Rajiv Gandhi University of Health Sciences Karnataka
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
| | | |
|1. |NAME OF THE CANDIDATE AND ADDRESS |Dr. ROOH AFZA, |
| |(IN BLOCK LETTERS) |PG STUDENT, |
| | |DEPARTMENT OF PERIODONTICS, |
| | |THE OXFORD DENTAL COLLEGE HOSPITAL |
| | |AND RESEARCH CENTRE, |
| | |HOSUR ROAD, BOMMANNAHALLI, |
| | |BANGALORE- 560068. |
| | | |
|2. |NAME OF THE INSTITUTION |THE OXFORD DENTAL COLLEGE |
| | |HOSPITAL AND RESEARCH CENTRE, |
| | |BANGALORE- 560068. |
| | | |
| | | |
|3. |COURSE OF THE STUDY AND SUBJECT |MASTER OF DENTAL SURGERY, |
| | |PERIODONTICS. |
| | | |
|4. |DATE OF ADMISSION TO COURSE |27th MAY, 2011 |
| | |
|5. |TITLE OF THE TOPIC: |
| | |
| |A CLINICAL AND MICROBIOLOGICAL STUDY TO COMPARE THE |
| | |
| |TREATMENT OF PERIODONTAL ABSCESS WITH DRAINAGE AND SCALING |
| |AND ROOT PLANING WITH AND WITHOUT ANTIBIOTICS. |
| | |
| | |
| | |
|6. |BRIEF RESUME OF INTENDED WORK |
| |6.1 NEED FOR THE STUDY |
| |Periodontal abscess is defined as a localized purulent infection affecting the tissues surrounding a periodontal pocket that can |
| |lead to the destruction of supporting structures.1 Periodontal abscesses often arise as an acute exacerbation of a pre-existing |
| |pocket. It is one of the few clinical situations in periodontics where patients may seek immediate care. Different aetiologies |
| |have been proposed, some of them related to the exacerbation of a non-treated periodontitis, in patients after periodontal |
| |surgery, during preventive maintenance, after systemic antibiotic therapy and as a result of recurrent disease. Conditions in |
| |which periodontal abscess is not related to inflammatory periodontal disease include tooth perforation or fracture and foreign |
| |body impaction.2 The periodontal pathogens found in significant numbers in periodontal abscess include Fusobacterium nucleatum, |
| |Porphyromonas gingivalis, Prevotella intermedia, Peptostreptococcos micros and Tannerella forsythia. Poorly controlled diabetes |
| |mellitus has also been considered as a predisposing factor for periodontal abscess formation. Formation of periodontal abscess has|
| |been reported as a major cause of tooth loss; however, with proper treatment followed by consistent preventive periodontal |
| |maintenance, teeth with significant bone loss may be retained for many years. |
| |Periodontal diseases are one of the most common bacterial infections affecting the oral cavity and the best way to treat them is |
| |to control the causative organisms. It is clear that systemically administered antibiotics provide clinical benefit in the |
| |treatment of periodontal abscesses. If antibiotics confer therapeutic advantage, should they be given to all patients with |
| |periodontal abscess? If not who should receive these agents and how severe does the periodontal infections have to be in order to |
| |justify the use of an antimicrobial agent? 3 |
| |Thus the purpose of this study is to assess if antibiotic therapy is required as a routine in all cases of periodontal abscesses. |
| | |
| | |
| | |
| | |
| | |
| | |
| |6.2 REVIEW OF LITERATURE |
| |In a clinical and microbiological study 20 patients suffering from abscess of periodontal origin were treated and followed |
| |clinically and microbiologically for 6 months. Microbiological examination was performed using culture technique. Treatment |
| |included supragingival scaling, drainage and irrigation of the periodontal pocket with 0.85% Sodium Chloride and systemic |
| |Tetracycline administration. After 6 months, abscess sites demonstrated a reduced probing depth, less bleeding on probing and gain|
| |of attachment. Abscess sites showed no Porphyromonas gingivalis and the proportion of Prevotella intermedia was significantly |
| |reduced 6 months after treatment.4 |
| |A retrospective study focused on the frequency of tooth loss due to periodontal abscess among 42 patients who were treated by a |
| |single clinician over a 5 to 29 year period showed that a total of 109 teeth were affected by periodontal abscess of which 49 |
| |teeth were lost and 60 were successfully maintained over an average of 12.5years. This suggests that teeth with a history of |
| |periodontal abscess can be treated and maintained for several years.5 |
| |In a microbiological study involving 23 adult periodontitis patients, the occurrence of β-lactamase producing bacteria was |
| |determined. β-lactamase in whole sub gingival plaque was detected in 12 patient samples. It was concluded that β-lactamase |
| |activity in sub gingival bacteria is a common feature.6 |
| |In a longitudinal clinical study the clinical and microbiological efficacy of 2 different antibiotic regimes were compared in the |
| |treatment of acute periodontal abscesses. Microbiological samples were taken from the lesion and the patient was randomly assigned|
| |to one of the 2 antibiotic regimes: Azithromycin or Amoxicillin. Microbiologically, short term reductions were detected with both |
| |antibiotics, however fast recolonization occurred after a month. No significant differences were found between both treatment |
| |regimes. Antibiotic susceptibilities demonstrated no resistances for Amoxicillin / Clavulanate, while 2- 3 strains of each subject|
| |studied pathogen were resistant to Azithromycin.7 |
| |Two systematic reviews have indicated that systemically administered antibiotics provide a clear clinical benefit in terms of mean|
| |periodontal attachment level gain post therapy when compared with groups not receiving these agents. 8, 9 |
| | |
| |In a descriptive clinical and microbiological study, 54 subjects presented with 60 periodontal abscesses, samples were cultured |
| |for anaerobic and facultative bacteria. Selected isolates of Porphyromonas gingivalis and Prevotella intermedia were used to test |
| |susceptibility to Amoxicillin, Azithromycin, Tetracycline and Metronidazole. Some periodontopathogens showed antimicrobial |
| |resistance to Tetracycline, Metronidazole and Amoxicillin, but not to Azithromycin. Hence, rationale use of antibiotic adjunctive |
| |therapy in abscess treatment should be taken into account.10 |
| | |
| | |
| |6.3 AIMS AND OBJECTIVES OF THE STUDY |
| |To assess the prevalence of Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia at sites with periodontal |
| |abscess. |
| | |
| |To assess the influence of drainage, scaling and root planing on the prevalence of Fusobacterium nucleatum, Porphyromonas |
| |gingivalis and Prevotella intermedia at sites with periodontal abscess. |
| | |
| |To assess the influence of systemic antibiotics on the prevalence of Fusobacterium nucleatum, Porphyromonas gingivalis and |
| |Prevotella intermedia at sites with periodontal abscess. |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
|7. |MATERIAL AND METHODS |
| |7.1 SOURCE OF DATA |
| |Patients diagnosed with periodontal abscesses will be selected based on the criteria mentioned below from the Department of |
| |Periodontics, The Oxford Dental College, Hospital and Research Centre, Bommanahalli, Bangalore. |
| |The purpose of the study will be explained in detail to the subjects and an informed consent will be obtained. |
| | |
| |7.2 METHOD OF COLLECTION OF DATA |
| |INCLUSION CRITERIA :- |
| |Age group between 18 to 60 years. |
| |Patients complaining of localised pain and swelling related to a periodontal area. |
| |Affected area showing oedema, swelling and redness. |
| |On periodontal examination the swelling should be associated with a periodontal pocket with bleeding and suppuration. |
| |Non vital teeth with a clear primary periodontal lesion (presence of a deep periodontal pocket). |
| | |
| |EXCLUSION CRITERIA :- |
| |Patients with periodontal abscess associated with systemic complications like fever and cellulitis are excluded. |
| |Patients with known allergies to Penicillin, Macrolides or Lactose. |
| |Use of antibiotics 4-5 weeks prior to the study. |
| |Other systemic infections which could need additional medication. |
| |Endodontal abscesses are excluded based on vitality tests and radiographic examination. |
| |Pregnant and lactating women. |
| |Medically compromised patients. |
| |Systemic diseases. |
| | |
| | |
| | |
| | |
| |7.3 STUDY DESIGN :- |
| |In this Comparative study a total of 30 subjects satisfying the above mentioned criteria will be recruited and categorized |
| |randomly into 2 groups Group A and Group B of 15 subjects each. |
| |Group A - Periodontal abscess group without systemic antibiotic therapy. |
| |Group B - Periodontal abscess group with systemic antibiotic therapy. |
| |Amoxicillin - 500 mg 3 times a day for 5 days. |
| |Detailed instructions are given to patients regarding timing, dosages and possible adverse effects. In order to assess drug |
| |compliance, patients are asked to bring the empty blisters at the 2nd visit. |
| | |
| |BASELINE VISIT :– |
| |At baseline, the following procedures are carried out. |
| |a) Photographs of the abscess area. |
| |b) Blood sampling. |
| |c) Microbiological sampling. |
| |d) Clinical examination. |
| |The following clinical parameters will be recorded for all the patients:- |
| |Plaque Index (Silness and Loe). |
| |Gingival Index (Loe and Silness). |
| |Bleeding index (Ainamo and Bay). |
| |Probing pocket depth in mm. |
| |Clinical attachment level in mm. |
| | |
| |Group A: Subgingival microbiological samples will be collected from the periodontal pocket associated to the abscess prior to |
| |drainage following which scaling and root planing will be rendered. Further the patient will be recalled after 5 days and samples |
| |will be collected again. |
| | |
| |Group B: Subgingival microbiological samples will be collected prior and after abscess drainage as mentioned in group A but |
| |antimicrobials will be administered after drainage for 5 days. |
| | |
| |2nd VISIT ( 5 Days after baseline) |
| |In the 2nd visit the same clinical and microbiological variables are assessed again. A detailed history of any adverse reaction or|
| |compliance problems related to the assigned medication is recorded. In addition to this, occurrence of other health problems or |
| |intake of other medications is also recorded. |
| | |
| |METHOD OF COLLECTION OF SAMPLE: |
| |After the clinical parameters are recorded, supragingival plaque is removed from the tooth with sterile gauze and isolated with |
| |cotton rolls and subgingival microbiological samples are collected from the periodontal pocket associated to the abscess with |
| |sterile curettes and placed into transport media. |
| |The results obtained will be statistically analyzed and compared for the two groups using appropriate statistical analysis |
| |(Student T test). |
| | |
| |Duration of the study |
| |1 year. |
| | |
| |7.4 Does this study require any investigation or interventions to be conducted on patients or other human beings? |
| |Yes, subgingival microbiological samples will be collected from the patients and subjected to PCR analysis, blood samples will be|
| |analyzed for the evaluation of routine variables, abscess will be drained, scaling and root planing rendered and systemic |
| |antibiotics advised. |
| | |
| |7.5 Has ethical clearance been obtained from your institution? |
| |Yes, a copy of certificate is enclosed. |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| |LIST OF REFERENCES: |
| |Meng HX: Periodontal abscess. Ann Periodontol 1999; 4(1): 79-83. |
| | |
| |Kareha MJ, Rosenberg ES, Dehaven H: Therapeutic considerations in the management of a periodontal abscess with an intrabony |
| |defect. J Clin Periodontol 1981; 8: 375- 386. |
| | |
| |Haffajee AD. Systemic antibiotics: To use or not to use in the treatment of periodontal infections. That is the question. J Clin |
| |Periodontol 2006; 33: 359- 361. |
| | |
| |Hafstrom CA, Wikstrom MB, Renvert SN, Dahlen GG: Effect of treatment on some periodontopathogens and their antibody levels in |
| |periodontal abscess. J Periodontol 1994; 65: 1022- 1028. |
| | |
| |Mcleod DE, Lainson PA, Spivey JD: Tooth loss due to periodontal abscess: a retrospective study. J Periodontol; 1997; 68(10): 963- |
| |966. |
| | |
| |Van Winkelhoff AJ, Winkel EG, Barendregt D, Dellemijn- Kippuw N, Stijne A, Van der Velden U: β-lactamase producing bacteria in |
| |adult periodontitis. J Clin Periodontol 1997:24(8): 538-543. |
| | |
| |Herrera D, Roldan S, O’ Connor A, Sanz M: The periodontal abscess (II). Short term clinical and microbiological efficacy of two |
| |systemic antibiotic regimes. J Clin Periodontol 2000; 27: 395-404. |
| | |
| |Herrera D, Sanz M, Jepsen S, Needleman I, Roldan S: A systemic review on the effect of systemic antimicrobials as an adjunct to |
| |scaling and root planning in periodontitis patients. J Clin Periodontol 2002; 29(3): 136-159. |
| | |
| | |
| | |
| |Haffajee AD, Socransky SS, Gunsolley JC: Systemic anti-infective periodontal therapy. A systematic review. Ann Periodontol 2003; |
| |8(1): 115-181. |
| | |
| |Jaramillo A, Arce RM, Herrera D, Betancourth M, Botero JE, Contreras A: Clinical and microbiological characterization of |
| |periodontal abscesses. J Clin Periodontol 2005; 32: 1213-1218. |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | | |
|9. |SIGNATURE OF THE CANDIDATE | |
| | | |
|10. |REMARKS OF THE GUIDE | |
| | | |
| | | |
|11. |NAME AND DESIGNATION OF THE GUIDE |DR. SHOBA. C |
| | |READER |
| | |DEPARTMENT OF PERIODONTICS |
| | | |
| | | |
| |SIGNATURE | |
| | | |
| | | |
| | | |
| | | |
| | | |
|12. |HEAD OF THE DEPARTMENT |DR. A. V. RAMESH |
| | |PROFESSOR AND HEAD |
| | |DEPARTMENT OF PERIODONTICS |
| | | |
| |SIGNATURE | |
| | | |
| | | |
| | | |
|13. |REMARKS OF PRINCIPAL | |
| | | |
| | | |
| | | |
| |SIGNATURE | |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- 1 university of washington
- periodontal endodontic or endodontic
- repatriation medical authority
- thesis synopsis
- classification of diseases and conditions affecting the
- 3 veterans affairs
- rajiv gandhi university of health sciences karnataka
- prevention and treatment of periodontal diseases in
- 1 dental consultants dental consulting firm
Related searches
- archives of biological sciences journal
- definition of social sciences pdf
- blackrock health sciences fact sheet
- list of social sciences degrees
- blackrock health sciences trust
- blackrock health sciences stock
- archives of biological sciences impact
- institute of mathematical sciences chennai
- university of natural health scam
- university of texas health system
- university of tampa health center
- university of medical sciences ondo