1973. p. 21.
  2. Costerton JW, Lewandowski Z, DeBeer D, et al. Biofilms, the customized microniche. J Bacteriol 1994;176(8):2137–2142.
  3. Hojo K, Nagaoka S, Ohshima T, et al. Bacterial interactions in dental biofilm development. J Dent Res 2009;88(11):982–990.
  4. Axelsson P. Preventive material, methods, and programs, Vol. 4. Chicago: Quintessence Publishing Co. Inc.; 2004.
  5. Loesche WJ. Chemotherapy of dental plaque infections. Oral Sci Rev 1976;9:65–107.
  6. Theilade E. The non-specific theory in microbial etiology of inf lammatory periodontal diseases. J Clin Periodontol 1986;13(10):905–911.
  7. Marsh PD. Host defenses and microbial homeostasis: role of microbial interactions. J Dent Res 1989;68:1567–1575.
  8. Pejcic A, Pesevska S, Grigorov I, et al. Periodontitis as a risk factor for general disorders. Acta Facult Med Naiss 2006;23(1):59–65.
  9. Jenabian N, Moghadamnia A, Abdollahi Y, et al. Comparison of the efficacy of short-term and long-term azithromycin regimen with metronidazole and amoxicillin for treatment of moderate chronic periodontitis in adults. J Dent School 2013;31:37–43.
  10. Bidault P, Chandad F, Grenier D. Systemic antibiotic therapy in the treatment of periodontitis. J Can Dent Assoc 2007;73(6):515–520.
  11. Moeintaghavi A, Talebi-ardakani MR, Haerian-ardakani A, et al. Adjunctive effects of systemic amoxicillin and metronidazole with scaling and root planing: a randomized, placebo-controlled clinical trial. J Contemp Dent Pract 2007;8(5):51–59.
  12. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4(1):1–6.
  13. Van Dyke TE, Shailesh D. Risk factors for periodontitis. J Int Acad Periodontol 2005;7(1):3–7.
  14. Paster BJ, Boches SK, Galvin JL, et al. Bacterial diversity in human subgingival plaque. J Bacteriol 2001;183(12):3770–3783.
  15. Nishihara T, Koseki T. Microbial etiology of periodontitis. Periodontol 2000 2004;36:14–26.
  16. Feng Z, Weinberg A. Role of bacteria in health and disease of periodontal tissues. Periodontol 2000 2006;40:50–76.
  17. Slots J, Ting M. Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in human periodontal disease: occurrence and treatment. Periodontol 2000 1999;20:82–121.
  18. Schenkein HA. Host responses in maintaining periodontal health and determining periodontal disease. Periodontol 2000 2006;40:77–93.
  19. Kinane DF, Lappin DF. Clinical, pathological and immunological aspects of periodontal disease. Acta Odontol Scand 2001;59(3): 154–160.
  20. Madianos PN, Bobetsis YA, Kinane DF. Generation of inflammatory stimuli: how bacteria set up inflammatory responses in the gingiva. J Clin Periodontol 2005;32(Suppl 6):57–71.
  21. Sorsa T, Tjäderhane L, Salo T. Matrix metalloproteinases (MMPs) in oral diseases. Oral Dis 2004;10(6):311–318.
  22. Reynolds JJ, Meikle MC. Mechanisms of connective tissue matrix destruction in periodontitis. Periodontol 2000 1997;14:144–157.
  23. Kaldahl WB, Kalkwarf KL, Patil KD. A review of longitudinal studies that compared periodontal therapies. J Periodontol 1993;64(4):243–253.
  24. Kaldahl WB, Kalkwarf KL, Patil KD, et al. Long-term evaluation of periodontal therapy: I. Response to 4 therapeutic modalities. J Periodontol 1996;67(2):93–102.
  25. Zambon JJ, Chr is ter sson LA, Slot s J. Act inobaci l lus actinomycetemcomitans in human periodontal disease. Prevalence in patient groups and distribution of biotypes and serotypes within families. J Periodontol 1983;54(12):707–711.
  26. Wolff LF, Liljemark WF, Bloomquist CG, et al. The distribution of Actinobacillus actinomycetemcomitans in human plaque. J Periodontal Res 1985;20(3):237–250.
  27. van Palenstein Helderman WH. Is antibiotic therapy justified in the treatment of human chronic inflammatory periodontal disease? J Clin Periodontol 1986;13(10):932–938.
  28. Gillett R, Johnson NW. Bacterial invasion of the periodontium in a case of juvenile periodontitis. J Clin Periodontol 1982;9(1):93–100.
  29. Saglie R, Newman MG, Carranza Jr FA, et al. Bacterial invasion of gingiva in advanced periodontitis in humans. J Periodontol 1982;53(4):217–222.
  30. Soares GM, Figueiredo LC, Faveri M, et al. Mechanisms of action of systemic antibiotics used in periodontal treatment and mechanisms of bacterial resistance to these drugs. J Appl Oral Sci 2012;20(3): 295–309.
  31. Heitz-Mayfield LJ. Systemic antibiotics in periodontal therapy. Aust Dent J 2009;54(1 Suppl):S96–S101.
  32. Socransky SS, Haffajee AD, Cugini MA, et al. Microbial complexes in subgingival plaque. J Clin Periodontol 1998;25(2):134–144.
  33. Feres M, Haffajee AD, Allard K, et al. Change in subgingival microbial profiles in adult periodontitis subjects receiving either systemicallyadministered amoxicillin or metronidazole. J Clin Periodontol 2001;28:597–609.
  34. Herrera D, Alonso B, León R, et al. Antimicrobial therapy in periodontitis: the use of systemic antimicrobials against the subgingival biofilm. J Clin Periodontol 2008;35(8 Suppl):45–66.
  35. Llor C, Sierra N, Hernández S, et al. The higher the number of daily doses of antibiotic treatment in lower respiratory tract infection the worse the compliance. J Antimicrob Chemother 2009;63(2):396–399.
  36. Foulds G, Shepard RM, Johnson RB. The pharmacokinetics of azithromycin in human serum and tissues. J Antimicrob Chemother 1990;25(Suppl A):73–82.
  37. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the american heart association: a guideline from the american heart association rheumatic fever, endocarditis, and kawasaki disease committee, council on cardiovascular disease in the young, and the council on clinical cardiology, council on cardiovascular surgery and anesthesia, and the quality of care and outcomes research interdisciplinary working group. Circulation 2007;116(15):1736–1754.
  38. Pejčić A, Kesić L, Obradović R, et al. Antibiotics in the management of periodontal disease. Sci J Fac Med Niš 2010;27(2):85–92.
  39. Feres M, Haffajee AD, Allard K, et al. Antibiotic resistance of subgingival species during and after antibiotic therapy. J Clin Periodontol 2002;29(8):724–735.
  40. van Winkelhoff AJ, Herrera D, Oteo A, et al. Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in The Netherlands and Spain. J Clin Periodontol 2005;32(8):893–898.
  41. Walker CB. The acquisition of antibiotic resistance in the periodontal microflora. Periodontol 2000 1996;10:79–88.
  42. Walker CB. Selected antimicrobial agents: mechanisms of action, side effects and drug interactions. Periodontol 2000 1996;10:12–28.
  43. Nikaido H. Multidrug resistance in bacteria. Annu Rev Biochem 2009;78:119–146.
  44. Nikaido H. Prevention of drug access to bacterial targets: permeability barriers and active efflux. Science 1994;264(5157):382–388.
  45. Ince D, Hooper DC. Quinolone resistance due to reduced target enzyme expression. J Bacteriol 2003;185(23):6883–6892.
  46. Spratt BG. Resistance to antibiotics mediated by target alterations. Science 1994;264(5157):388–393.
  47. Davies J. Inactivation of antibiotics and the dissemination of resistance genes. Science 1994;264(5157):375–382.
  48. Robicsek A, Strahilevitz J, Jacoby GA, et al. Fluoroquinolonemodifying enzyme: a new adaptation of a common aminoglycoside acetyltransferase. Nat Med 2006;12(1):83–88.
  49. Sedlacek MJ, Walker C. Antibiotic resistance in an in vitro subgingival biofilm model. Oral Microbiol Immunol 2007;22(5):333–339.
  50. Rickard AH, Gilbert P, High NJ, et al. Bacterial coaggregation: an integral process in the development of multi-species biofilms. Trends Microbiol 2003;11(2):94–100.
  51. De Beer D, Srinivasan R, Stewart PS. Direct measurement of chlorine penetration into biofilms during disinfection. Appl Environ Microbiol 1994;60(12):4339–4344.
  52. Suci PA, Mittelman MW, Yu FP, et al. Investigation of ciprofloxacin penetration into Pseudomonas aeruginosa biofilms. Antimicrob Agents Chemother 1994;38(9):2125–2133.
  53. Stewart PS. Theoretical aspects of antibiotic diffusion into microbial biofilms. Antimicrob Agents Chemother 1996;40(11):2517–2522.
  54. Stewart PS. Diffusion in biofilms. J Bacteriol 2003;185:1485–1491.
  55. Wimpenny J. Laboratory models of biofilm. In: Heman HN, Wilson M, ed. Dental plaque revisted: oral biofilms in health and disease. Cardiff: Bioline; 1999. pp. 89–110.
  56. de Beer D, Stoodley P, Roe F, et al. Effects of biofilm structures on oxygen distribution and mass transport. Biotechnol Bioeng 1994;43(11):1131–1138.
  57. Mah TF, O’Toole GA. Mechanisms of biofilm resistance to antimicrobial agents. Trends Microbiol 2001;9(1):34–39.
  58. Sauer K. The genomics and proteomics of biofilm formation. Genome Biol 2003;4(6):219.
  59. Brooun A, Liu S, Lewis K. A dose-response study of antibiotic resistance in Pseudomonas aeruginosa biofilms. Antimicrob Agents Chemother 2000;44(3):640–646.
  60. Mah TF, Pitts B, Pellock B, et al. A genetic basis for pseudomonas aeruginosa biofilm antibiotic resistance. Nature 2003;426(6964): 306–310.
  61. Hai JH, Lee C, Kapila YL, et al. Antibiotic prescribing practices in periodontal surgeries with and without bone grafting. J Periodontol 2019. DOI: 10.1002/JPER.19-0195. [Epub ahead of print].
  62. Ong A, Kim J, Loo S, et al. Prescribing trends of systemic antibiotics by periodontists in Australia. J Periodontol 2019;90(9):982–992.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.