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Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis

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Slots, Jørgen
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Genre
Journal article
Date
2023-01-28
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Department
Periodontology and Oral Implantology
Subject
Amoxicillin
 Anti-infective agents
 Ciprofloxacin
 Metronidazole
 Periodontal pathogens
 Periodontitis
 Povidone-iodine
 Sodium hypochlorite
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http://hdl.handle.net/20.500.12613/10882
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RamsEtAl-JournalArticle-2023-01.pdf
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DOI
https://doi.org/10.3390/antibiotics12020265
Abstract
This study evaluated a combined systemic and topical anti-infective periodontal treatment of 35 adults who had experienced ongoing periodontal breakdown following conventional surgical periodontics. The prescribed anti-infective therapy, based on microbiological testing, consisted of a single course of metronidazole plus ciprofloxacin (23 patients), metronidazole plus amoxicillin/clavulanic acid (10 patients), and metronidazole plus ciprofloxacin followed by metronidazole plus amoxicillin/clavulanic acid (2 patients). In addition, the study patients received 0.1% povidone-iodine subgingival disinfection during non-surgical root debridement and daily patient administered oral irrigation with 0.1% sodium hypochlorite. At 1 and 5 years post-treatment, all study patients showed gains in clinical periodontal attachment with no further attachment loss, and significant decreases in pocket probing depth, bleeding on probing, and subgingival temperature. The greatest disease resolution occurred in patients who at baseline harbored predominantly major periodontal pathogens which post-antibiotics became non-detectable and substituted by non-periodontopathic viridans streptococci. The personalized and minimally invasive anti-infective treatment regimen described here controlled periodontitis disease activity and markedly improved the clinical and microbiological status of the refractory periodontitis patients.
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Citation
Rams, T.E.; Slots, J. Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis. Antibiotics 2023, 12, 265. https://doi.org/10.3390/antibiotics12020265
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MDPI
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Antibiotics, Vol. 12, Iss. 2
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