medigraphic.com
ISSN 0001-0944 (Print)
Órgano Oficial de la Asociación Dental Mexicana

2025, Number 2

<< Back Next >>

Rev ADM 2025; 82 (2)

Adjuvant effect of metronidazole plus amoxicillin versus the probiotic Bifidobacterium lactis HN019 in the treatment of periodontitis stage II grade A and B.

Flores MJE

Language: Spanish
References: 49
Page: 62-77
PDF size: 1992.32 Kb.


ABSTRACT

The present work sought to have as an alternative to the conventional protocol to Scaling and Root Planing (SRP) to stop the progression of periodontitis, which consists of the systemic administration of the combination of metronidazole plus amoxicillin, considered the gold standard for this disease, by the use of the probiotic Bifidobacterium lactis HN019; where after doing a bibliographic review it was determined that this probiotic offers the same or even superior results in clinical attachment gain, reduction of bleeding on generalized probing of more than 30%, and bacterial dental plaque index in patients who have periodontal pockets of up to 5 mm with a diagnosis of periodontitis stage II grade A and B to the patients of the Dental Specialties Unit.


REFERENCES

  1. Kumar S. Evidence-based update on diagnosis and management of gingivitis and periodontitis. Dent Clin North Am. 2019; 63 (1): 69-81. Available in: https://doi.org/10.1016/j.cden.2018.08.005

  2. Caton JG, Armitage G, Berglundh T et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018; 45 Suppl 20: S1-S8.

  3. Herrera D. La nueva clasificación de las enfermedades periodontales y periimplantarias. Periodoncia Clínica. 2018; 11: 94-110.

  4. Invernici MM, Salvador SL, Silva PHF et al. Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: A randomized clinical trial. J Clin Periodontol. 2018; 45 (10): 1198-1210.

  5. Genco CA, Simpson W, Olczak T. Porphyromonas gingivalis. Iron Transport in Bacteria. 2014; 329-343. doi: 10.1128/9781555816544.ch21.

  6. Teughels W, Feres M, Oud V et al. Adjunctive effect of systemic antimicrobials in periodontitis therapy: a systematic review and meta-analysis. J Clin Periodontol. 2020; 47 Suppl 22: 257-281. Available in: https://doi.org/10.1111/jcpe.13264

  7. Groeger S, Meyle J. Oral mucosal epithelial cells. Front Immunol. 2019; 10: 208. Available in: https://doi.org/10.3389/fimmu.2019.00208

  8. Morales A, Contador R, Bravo J et al. Clinical effects of probiotic or azithromycin as an adjunct to scaling and root planning in the treatment of stage III periodontitis: a pilot randomized controlled clinical trial. BMC Oral Health. 2021; 21 (1): 12.

  9. Araujo LDC, Furlaneto FAC, da Silva LAB, Kapila YL. Use of the probiotic Bifidobacterium animalis subsp. lactis HN019 in oral diseases. Int J Mol Sci. 2022; 23 (16): 9334. Available in: https://doi.org/10.3390/ijms23169334

  10. Zheng S, Yu S, Fan X et al. Porphyromonas gingivalis survival skills: immune evasion. J Periodontal Res. 2021; 56 (6): 1007-1018. Available in: https://doi.org/10.1111/jre.12915

  11. Gheisary Z, Mahmood R, Harri Shivanantham A et al. The clinical, microbiological, and immunological effects of probiotic supplementation on prevention and treatment of periodontal diseases: a systematic review and meta-analysis. Nutrients. 2022; 14 (5): 1036. Available in: https://doi.org/10.3390/nu14051036

  12. Nguyen T, Brody H, Radaic A, Kapila Y. Probiotics for periodontal health-Current molecular findings. Periodontol 2000. 2021; 87 (1): 254-267. Available in: https://doi.org/10.1111/prd.12382

  13. Britos MR, Sin CS, Ortega SM. Porphyromonas gingivalis, patógeno de relevancia en la enfermedad periodontal. Uriunne. 2017; 42: 46-49.

  14. Araujo LDC, Segato RAB, Reis TPC et al. Effect of systemic administration of Bifidobacterium animalis subsp. lactis HN019 on apical periodontitis. Braz Oral Res. 2023; 37: e115.

  15. Mombelli A. Microbial colonization of the periodontal pocket and its significance for periodontal therapy. Periodontol 2000. 2018; 76 (1): 85-96. Available in: https://doi.org/10.1111/prd.12147 (2018).

  16. Cardoso RS, Messora MR, Silva PHF et al. Effects of Bifidobacterium animalis subsp. lactis HN019 on ligature-induced periodontitis in rats with experimental rheumatoid arthritis. Benef Microbes. 2020; 11 (1): 33-46.

  17. Silva GA, Moreira ALG, Silva PHF et al. The use of probiotics can reduce the severity of experimental periodontitis in rats with metabolic syndrome: an immunoenzymatic and microtomographic study. J Periodontol. 2022; 93 (2): e1-e12.

  18. Sutthiboonyapan P, Wang HL, Charatkulangkun O. Flowcharts for easy periodontal diagnosis based on the 2018 new periodontal classification. Clin Adv Periodontics. 2020; 10 (3): 155-160.

  19. Ricoldi MST, Furlaneto FAC, Oliveira LFF et al. Effects of the probiotic Bifidobacterium animalis subsp. lactis on the non-surgical treatment of periodontitis. A histomorphometric, microtomographic and immunohistochemical study in rats. PLoS One. 2017; 12 (6): e0179946.

  20. De Vos WM, Tilg H, Van Hul M, Cani PD. Gut microbiome and health: mechanistic insights. Gut. 2022; 71 (5): 1020-1032.

  21. Dimidi E, Christodoulides S, Fragkos KC, Scott SM, Whelan K. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014; 100 (4): 1075-1084. Available in: https://doi.org/10.3945/ajcn.114.089151

  22. Ramos TCS, Boas MLV, Nunes CMM et al. Effect of systemic antibiotic and probiotic therapies as adjuvant treatments of subgingival instrumentation for periodontitis: a randomized controlled clinical study. J Appl Oral Sci. 2022; 30: e20210583.

  23. De Almeida Silva Levi YL, Ribeiro MC, Silva PHF et al. Effects of oral administration of Bifidobacterium animalis subsp. lactis HN019 on the treatment of plaque-induced generalized gingivitis. Clin Oral Investig. 2023; 27 (1): 387-398.

  24. Huttner A, Bielicki J, Clements MN et al. Oral amoxicillin and amoxicillin-clavulanic acid: properties, indications and usage. Clin Microbiol Infect. 2020; 26 (7): 871-879. Available in: https://doi.org/10.1016/j.cmi.2019.11.028

  25. Hatz CR, Cremona M, Liu CC, Schmidlin PR, Conen A. Antibiotic prophylaxis with amoxicillin to prevent infective endocarditis in periodontitis patients reconsidered: a narrative review. Swiss Med Wkly. 2021; 151: w30078. Available in: https://doi.org/10.4414/SMW.2021.w30078

  26. Zandbergen D, Slot DE, Niederman R, Van der Weijden FA. The concomitant administration of systemic amoxicillin and metronidazole compared to scaling and root planing alone in treating periodontitis: =a systematic review=. BMC Oral Health. 2016; 16: 27.

  27. Momand P, Becktor JP, Naimi-Akbar A, Tobin G, Götrick B. Effect of antibiotic prophylaxis in dental implant surgery: A multicenter placebo-controlled double-blinded randomized clinical trial. Clin Implant Dent Relat Res. 2022; 24 (1): 116-124.

  28. Agúndez JA, Mayorga C, García-Martin E. Drug metabolism and hypersensitivity reactions to drugs. Curr Opin Allergy Clin Immunol. 2015; 15 (4): 277-284. Available in: https://doi.org/10.1097/ACI.0000000000000174

  29. Faveri M, Retamal-Valdes B, Mestnik MJ et al. Microbiological effects of amoxicillin plus metronidazole in the treatment of young patients with Stages III and IV periodontitis: A secondary analysis from a 1-year double-blinded placebo-controlled randomized clinical trial. J Periodontol. 2023; 94 (4): 498-508.

  30. Feres M, Retamal-Valdes B, Fermiano D et al. Microbiome changes in young periodontitis patients treated with adjunctive metronidazole and amoxicillin. J Periodontol. 2021; 92 (4): 467-478.

  31. Cosgarea R, Heumann C, Juncar R et al. One year results of a randomized controlled clinical study evaluating the effects of non-surgical periodontal therapy of chronic periodontitis in conjunction with three or seven days systemic administration of amoxicillin/metronidazole. PLoS One. 2017; 12 (6): e0179592.

  32. Dingsdag SA, Hunter N. Metronidazole: an update on metabolism, structure-cytotoxicity and resistance mechanisms. J Antimicrob Chemother. 2018; 73 (2): 265-279.

  33. Mtshali A, Ngcapu S, Govender K et al. In vitro effect of 5-nitroimidazole drugs against trichomonas vaginalis clinical isolates. Microbiol Spectr. 2022; 10 (4): e0091222.

  34. Zemanová N, Lnenicková K, Vavrecková M et al. Gut microbiome affects the metabolism of metronidazole in mice through regulation of hepatic cytochromes P450 expression. PLoS One. 2021; 16 (11): e0259643.

  35. Karrabi M, Baghani Z. Amoxicillin/metronidazole dose impact as an adjunctive therapy for stage II-III grade C periodontitis (aggressive periodontitis) at 3- and 6-month follow-ups: a systematic review and meta-analysis. J Oral Maxillofac Res. 2022; 13 (1): e2.

  36. Eickholz P, Koch R, Göde M et al. Clinical benefits of systemic amoxicillin/metronidazole may depend on periodontitis stage and grade: An exploratory sub-analysis of the ABPARO trial. J Clin Periodontol. 2023; 50 (9): 1239-1252.

  37. Puzhankara L, Banerjee A, Chopra A, Venkitachalam R, Kedlaya MN. Effectiveness of probiotics compared to antibiotics to treat periodontal disease: systematic review. Oral Dis. 2024; 30 (5): 2820-2837. doi: 10.1111/odi.14781.

  38. Tonetti MS, Sanz M. Implementation of the new classification of periodontal diseases: Decision-making algorithms for clinical practice and education. J Clin Periodontol. 2019; 46 (4): 398-405

  39. Liaw A, Miller C, Nimmo A. Comparing the periodontal tissue response to non-surgical scaling and root planing alone, adjunctive azithromycin, or adjunctive amoxicillin plus metronidazole in generalized chronic moderate-to-severe periodontitis: a preliminary randomized controlled trial. Aust Dent J. 2019; 64 (2): 145-152.

  40. Oliveira LF, Salvador SL, Silva PH et al. Benefits of bifidobacterium animalis subsp. lactis probiotic in experimental periodontitis. J Periodontol. 2017; 88 (2): 197-208.

  41. Martínez BKE, Bulnes LRM, González AM. Prevalencia de periodontitis crónica moderada y avanzada generalizada como factor de riesgo cardiovascular. Rev ADM, 2021; 78: 22-27.

  42. Kwon T, Lamster IB, Levin L. Current Concepts in the Management of Periodontitis. Int Dent J. 2021; 71 (6): 462-476. Available in: https://doi.org/10.1111/idj.12630

  43. Barboza EP, Arriaga PC, Luz DP, Montez C, Vianna KC. Systematic review of the effect of probiotics on experimental gingivitis in humans. Braz Oral Res. 2020; 34: e031.

  44. Ghazal M, Ahmed S, Farooqui WA et al. A placebo-controlled randomized clinical trial of antibiotics versus probiotics as an adjuvant to nonsurgical periodontal treatment among smokers with stage III, grade C generalized periodontitis. Clin Adv Periodontics. 2023; 13 (3): 197-204.

  45. Ng E, Tay JRH, Saffari SE, Lim LP, Chung KM, Ong MMA. Adjunctive probiotics after periodontal debridement versus placebo: a systematic review and meta-analysis. Acta Odontol Scand. 2022; 80 (2): 81-90. Available in: https://doi.org/10.1080/00016357.2021.1942193

  46. Ikram S, Hassan N, Baig S et al. Effect of local probiotic (Lactobacillus reuteri) vs systemic antibiotic therapy as an adjunct to non-surgical periodontal treatment in chronic periodontitis. J Investig Clin Dent. 2019; 10 (2): e12393.

  47. Invernici MM, Furlaneto FAC, Salvador SL et al. Bifidobacterium animalis subsp lactis HN019 presents antimicrobial potential against periodontopathogens and modulates the immunological response of oral mucosa in periodontitis patients. PLoS One. 2020; 15 (9): e0238425.

  48. Rabetafika HN, Razafindralambo A, Ebenso B, Razafindralambo HL. Probiotics as antibiotic alternatives for human and animal applications. Encyclopedia. 2023; 3: 561-581.

  49. Akram Z, Shafqat SS, Aati S, Kujan O, Fawzy A. Clinical efficacy of probiotics in the treatment of gingivitis: a systematic review and meta-analysis. Aust Dent J. 2020; 65 (1): 12-20. Available in: https://doi.org/10.1111/adj.12733




2020     |     www.medigraphic.com