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Benefits of early systemic antibiotics in localized aggressive periodontitis: a retrospective study.

ABSTRACT: Treatment of localized aggressive periodontitis (LAP) may include systemic antibiotics, yet it is unclear at what stage of treatment planning antibiotics are most effective.This retrospective analysis compared immediate versus delayed antibiotic therapy on clinical parameters and gingival crevicular fluid (GCF) inflammatory mediators.At baseline, 3 months and 6 months after treatment, clinical parameters [probing depth (PD), clinical attachment level (CAL), bleeding on probing (BoP) and plaque] and GCF were collected from LAP participants, who received a 7-day antibiotic regimen immediately (ImA) or 3 months following (DelA) mechanical therapy.Although both groups presented significant CAL reductions at 6 months, only ImA resulted in a reduction in mean PD at both 3 and 6 months, along with reductions in CAL and BoP at 3 months following therapy. In addition, GCF mediators were higher in DelA group at 3 months post mechanical treatment, but were significantly reduced 6 months following antibiotic therapy.ImA and DelA regimens were both effective in improving CAL by 6 months post therapy. However, ImA allowed for better improvement in overall clinical parameters early in the course of treatment, concomitant with lower levels of inflammatory mediators within the GCF.

SUBMITTER: Beliveau D

PROVIDER: S-EPMC3467316 | biostudies-literature | 2012 Nov

REPOSITORIES: biostudies-literature

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Benefits of early systemic antibiotics in localized aggressive periodontitis: a retrospective study.

Beliveau Dennis D Magnusson Ingvar I Bidwell John A JA Zapert Edward F EF Aukhil Ikramuddin I Wallet Shannon M SM Shaddox Luciana M LM

Journal of clinical periodontology 20120829 11

<h4>Background</h4>Treatment of localized aggressive periodontitis (LAP) may include systemic antibiotics, yet it is unclear at what stage of treatment planning antibiotics are most effective.<h4>Aim</h4>This retrospective analysis compared immediate versus delayed antibiotic therapy on clinical parameters and gingival crevicular fluid (GCF) inflammatory mediators.<h4>Material and methods</h4>At baseline, 3 months and 6 months after treatment, clinical parameters [probing depth (PD), clinical at ...[more]

PMID: 22931240

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Project description:Localized aggressive periodontitis (LAP) patients possess a systemic hyperinflammatory response after lipopolysaccharide stimulation. However, the levels of inflammatory and bone biomarkers in plasma, as well as possible associations between local and plasma biomarkers, are unknown in LAP. This cross-sectional study aimed to characterize gingival crevicular fluid (GCF) and plasma biomarker profiles in LAP patients, their healthy siblings (HS), and healthy unrelated controls (HC). Fifty-eight LAP subjects, 33 HS, and 49 HC (African Americans, aged 5 to 25 y) were included. Following collection of clinical parameters with GCF and plasma samples, levels of 16 inflammatory and bone resorption biomarkers were determined with Milliplex. Univariate and correlation analyses were performed among all clinical and laboratorial parameters. Discriminant analyses were used to investigate groups of biomarkers discriminating LAP from HS and HC in GCF and plasma. GCF levels of multiple cytokines and chemokines and RANKL:OPG ratio (receptor activator of nuclear factor kappa-B ligand:osteoprotegerin) were higher in LAP disease, most of which positively correlated with probing depth and attachment loss of sampled sites. A group of IL-12p40, IL-6, IL-12p70, IL-2, and MIP-1? discriminated LAP diseased sites from twheir healthy sites, as well as from HS and HC healthy sites. In plasma, only RANKL levels were increased in LAP versus controls, which positively correlated with the percentage of affected sites and deep/bleeding sites. A plasma inflammatory profile including MIP-1?, IL-8, IL-10, and INF-? could significantly discriminate LAP patients from HS and HC. No correlations were found between GCF and plasma levels of biomarkers. In conclusion, an inflammatory profile including groups of specific biomarkers in GCF and plasma may significantly discriminate LAP from healthy individuals. The hyperinflammatory response previously found in the peripheral blood of LAP patients is dependent on lipopolysaccharide stimulation, apparently resulting mostly in local tissue destruction and changes in biomarker profile, with a slight influence in the systemic inflammatory profile (ClinicalTrials.gov NCT01330719). Knowledge Transfer Statement: The results of this study can be possibly used by clinicians in the future as diagnostic tools for localized aggressive periodontitis. Thus, in the future, with proper consideration of cost, patient preference, chair-side feasibility and ultimately further studies validating the role of GCF markers for disease progression and response to treatment, this information could lead to more appropriate therapeutic decisions and the development of preventive approaches for susceptible patients.

Dataset Information

Benefits of early systemic antibiotics in localized aggressive periodontitis: a retrospective study.

Publications

Benefits of early systemic antibiotics in localized aggressive periodontitis: a retrospective study.

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