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- periodontitis (3)
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Periodontitis is a multifactorial disease. The aim of this explorative study was to investigate the role of Interleukin-(IL)-1, IL-4, GATA-3 and Cyclooxygenase-(COX)-2 polymorphisms after non-surgical periodontal therapy with adjunctive systemic antibiotics (amoxicillin/metronidazole) and subsequent maintenance in a Caucasian population. Analyses were performed using blood samples from periodontitis patients of a multi-center trial (ClinicalTrials.gov NCT00707369=ABPARO-study). Polymorphisms were analyzed using quantitative real-time PCR. Clinical attachment levels (CAL), percentage of sites showing further attachment loss (PSAL) ≥1.3 mm, bleeding on probing (BOP) and plaque score were assessed. Exploratory statistical analysis was performed. A total of 209 samples were genotyped. Patients carrying heterozygous genotypes and single-nucleotide-polymorphisms (SNP) on the GATA-3-IVS4 +1468 gene locus showed less CAL loss than patients carrying wild type. Heterozygous genotypes and SNPs on the IL-1A-889, IL-1B +3954, IL-4-34, IL-4-590, GATA-3-IVS4 +1468 and COX-2-1195 gene loci did not influence CAL. In multivariate analysis, CAL was lower in patients carrying GATA-3 heterozygous genotypes and SNPs than those carrying wild-types. For the first time, effects of different genotypes were analyzed in periodontitis progression after periodontal therapy and during supportive treatment using systemic antibiotics demonstrating a slight association of GATA-3 gene locus with CAL. This result suggests that GATA-3 genotypes are a contributory but non-essential risk factor for periodontal disease progression.
Aim
The aim of this study was to evaluate the effect of non‐surgical periodontal therapy on circulating levels of the systemic inflammation‐associated biomarkers orosomucoid (ORM), high‐sensitivity C‐reactive protein (hsCRP), chemerin, and retinol‐binding protein 4 (RBP4) in overweight or normal‐weight patients with periodontitis at 27.5 months after therapy.
Materials and methods
This exploratory subanalysis includes patients from the ABPARO‐trial (ClinicalTrials.gov NCT00707369). The per‐protocol collective provided untreated periodontitis patients with high (≥28 kg/m\(^{2}\)) or moderate (21–24 kg/m\(^{2}\)) BMI. Out of the per‐protocol collective, 80 patients were randomly selected and stratified for BMI group, sex, and treatment group (antibiotics/placebo), resulting in 40 overweight and normal‐weight patients. Patients received non‐surgical periodontal therapy and maintenance at 3‐month intervals. Plasma samples from baseline and 27.5 months following initial treatment were used to measure the concentrations of ORM, hsCRP, chemerin, and RBP4.
Results
At the 27.5‐month examination, ORM and hsCRP decreased noticeably in the overweight group (ORM: p = .001, hsCRP: p = .004) and normal‐weight patients (ORM: p = .007, hsCRP: p < .001). Chemerin decreased in the overweight group (p = .048), and RBP4 concentrations remained stable.
Conclusion
Non‐surgical periodontal therapy reduced systemically elevated inflammation‐associated biomarkers in periodontitis patients. These improvements were more pronounced in overweight patients than in normal‐weight patients.
Aim
The aim was to identify benefit thresholds for clinical variables. We hypothesize, if variables fall below or exceed these threshold levels, systemic amoxicillin/metronidazole may contribute to reducing progression of periodontitis.
Material & Methods
This is an explorative per-protocol collective analysis (n = 345) conducted on the placebo-controlled, multi-centre ABPARO trial (ClinicalTrials.gov NCT00707369). Patients received debridement with systemic amoxicillin 500 mg/metronidazole 400 mg (3×/day, 7 days, n = 170) or placebo (n = 175) and maintenance therapy every three months. To identify thresholds, each of the following baseline characteristics was classified into two groups (≥threshold value/<threshold value): bleeding on probing, extent of pocket probing depth (PPD) ≥ 5 mm, mean clinical attachment level and age. Treatment effect (% of sites with new attachment loss ≥ 1.3 mm at 27.5 months post-treatment) was calculated.
Results
Adjunctive antimicrobials reduced median new attachment loss in patients < 55 years (5.2%), or with ≥ 35% PPD ≥ 5 mm (4.5%) or with a mean attachment level > 5 mm (5.2%) at baseline compared to the placebo (9.0%, 11.6%, and 12.5%, respectively; p < 0.005).
Conclusions
The clinical benefits of systemic amoxicillin/metronidazole may depend on periodontitis severity and patients' age.