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Title Comparison of Anti-inflammatory Effects Produced in Gingiva by Metronidazole and Azithromycin
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Publication Date
Degree MS
Discipline/Department Dentistry
Degree Level masters
University/Publisher The Ohio State University
Abstract Objective: Previous studies suggest that azithromycin (AZM) inhibits subclinical gingi-val inflammation in individuals with minimal plaque and clinically healthy gingiva. While it is unclear whether other antibiotics produce similar effects in gingiva, metroni-dazole (MET) has been shown to decrease pro-inflammatory cytokine production by cul-tured periodontal ligament cells. This randomized, blinded, crossover study compared anti-inflammatory effects produced by AZM and MET.Methods: Twelve healthy adult subjects with good oral hygiene and clinically healthy gingiva were randomly allocated to receive a blinded regimen of either AZM (500mg ini-tial dose, then 250mg at 24 and 48 hrs) or MET (375mg every 12 hr for 48 hr). At base-line (immediately before starting the regimens) and 2, 4, 7 and 14 days later, gingival crevicular fluid (GCF) samples were collected from twelve maxillary interproximal sites, measured with a calibrated Periotron, pooled, and stored frozen. After a 21 day washout period, each subject received the alternative regimen. A second set of GCF samples were collected at the same time points. GCF samples were assayed for pro- and anti-inflammatory cytokine signatures by multiplex immunoassay.Results: Both agents induced significant transient decreases in the rate of GCF flow on days 2, 4 and 7. No significant differences in their effects were observed. With both an-tibiotics, the GCF flow rate increased to approximately 86% of baseline between days 7 and 14. In parallel with their effects on GCF volume, AZM and MET induced transient reductions in the GCF content of several pro-inflammatory cytokines (IL-1ß, IL-12, IL-17, G-CSF) as well as IL-8, RANTES, VEGF, and IL-4. The effects of AZM and MET were similar in magnitude and the most significant decreases below baseline levels were apparent on days 4 and 7. MET induced a larger decrease in GCF IL-8 content than AZM. Neither agent produced significant changes in the amounts of the anti-inflammatory cytokines IL-10 and IL-1 receptor antagonist in GCF. Conclusions: In addition to their known antimicrobial effects, AZM and MET both ap-pear to inhibit production of a similar range of pro-inflammatory cytokines and chemoki-nes in gingiva. This could potentially enhance the efficacy of these agents in the treat-ment of inflammatory periodontitis.
Subjects/Keywords Dentistry; Periodontics; Antibiotics; Azithromycin; Metronidazole; GCF; Periodontitis; healthy gingiva
Contributors Walters, John (Advisor)
Language en
Rights unrestricted ; This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
Country of Publication us
Format application/pdf
Record ID oai:etd.ohiolink.edu:osu1402670626
Repository ohiolink
Date Indexed 2021-01-29
Grantor The Ohio State University

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…10 Chapter 4 Discussion ……………………………………………………………………23 References ……………………………………………………………………………….30 Appendix A………………………………………………………………………………40 vii List of Tables Table 1: Composition of Subject Groups………………………………………………14 Table 2: Changes in GCF

…Biological Mediator Content Induced by AZM and MET….15 viii List of Figures Figure 1: Flowchart of subject enrollment and allocation……………………………….17 Figure 2: Effects of systemic AZM and MET on pooled GCF volume………………….18 Figure 3: Effects of systemic AZM…

…and MET on the GCF content of IL-1β and G-CSF.19 Figure 4: Effects of AZM and MET on the GCF content of IL-12 (p70) and IL-17…….20 Figure 5: Effects of AZM and MET on GCF IL-8 and RANTES content………………21 Figure 6: Effects of systemic AZM and…

…MET on the GCF content of VEGF and IL-4…22 ix CHAPTER 1 INTRODUCTION Periodontitis is a destructive inflammatory disorder that is caused by a polymicrobial infection. Periodontitis leads to formation of periodontal pockets and loss of alveolar bone…

…Gingival crevicular fluid is a serum transudate or inflammatory exudate that (GCF) contains serum components, bacterial by-products, inflammatory mediators, host-derived enzymes, and tissue-break-down products. GCF production is induced by…

…inflammation, trauma, or mechanical stimulation that causes an increase in the permeability of capillaries underlying the junctional epithelium and sulcular epithelium (Egelberg, 1966). The rate of GCF flow is high in gingivitis and relatively low in…

…al. 1979, Lamster et al., 1980; Rudin et al., 1979), and GCF flow rate is considered to be a useful indicator of gingival inflammation (Griffiths, 2003). A fundamental goal in the treatment of periodontitis is the elimination of…

…effect on gram-negative bacteria (Hirsch et al, 2012). Furthermore, AZM appears to be capable of infiltrating biofilm (Tamura et al,.2008) and its concentrations were 15 to 50-fold higher in GCF than in blood serum (Jain et al…

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