Azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement
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The Ohio State University / OhioLINK
2019
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ndltd-OhioLink-oai-etd.ohiolink.edu-osu15623309304913382021-08-03T07:11:43Z Azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement Brett, Christopher A. Dentistry Background: There is evidence that a single prophylactic dose of amoxicillin (AMX) can reduce early implant complications, but alternative antibiotics may be more effective. Azithromycin (AZM) has a long half-life in gingival crevicular fluid (GCF) and peri-implant crevicular fluid (PICF) during initial healing at the implant placement site, and it has beneficial anti-microbial and inflammatory effects. This study measured AZM concentration in crevicular fluid of tooth and implant sites associated with a newly-placed single stage implant and confirmed preliminary findings from previous studies of the pharmacokinetics of single-dose prophylactic AMX. This study also assessed the corresponding phylogenetic and functional changes in gingival crevice bacteria.Methods: Healthy adult patients requiring one-stage dental implant placement were administered 500 mg azithromycin before surgery (n = 8). Bacterial and crevicular fluid samples were taken from the adjacent tooth pre-operatively and from the new implant and adjacent tooth at various time points during the first twelve weeks of post-operative healing. AZM levels were measured by bioassay. Microbial community profiles, including phylogenetic and functional capacity, were acquired using whole genome shotgun sequencing. AMZ and microbial community profiles were compared between tooth and implant sites and over time.Results: From baseline to day 20, GCF and PICF volumes followed similar trajectories, reaching a maximum at day 6 and subsequently decreasing to pre-surgical levels. Respective mean AZM concentrations in GCF and PICF were, 1.67 µg/mL and 1.60 µg/mL on day 3, and 0.71 µg/mL and 0.64 µg/mL on day 13. Observed AZM content (in ng per 30-second crevice fluid sample) demonstrated a corresponding decline. Based on linear discriminant analysis (LDA), significant (P = 0.0008) clustering of microbial profiles was observed between subjects grouped by site and time point. Using DESeq2, 8% and 11% of species demonstrated statistically significant differences (p <0.05) in relative abundance on days 3 and 13, respectively. For differences in gene function abundance between tooth and implant, 15% and 14% were found to be statistically significant on day 3 and 13, respectively. At both time points, the vast majority of functions were more abundant at implant sites.Conclusions: This study expands upon previous findings indicating that a single prophylactic dose prior to implant placement leads to sustained, effective AZM concentrations. The presence of AZM during early peri-implant healing causes a significant collective shift in sulcular species, leading to the development of distinct microbiomes in tooth and peri-implant crevices, which largely retain similar functional potentials. This study suggests that AZM may be more beneficial than AMX in preventing complications in peri-implant wound healing due to its extended availability at the implant placement site. 2019 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu1562330930491338 http://rave.ohiolink.edu/etdc/view?acc_num=osu1562330930491338 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. |
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NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Dentistry |
| spellingShingle |
Dentistry Brett, Christopher A. Azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement |
| author |
Brett, Christopher A. |
| author_facet |
Brett, Christopher A. |
| author_sort |
Brett, Christopher A. |
| title |
Azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement |
| title_short |
Azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement |
| title_full |
Azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement |
| title_fullStr |
Azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement |
| title_full_unstemmed |
Azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement |
| title_sort |
azithromycin concentration in peri-implant crevicular fluid and its influence on microbial colonization dynamics following a single prophylactic dose prior to implant placement |
| publisher |
The Ohio State University / OhioLINK |
| publishDate |
2019 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=osu1562330930491338 |
| work_keys_str_mv |
AT brettchristophera azithromycinconcentrationinperiimplantcrevicularfluidanditsinfluenceonmicrobialcolonizationdynamicsfollowingasingleprophylacticdosepriortoimplantplacement |
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1719455824428924928 |