Lectura 19.pdf

One isolate of a actino mycetemcomitans and two of p

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metronidazole. One isolate of A. actino- mycetemcomitans and two of P. inter- media/nigrescens were resistant to amoxicillin. None of the bacteria tested presented resistance to azithromycin. Discussion In this study, most periodontal abscesses were found to be related with a previous history of periodontal disease, sug- gesting that it could be considered as a complication of periodontitis, as reported by others (McLeod et al. 1997, Herrera et al. 2000a). In a small propor- tion of cases (6.6%), abscesses were found to be a complication of perio- dontal therapy. Most likely, the presence and occlusion of periodontal pockets because of periodontal instrumentation could explain the development of these lesions. Interestingly, the most common group of teeth affected by periodontal abscess in this study population was lower incisors. In contrast, Herrera et al. (2000a) found the molar group to be the most affected. The microbiota of periodontal abscesses has been characterized by the presence of periodontal pathogens present in chronic and aggressive periodontitis. In this study, Fusobacterium spp., P. inter- media/nigrescens and P. gingivalis were found to be the most prevalent micro- organisms associated with periodontal abscesses. This is in agreement with previous reports (Newman & Sims 1979, van Winkelhoff et al. 1985, Topoll et al. 1990). Other microorgan- Table 2 . Clinical description of periodontal abscesses Clinical parameter n Frequency ( n 5 60), n (%) BOP 60 (100) PD (mm Æ SD) 9.3 Æ 2.5 Redness 56 (93.3) Tumefaction 57 (95) Suppuration 56 (93.3) Mobility 1 30 (50) 2 17 (28.3) 3 13 (21.6) Radiographic bone loss Slight 4 (6.6) Moderate 19 (31.6) Severe 37 (61.6) Radiographic absence of periodontal ligament space 54 (90) Pain 41 (68.3) Dental extrusion 14 (23.3) History of periodontitis 52 (86.6) History of past periodontal treatment 7 (11.6) Periodontitis-related abscess 49 (81.6) Periodontal treatment-related abscess 4 (6.6) Trauma-related abscess 3 (5) n As described in ‘‘Materials and Methods’’. BOP, bleeding on probing; PD, probing depth. Fig. 1 . (a) Clinical appearance of perio- dontal abscess affecting the lower second right molar. The site shows localized puru- lent accumulation, redness, bleeding on probing and suppuration. (b) Radiographic aspect of periodontal abscess affecting the first upper right molar. Notice severe perio- dontal destruction and the involvement of the furcation area. Lower anterior teeth were most affected by abscesses followed by upper anterior and lower molar teeth. Upper molar Upper bicuspid Upper anterior Lower molar Lower bicuspid Lower anterior 41.6% 13.4% 1.6% 20% 18.4% 5% Fig. 2 . Frequency distribution (%) of abscesses according to teeth. Characterization of periodontal abscesses 1215
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isms have been isolated from perio- dontal abscesses. In a previous report (Herrera et al. 2000b), a higher preva- lence of T. forsythia was found (66.7%) than that in the present study (15%).
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  • Fall '19
  • Periodontitis, periodontal abscess

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