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Mariano Sanz - One of the best experts on this subject based on the ideXlab platform.
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the Periodontal Abscess ii short term clinical and microbiological efficacy of 2 systemic antibiotic regimes
Journal of Clinical Periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Ana Oconnor, Mariano SanzAbstract:Background/aims: The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute Periodontal Abscesses. Method: After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3–5 days, 10–12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10–12 days). Blood and urine samples were collected at baseline and after 10–12 days. Microbiological samples were processed by anaerobic culturing, and isolated Periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. Results: 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (p<0.01). Objective clinical variables also showed clear improvements, being statistically significant after 30 days with probing pocket depth in the azithromycin group (p<0.01). Microbiologically, short-term reductions were detected with both antibiotics, however fast recolonization occurred after the third visit. No significant differences were found between both treatment regimes. Antibiotic susceptibilities demonstrated no resistances for amoxicillin/clavulanate, while 2–3 strains of each studied pathogen were resistant to azithromycin. Conclusions: However, both antibiotic regimes were effective in the short-term treatment of Periodontal Abscesses in periodontitis patients.
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The Periodontal Abscess (I). Clinical and microbiological findings
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Iciar González, Mariano SanzAbstract:Background/aims: Little information is available regarding the diagnosis and microbiology of Periodontal Abscesses. The aim of this descriptive clinical and microbiological study was to provide more information in order to help in the characterisation of the Periodontal Abscess associated to periodontitis. Method: 29 consecutive patients with a Periodontal Abscess were studied by the assessment of clinical variables, including both subjective (pain, edema, redness and swelling) and objective (bleeding on probing, suppuration, probing pocket depth, tooth mobility and cervical lymphadenopathy) parameters. Microbiological samples were taken for anaerobic microbiology and processed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards. Results: 62% of the Abscesses affected untreated periodontitis patients, and 69% were associated with a molar tooth. More than 75% of the Abscesses had moderate-severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all Abscesses, while suppuration on sampling was detected in 66%. Mean associated pocket depth was 7.28 mm, and 79% of teeth presented some degree of mobility. Cervical lymphadenopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% of the patients. High prevalences of putative Periodontal pathogens were found, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus. Conclusions: The Periodontal Abscess has clear clinical characteristics and is usually associated with severe Periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacterial mass with a high prevalence of well-recognised Periodontal pathogens.
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The Periodontal Abscess: a review
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Mariano SanzAbstract:Background/aims: The Periodontal Abscess is a frequent Periodontal condition in which Periodontal tissues may be rapidly destroyed. Its importance is based on the possible need of urgent care, the affectation of tooth prognosis, and the possibility of infection spreading. There is scant information in the scientific literature regarding this condition and most of it has been published as case reports and text books, where conclusions are not evidence-based, but rather empirical observations made by recognised clinicians. The aim of this review was to critically analyse all available information on this subject in the dental and medical literature, including information on its prevalence, proposed etiologies and pathogenesis, diagnosis, microbiology and treatment alternatives. The Periodontal Abscess is the 3rd most frequent dental emergency, and it is specially prevalent among untreated Periodontal patients and Periodontal patients during maintenance. Different etiologies have been proposed, and 2 main groups can be distinguished, depending on its relation with Periodontal pockets. In the case of a periodontitis-related Abscess, the condition may appear as an exacerbation of a non-treated periodontitis or during the course of Periodontal therapy. In non-periodontitis related Abscesses, impactation of foreign objects, and radicular abnormalities are the 2 main causes. The Abscess microflora seems to be similar to that of adult periodontitis, and it is dominated by gram-negative anaerobic rods, including well-known Periodontal pathogens. Complications and consequences include tooth loss and the spread of the infection to other body sites. Diagnosis and treatment is mainly based on empiricism, since evidence-based data are not available. The role of systemic antibiotics, in the treatment of Periodontal Abscesses, is especially controversial.
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The Periodontal Abscess (II). Short-term clinical and microbiological efficacy of 2 systemic antibiotic regimes †
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Ana O'connor, Mariano SanzAbstract:Background/aims: The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute Periodontal Abscesses. Method: After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3–5 days, 10–12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10–12 days). Blood and urine samples were collected at baseline and after 10–12 days. Microbiological samples were processed by anaerobic culturing, and isolated Periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. Results: 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (p
David Herrera - One of the best experts on this subject based on the ideXlab platform.
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the Periodontal Abscess ii short term clinical and microbiological efficacy of 2 systemic antibiotic regimes
Journal of Clinical Periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Ana Oconnor, Mariano SanzAbstract:Background/aims: The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute Periodontal Abscesses. Method: After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3–5 days, 10–12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10–12 days). Blood and urine samples were collected at baseline and after 10–12 days. Microbiological samples were processed by anaerobic culturing, and isolated Periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. Results: 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (p<0.01). Objective clinical variables also showed clear improvements, being statistically significant after 30 days with probing pocket depth in the azithromycin group (p<0.01). Microbiologically, short-term reductions were detected with both antibiotics, however fast recolonization occurred after the third visit. No significant differences were found between both treatment regimes. Antibiotic susceptibilities demonstrated no resistances for amoxicillin/clavulanate, while 2–3 strains of each studied pathogen were resistant to azithromycin. Conclusions: However, both antibiotic regimes were effective in the short-term treatment of Periodontal Abscesses in periodontitis patients.
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The Periodontal Abscess (I). Clinical and microbiological findings
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Iciar González, Mariano SanzAbstract:Background/aims: Little information is available regarding the diagnosis and microbiology of Periodontal Abscesses. The aim of this descriptive clinical and microbiological study was to provide more information in order to help in the characterisation of the Periodontal Abscess associated to periodontitis. Method: 29 consecutive patients with a Periodontal Abscess were studied by the assessment of clinical variables, including both subjective (pain, edema, redness and swelling) and objective (bleeding on probing, suppuration, probing pocket depth, tooth mobility and cervical lymphadenopathy) parameters. Microbiological samples were taken for anaerobic microbiology and processed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards. Results: 62% of the Abscesses affected untreated periodontitis patients, and 69% were associated with a molar tooth. More than 75% of the Abscesses had moderate-severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all Abscesses, while suppuration on sampling was detected in 66%. Mean associated pocket depth was 7.28 mm, and 79% of teeth presented some degree of mobility. Cervical lymphadenopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% of the patients. High prevalences of putative Periodontal pathogens were found, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus. Conclusions: The Periodontal Abscess has clear clinical characteristics and is usually associated with severe Periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacterial mass with a high prevalence of well-recognised Periodontal pathogens.
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The Periodontal Abscess: a review
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Mariano SanzAbstract:Background/aims: The Periodontal Abscess is a frequent Periodontal condition in which Periodontal tissues may be rapidly destroyed. Its importance is based on the possible need of urgent care, the affectation of tooth prognosis, and the possibility of infection spreading. There is scant information in the scientific literature regarding this condition and most of it has been published as case reports and text books, where conclusions are not evidence-based, but rather empirical observations made by recognised clinicians. The aim of this review was to critically analyse all available information on this subject in the dental and medical literature, including information on its prevalence, proposed etiologies and pathogenesis, diagnosis, microbiology and treatment alternatives. The Periodontal Abscess is the 3rd most frequent dental emergency, and it is specially prevalent among untreated Periodontal patients and Periodontal patients during maintenance. Different etiologies have been proposed, and 2 main groups can be distinguished, depending on its relation with Periodontal pockets. In the case of a periodontitis-related Abscess, the condition may appear as an exacerbation of a non-treated periodontitis or during the course of Periodontal therapy. In non-periodontitis related Abscesses, impactation of foreign objects, and radicular abnormalities are the 2 main causes. The Abscess microflora seems to be similar to that of adult periodontitis, and it is dominated by gram-negative anaerobic rods, including well-known Periodontal pathogens. Complications and consequences include tooth loss and the spread of the infection to other body sites. Diagnosis and treatment is mainly based on empiricism, since evidence-based data are not available. The role of systemic antibiotics, in the treatment of Periodontal Abscesses, is especially controversial.
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The Periodontal Abscess (II). Short-term clinical and microbiological efficacy of 2 systemic antibiotic regimes †
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Ana O'connor, Mariano SanzAbstract:Background/aims: The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute Periodontal Abscesses. Method: After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3–5 days, 10–12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10–12 days). Blood and urine samples were collected at baseline and after 10–12 days. Microbiological samples were processed by anaerobic culturing, and isolated Periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. Results: 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (p
Silvia Roldán - One of the best experts on this subject based on the ideXlab platform.
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the Periodontal Abscess ii short term clinical and microbiological efficacy of 2 systemic antibiotic regimes
Journal of Clinical Periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Ana Oconnor, Mariano SanzAbstract:Background/aims: The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute Periodontal Abscesses. Method: After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3–5 days, 10–12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10–12 days). Blood and urine samples were collected at baseline and after 10–12 days. Microbiological samples were processed by anaerobic culturing, and isolated Periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. Results: 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (p<0.01). Objective clinical variables also showed clear improvements, being statistically significant after 30 days with probing pocket depth in the azithromycin group (p<0.01). Microbiologically, short-term reductions were detected with both antibiotics, however fast recolonization occurred after the third visit. No significant differences were found between both treatment regimes. Antibiotic susceptibilities demonstrated no resistances for amoxicillin/clavulanate, while 2–3 strains of each studied pathogen were resistant to azithromycin. Conclusions: However, both antibiotic regimes were effective in the short-term treatment of Periodontal Abscesses in periodontitis patients.
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The Periodontal Abscess (I). Clinical and microbiological findings
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Iciar González, Mariano SanzAbstract:Background/aims: Little information is available regarding the diagnosis and microbiology of Periodontal Abscesses. The aim of this descriptive clinical and microbiological study was to provide more information in order to help in the characterisation of the Periodontal Abscess associated to periodontitis. Method: 29 consecutive patients with a Periodontal Abscess were studied by the assessment of clinical variables, including both subjective (pain, edema, redness and swelling) and objective (bleeding on probing, suppuration, probing pocket depth, tooth mobility and cervical lymphadenopathy) parameters. Microbiological samples were taken for anaerobic microbiology and processed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards. Results: 62% of the Abscesses affected untreated periodontitis patients, and 69% were associated with a molar tooth. More than 75% of the Abscesses had moderate-severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all Abscesses, while suppuration on sampling was detected in 66%. Mean associated pocket depth was 7.28 mm, and 79% of teeth presented some degree of mobility. Cervical lymphadenopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% of the patients. High prevalences of putative Periodontal pathogens were found, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus. Conclusions: The Periodontal Abscess has clear clinical characteristics and is usually associated with severe Periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacterial mass with a high prevalence of well-recognised Periodontal pathogens.
-
The Periodontal Abscess: a review
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Mariano SanzAbstract:Background/aims: The Periodontal Abscess is a frequent Periodontal condition in which Periodontal tissues may be rapidly destroyed. Its importance is based on the possible need of urgent care, the affectation of tooth prognosis, and the possibility of infection spreading. There is scant information in the scientific literature regarding this condition and most of it has been published as case reports and text books, where conclusions are not evidence-based, but rather empirical observations made by recognised clinicians. The aim of this review was to critically analyse all available information on this subject in the dental and medical literature, including information on its prevalence, proposed etiologies and pathogenesis, diagnosis, microbiology and treatment alternatives. The Periodontal Abscess is the 3rd most frequent dental emergency, and it is specially prevalent among untreated Periodontal patients and Periodontal patients during maintenance. Different etiologies have been proposed, and 2 main groups can be distinguished, depending on its relation with Periodontal pockets. In the case of a periodontitis-related Abscess, the condition may appear as an exacerbation of a non-treated periodontitis or during the course of Periodontal therapy. In non-periodontitis related Abscesses, impactation of foreign objects, and radicular abnormalities are the 2 main causes. The Abscess microflora seems to be similar to that of adult periodontitis, and it is dominated by gram-negative anaerobic rods, including well-known Periodontal pathogens. Complications and consequences include tooth loss and the spread of the infection to other body sites. Diagnosis and treatment is mainly based on empiricism, since evidence-based data are not available. The role of systemic antibiotics, in the treatment of Periodontal Abscesses, is especially controversial.
-
The Periodontal Abscess (II). Short-term clinical and microbiological efficacy of 2 systemic antibiotic regimes †
Journal of clinical periodontology, 2000Co-Authors: David Herrera, Silvia Roldán, Ana O'connor, Mariano SanzAbstract:Background/aims: The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute Periodontal Abscesses. Method: After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3–5 days, 10–12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10–12 days). Blood and urine samples were collected at baseline and after 10–12 days. Microbiological samples were processed by anaerobic culturing, and isolated Periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. Results: 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (p
Wu Wen-lei - One of the best experts on this subject based on the ideXlab platform.
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Application of root canal treatment in the treatment of Periodontal Abscess
Chinese Journal of Conservative Dentistry, 2011Co-Authors: Wu Wen-leiAbstract:AIM:To investigate the effects of root canal treatment on recurrent Periodontal Abscess.METHODS:Sixty-two patients with medium to severe periodontitis were enrolled in this clinical study.The control group received Periodontal therapy and local application of drugs.The experimental group received Periodontal therapy and root canal treatment.The cases were followed up at 1 month,3 months,6 months and 1 year after treatment.RESULTS:Three months after treatment,significant differences were found between the control group and experiment group in all indices including probing depth,attachment loss,bleeding index and tooth mobility.CONCLUSION:Periodontal therapy alone is not sufficient for the treatment of recurrent Periodontal Abscess.Periodontal therapy plus root canal treatment can substantially increase the treatment effects.
Atsushi Saito - One of the best experts on this subject based on the ideXlab platform.
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Periodontal Abscess: a Review and the Role of Antimicrobial Therapy
Current Oral Health Reports, 2017Co-Authors: Sachiyo Tomita, Atsushi SaitoAbstract:Purpose of Review The aim was to summarize current knowledge about Periodontal Abscesses and describe recent research on antimicrobial treatment. Recent Findings For Periodontal Abscess treatment, antimicrobial therapy is implemented as an adjunct modality to subgingival debridement and/or Abscess drainage. Among available systemic antimicrobial agents, amoxicillin (plus clavulanate), metronidazole, and azithromycin are often used with good clinical results. In our studies of patients with acute Periodontal lesions, systemic administration of a new fluoroquinolone, sitafloxacin, yielded a significant improvement in clinical parameters, and was effective against subgingival bacteria, with no significant impact on the antimicrobial susceptibility of Periodontal bacteria. Summary Plaque control during initial Periodontal therapy or maintenance care is critical for the prevention and treatment of Periodontal Abscesses. In the case of acute Periodontal Abscesses, drainage is considered first. When drainage is not possible or insufficient, antimicrobial therapy should then be considered. Microbiological testing can contribute to the successful treatment.
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Periodontal Abscess: a Review and the Role of Antimicrobial Therapy
Current Oral Health Reports, 2017Co-Authors: Sachiyo Tomita, Atsushi SaitoAbstract:The aim was to summarize current knowledge about Periodontal Abscesses and describe recent research on antimicrobial treatment. For Periodontal Abscess treatment, antimicrobial therapy is implemented as an adjunct modality to subgingival debridement and/or Abscess drainage. Among available systemic antimicrobial agents, amoxicillin (plus clavulanate), metronidazole, and azithromycin are often used with good clinical results. In our studies of patients with acute Periodontal lesions, systemic administration of a new fluoroquinolone, sitafloxacin, yielded a significant improvement in clinical parameters, and was effective against subgingival bacteria, with no significant impact on the antimicrobial susceptibility of Periodontal bacteria. Plaque control during initial Periodontal therapy or maintenance care is critical for the prevention and treatment of Periodontal Abscesses. In the case of acute Periodontal Abscesses, drainage is considered first. When drainage is not possible or insufficient, antimicrobial therapy should then be considered. Microbiological testing can contribute to the successful treatment.