Discussion
inflammation, periodontitis, PD, Periodontitis
INFLAMMATION, PERIODONTITIS, DENTAL PLAQUE, PERIODONTAL DISEASE, PERIODONTITIS, INFLAMMATORY DISEASE
Periodontitis is an inflammatory disease that occurs due to prolonged inflammation of the gingiva, accumulation of opportunistic pathogens within subgingival dental plaque, their interaction with the host and the dysbiosis of microbiota embedded in dental biofilms (In the current manuscript, we have developed a fast method for culturing fresh periodontal samples with minimal sample processing that allows biofilm growth quantification in real time through impedance measurements. We show that VMGIII transport medium preserved initial bacterial composition and viability to form biofilms for up to 48h. This suggests that periodontal pocket samples could be collected, transferred from the dental clinics and stored in this media at room temperature until further laboratory analysis. In addition, periodontal biofilms grown Impedance-based measurements showed a remarkable variability in antibiotic susceptibility patterns for different patients with periodontal disease, and the antibiotic with best efficacy in reducing biofilm growth could not be predicted from the corresponding bacterial composition. Interestingly, the results in the current manuscript also highlight that amoxicillin and metronidazole combination often resulted in biofilm growth induction (Half of the patients were prescribed the antibiotic selected by one of the two methods, and we compared the clinical and microbiological outcomes after one and two months in both study groups. The results showed that clinical parameters such as PD, CAL and BOP were improved in both groups after treatment independently of the antibiotic used, and the improvement in BOP was larger in the RT-Culture group (Regarding microbiological parameters, 16S rRNA gene sequencing data showed that bacterial richness was significantly decreased only after the use of antibiotics selected by the RT-Culture system. This is a relevant feature as periodontitis is associated to higher numbers of bacterial species compared to the healthy condition (In addition, our results also indicate that antibiotics’ adjunctive influence on the subgingival microbiota depends on the antibiotic (Although many studies have been performed to investigate the critical factors in the occurrence and development of periodontitis and its treatment, to our knowledge, this is the first study which compares personalized antibiotic selection methods evaluating both clinical and microbiological outcomes. Multiple studies have shown that antibiotic use can improve the outcome of periodontal treatment (