amoxicillin-potassium-clavulanate-combination and Furcation-Defects

This study determined the microbial composition of the apical parts of the expanded polytetrafluoroethylene membrane surfaces facing the gingiva and the tooth in guided tissue regeneration. Microbial and clinical features of 2-to-3 wall periodontal bony defects treated with membranes with and without concomitant use of systemic Augmentin therapy were also determined. 18 patients with 18 study sites participated. 9 patients received systemic 500 mg Augmentin 1 h prior to surgery, and 500 mg TID for 8 days thereafter. 9 patients received no systemic antimicrobial therapy. Microbiological examination was performed 1 h prior to surgery, at the time of membrane removal at week 6, and at 6 months post-surgery. Microbial morphotypes, total viable counts, and the occurrence of selected microbial species were determined by phase-contrast microscopy, selective and non-selective culture, and DNA probes. Study sites were examined for probing pocket depths and attachment levels. At baseline, no microbial or clinical parameter showed statistical differences between groups. At 6 months, the Augmentin group demonstrated a significantly higher (P = 0.032; Student t-test) mean probing attachment gain (36.5% of potential gain to the cemento-enamel junction) than the 9 control patients (22.4% of potential gain). At the time of removal, membranes in the Augmentin group showed significantly fewer organisms than membranes in the control group (52.2 x 10(6) versus 488.6 x 10(6)). Sites free of pathogens on the membrane surface toward the tooth gained the most clinical attachment, even in the presence of various pathogens on the gingiva-facing membrane surface.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bacteria; Clavulanic Acids; Colony Count, Microbial; DNA Probes; DNA, Bacterial; Drug Therapy, Combination; Equipment Contamination; Female; Follow-Up Studies; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Microscopy, Phase-Contrast; Middle Aged; Periodontal Attachment Loss; Periodontal Pocket; Periodontium; Polytetrafluoroethylene; Wound Healing

The one-year results of a regenerative procedure in patients treated with or without antibiotics are presented. Expanded polytetrafluoroethylene (ePTFE) was placed over mandibular molar Class II furcation invasions and retained for four weeks. The patients in group 1 received no antibiotics; patients in group 2 received amoxicillin/clavulanate potassium during the first 10 post-operative days. The initial differences in tested microorganisms and post-surgical inflammation indicated that the use of the antibiotic might enhance the long-term outcome. After one year, the reduction in mean probing depth of the furcation invasions was 2.0 +/- 1.2 mm for group 1 and 1.8 +/- 1.1 mm for group 2. An overall gain of 0.8 mm of clinical attachment was found. Twenty-two of the 24 sites were re-entered. Wide individual variations were found but the changes between pre-treatment and one-year data for any of 6 linear measurements of hard tissue landmarks did not differ between groups or between pre-treatment and re-entry. A combination of an overall loss of 0.4 mm alveolar bone at the crest and 0.3 mm gain of bone at the bottom of the furcation defects was found. Volumetric analysis indicated an average 32% bone fill for both groups, ranging from a decrease in defect volume by 84% (gain) to an increase of the size of the furcation invasion by 66% (loss). A decrease in defect volume > 30% was found at 7 sites from each group. The antibiotic may have controlled initial inflammation, but 12 months later it had no direct effect on bone regeneration or soft tissue attachment.

Topics: Alveolar Bone Loss; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Bone Regeneration; Clavulanic Acids; Drug Therapy, Combination; Female; Follow-Up Studies; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Male; Mandible; Middle Aged; Molar; Regeneration; Statistics, Nonparametric; Treatment Outcome

Guided tissue regeneration procedures with Gore-Tex Periodontal Material are associated with a unique set of postoperative healing characteristics. Five healing complications are described in this study examining 102 sites. The occurrence of pain and purulence were the most common. In purulent sites, the majority of bacteria cultured were Actinomyces and Streptococcus spp. Resistance to antibiotics was common. Prevention and treatment of the healing complications are discussed.

Topics: Actinomyces; Adolescent; Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chi-Square Distribution; Clavulanic Acids; Doxycycline; Drug Resistance, Microbial; Drug Therapy, Combination; Edema; Female; Furcation Defects; Gingival Diseases; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Microbial Sensitivity Tests; Middle Aged; Pain, Postoperative; Periodontitis; Polytetrafluoroethylene; Postoperative Complications; Prevotella intermedia; Streptococcus; Suppuration; Surgical Flaps; Wound Healing