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(PDF) Piperacillin-Tazobactam As An Adjuvant in The Mechanical Treatment of Patients With Periodontitis - A Randomized Clinical Study
(PDF) Piperacillin-Tazobactam As An Adjuvant in The Mechanical Treatment of Patients With Periodontitis - A Randomized Clinical Study
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Piperacillin–Tazobactam as an Adjuvant in the Mechanical Treatment of Patients with Periodontitis: A Randomized Clinical Study
Authors:
In this study, the aim was to evaluate the effects of the adjuvant piperacillin–tazobactam
solution in the mechanical treatment of periodontitis. A single-blind split-mouth randomized Discover the world's
study, it included 24 participants. All of them presented periodontitis stage III according to research
the 2018 World Workshop classification and the presence of at least one of the following 20+ million
periodontal pathogens: Aggregatibacter actinomycetemcomitans; Porphyromona gingivalis; members
Treponema denticola; Tannerella forsythia; Prevotella intermedia. The study established
two groups: a control group (SRP: scaling and root planing) and a test group (SRP plus 135+ million
local piperacillin–tazobactam). The final recruitment included 11 women (45.8%) and 13 publications
men (54.2%). The age range was between 25 and 72 years, and the mean age was 57 ± 700k+ research
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10.20 years. Clinical controls were performed at 2 weeks, 3 months, and 6 months, projects
repeating the SRP and applying the piperacillin–tazobactam solution again at the 3-month
appointment. The clinical attachment level decreased by a mean of 2.13 ± 0.17 mm from
the baseline to 6 months in the test group versus 1.63 ± 0.18 mm in the control group. The
mean probing pocket depth decreased from 1.32 ± 0.09 mm in the test group, versus from
0.96 ± 0.14 mm on the control side. The plaque index in the test group decreased by 0.46
± 0.04, while it decreased by an average of 0.31 ± 0.04 in the control group. In conclusion,
the local use of piperacillin–tazobactam as complementary therapy produces better clinical
results in patients with periodontitis. However, these results are not maintained over time,
and so a more persistent local application is necessary.
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Article
Abstract: In this study, the aim was to evaluate the effects of the adjuvant piperacillin–tazobac
solution in the mechanical treatment of periodontitis. A single-blind split-mouth randomized st
it included 24 participants. All of them presented periodontitis stage III according to the 2018 W
Workshop classification and the presence of at least one of the following periodontal pathog
Aggregatibacter actinomycetemcomitans; Porphyromona gingivalis; Treponema denticola; Tannerella
Citation: Hurtado-Celotti, D.; sythia; Prevotella intermedia. The study established two groups: a control group (SRP: scaling
Martínez-Rodríguez, N.; root planing) and a test group (SRP plus local piperacillin–tazobactam). The final recruitmen
Ruiz-Sáenz, P.L.; Barona-Dorado, C.;
cluded 11 women (45.8%) and 13 men (54.2%). The age range was between 25 and 72 years, and
Santos-Marino, J.;
mean age was 57 ± 10.20 years. Clinical controls were performed at 2 weeks, 3 months, and 6 mon
Martínez-González, J.M.
repeating the SRP and applying the piperacillin–tazobactam solution again at the 3-month app
Piperacilina–Tazobactam as
ment. The clinical attachment level decreased by a mean of 2.13 ± 0.17 mm from the baseline
Adjuvant in Mechanical Treatment
of Patients with Periodontitis: A
months in the test group versus 1.63 ± 0.18 mm in the control group. The mean probing pocket d
Randomized Clinical Study. decreased from 1.32 ± 0.09 mm in the test group, versus from 0.96 ± 0.14 mm on the control
Antibiotics 2022, 11, 1689. The plaque index in the test group decreased by 0.46 ± 0.04, while it decreased by an average of
https://doi.org/10.3390/ ± 0.04 in the control group. In conclusion, the local use of piperacillin–tazobactam as complemen
antibiotics11121689 therapy produces better clinical results in patients with periodontitis. However, these results
not maintained over time, and so a more persistent local application is necessary.
Academic Editor: Elena Varoni
Nd:YAG laser and the application of different agents (such as sodium hypochlorite, p
idone–iodine, or chlorhexidine), which have different results in terms of the clinica
tachment level and bacterial load [2].
On the one hand, systemic antibiotic therapy in combination with SRP (scaling
root planing) has shown greater efficacy against the presence of periodontal pathog
bacteria compared with isolated mechanical therapy on aggressive or recurrent period
titis, as shown by the meta-analysis carried out by Keestra et al. [3].
However, the problem of adverse side effects and especially a seemingly eve
creasing risk of bacterial resistance urge clinicians to balance the risks and benefits w
with each individual patient
Given this improvement, and due to the global trend of reductions in systemic
antibiotic therapy, researchers are investigating the use of local antibiotics with the aim
reducing the probing pocket depth and increasing the clinical attachment level compa
with individual mechanical treatment [4–6].
Researchers have used different administrations of different antibiotics such as m
ronidazole gel, tetracycline fibers, doxycycline gel, minocycline gel or microsphe
azithromycin gel, and clarithromycin gel in different fields of dentistry [7–15]. In the p
lished studies, the researchers observed substantial heterogeneity in terms of the adm
istration protocol and the results obtained.
The combination of piperacillin–tazobactam is frequently used in the medical f
however, there are few studies in the dental field. One of them, conducted by Zirk e
[16] on odontogenic sinusitis, highlights its much higher effectiveness (93.3%) compa
with other antibiotics, such as ampicillin–sulbactam (80%), moxifloxacin (86.3%),
clindamycin (50%).
Researchers have also proven the effectiveness of the use of piperacillin–tazobac
in periodontitis. In a single study published in 2013, Lauenstein et al. [17] demonstr
substantial reductions in Treponema denticola, Fusobacterium nucleatum spp. Polymorph
Parvimona micra, and Fusobacterium periodonticum compared with the conventional
treatment.
Callow and Martínez-González [18] conducted a study on the inhibitory capacit
different antibiotics against periodontopathogenic germs, demonstrating the effective
of piperacillin–tazobactam in vitro. According to the results, piperacillin–tazobactam
a better response compared with that of amoxicillin/clavulanic acid and minocycline.
The lack of studies on this antibiotic association does not allow for a demonstra
as to whether its application can be of benefit in this highly prevalent disease. In this
text, the aim of the present study was to evaluate the effects of the piperacillin–tazobac
solution as an adjuvant in the mechanical treatment of periodontitis.
Patients who had a bacterial load of at least one of the periodontal pathogens at
time of diagnosis.
Patients were excluded from the study if they met one or more of the following
teria:
Patients younger than 18 years;
ASA III and IV patients;
Patients who had received periodontal treatment in the last 6 months;
Smoking patients;
Pregnant or lactating women;
Immunocompromised patients or patients in treatment with bisphosphonates.
2.2. Timeline
On the first visit, a complete periodontal examination and completed periodo
chart were performed. Subgingival samples were taken to confirm the presence of pe
dontopathogens. Once the inclusion criteria were met, and after obtaining informed
sent, the SRP was performed on both groups. In the test group, the piperacillin–tazo
tam gel solution was applied.
Clinical controls were carried out after two weeks, and then the treatment wa
peated three and six months later.
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