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Antimicrobial Peptides in the Treatment of Stage III Grade B Periodontitis
TAKE-HOME MESSAGE
- This study showed that, in patients with stage III grade B periodontitis, a significant reduction in the periodontal probing depth and bleeding index scores and a significantly higher attachment gain were observed at day 90 in the adjunctive antimicrobial peptide (AMP) group than in the adjunctive minocycline group and the scaling and root planing–only group compared with baseline values. At day 90, the abundance of periodontal probiotics was significantly higher in the AMP group than in the other two groups.
- The clinical efficacy of the adjunctive topical use of AMPs in the treatment of stage III grade B periodontitis is better than that of the adjunctive topical use of minocycline hydrochloride and mechanical treatment only. AMPs are more conducive to the transformation of the subgingival microecosystem to a healthy subgingival microecosystem, rather than simply killing the periodontal bacteria.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
To evaluate the effects of antimicrobial peptides (AMPs) on Stage III Grade B periodontitis.
METHODS
This trial abided by the principle of consistency test, approved by ethics committee and registered in clinical trials. All qualified 51 patients with Stage III Grade B periodontitis were randomly divided into three groups: SRP group, SRP with minocycline hydrochloride (Mino group) as Control groups, and SRP with AMPs (AMP group) as the Test group. Clinical examinations and subgingival plaques were monitored at baseline and at 7 and 90 days after treatment in the SRP, SRP with AMP and Mino groups.
RESULTS
The AMP group (Test group) had a reduced PD (Periodontal probing depth) and an attachment gain significantly higher than SRP and Mino groups (Control groups) at day 90. The abundance of periodontal pathogens was decreased in the AMP group at 7 and 90 days compared with the SRP group and Mino group. Only the AMP group showed an increase the abundance of periodontal probiotics including Capnocytophaga, Gemella, and Lactobacillus at 7 and 90 days.
CONCLUSIONS
This study shows that AMPs as an adjunct to SRP promote additional clinical and microbiological benefits in the treatment of Stage III Grade B periodontitis.
Additional Info
Disclosure statements are available on the authors' profiles:
Antimicrobial peptides in treatment of Stage III Grade B periodontitis: A randomized clinical trial
Oral Dis 2023 Nov 05;[EPub Ahead of Print], S Xiang, N Han, Y Xie, J Du, Z Luo, J Xu, Y LiuFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Chronic periodontitis is caused by the bacterial biofilm, leading to inflammation that can result in the destruction of periodontal tissues and ultimately cause tooth loss. It is challenging to treat patients diagnosed with stage III grade B periodontitis owing to the severity of the condition. Many antibiotics and antimicrobial agents have been studied as adjuncts to scaling and root planing (SRP) procedures. Antimicrobial peptides (AMPs) have been suggested as an alternative to using broad-spectrum antibiotics to avoid undesirable side effects. The purpose of this randomized clinical trial was to evaluate the effects of exogenous AMPs as an adjunct to SRP. AMPs have been shown to have inhibitory effects on periodontal pathogens, such as Porphyromonas gingivalis, and participate in the wound healing process. This study included 51 systemically healthy participants diagnosed with stage III grade B periodontitis based on clinical and radiographic parameters. They were randomly assigned to one of the three groups: SRP only, SRP plus minocycline hydrochloride gel, and SRP plus AMP gel. Microbiological sampling and clinical examinations were performed at baseline, 7 days, and 90 days. The results showed statistically significant improvements in probing depths and bleeding indices in the SRP plus AMP gel group compared with the other two groups after 90 days. Furthermore, microbiological sampling revealed that AMPs were able to reduce the number of periodontal pathogenic bacteria more effectively. The authors reported that, owing to the mechanism of action of AMPs, wound healing is accelerated, which could improve the ability of gingival tissues to resist the accumulation of plaque. The length of the study is a limitation, and a long-term follow-up is imperative to assess the effects of AMPs as an adjunct to SRP for patients in clinical practice.