The investigators hypothesize that blood dendritic cells harbor pathogens from the oral cavity in chronic periodontitis and disseminate these pathogens to atherosclerotic plaques.
To address this hypothesis, a clinical study in humans with moderate to severe chronic periodontitis has been designed. This is an interventional study involving scaling and root planing and two arms: 1. treatment with PO amoxocillin/metronidazole plus chlorhexidine oral rinse; 2. no antibiotics or oral rinse. It is expected that the antibiotics plus chlorhexidine will prevent the dendritic cell response to infection (bacteremia) elicited by scaling and root planing.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
18
PO Amoxicillin in 500 mg / Metronidazole 250 mg of each TID for 8 days plus 2 ounces of 0.12% chlorhexidine mouthrinse used BID
Full mouth scaling and root planing using hand instrumentation (curettes) and ultrasonic scalers
GHSU-CDM Clinical Research Center
Augusta, Georgia, United States
Frequency of Blood Dendritic Cells From Baseline
The frequency of blood dendritic cells, i.e. % CCR6+CD1a+ DCs by flow cytometry 30 days after treatment with 7 day regimen of antibiotics, mouthrinse therapy and scaling and root planing (SRP) will be compared to those who did not receive the antibiotics, but did receive mouthrinse and scaling and root planing (SRP)
Time frame: 30 days
Probing Attachment Levels
Probing attachment levels (distance from the cemento-enamel junction to the base of the periodontal pocket in mm at 6 sites p\[er tooth) will be monitored after 30 days
Time frame: 30 days
Serum Cytokine Response
serum CCL20 in pg/ml by ELISA will be measured after 30 days
Time frame: 30 days
Probing Depths
Probing depths (distance from the free gingival margin to the base of the pocket in mm at six sites per tooth) will be monitored after 30 days
Time frame: 30 days
Plaque Index
Plaque index of Silness and Loe will be monitored at buccal and lingual surfaces of all teeth after 30 days: 0 no visible microbial plaque 1. thin film of visible microbial plaque in sulcus 2. moderate accumulation of plaque in sulcus 3. large amount of plaque in sulcus or along free gingival margin
Time frame: 30 days
Gingival Index
Gingival index of Loe and Silness on facial, lingual and mesial surfaces of all teeth will be monitored after 30 days: 0 Normal, no inflammation 1. Mild inflammation, slight color change and edema, no bleeding 2. Moderate inflammation, redness, edema, bleeds on probing 3. Severe inflammation, marked redness and edema ulceration, spontaneous bleeding
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Time frame: 30 days