Clinical and microbiological characterization of periodontal abscesses

Abstract

Background/aim: The knowledge of clinical features, microbial composition and susceptibility to antimicrobials of periodontal abscesses has recently improved. This descriptive clinical and microbiological study provides more information on the characteristics of periodontal abscesses.

Materials and methods: Clinical parameters and subgingival samples were examined from 54 subjects presenting 60 periodontal abscesses. Samples were cultured for anaerobic and facultative bacteria, and data were expressed as frequency detection and mean proportion of isolation for microorganisms. Selected isolates of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Prevotella intermedia/nigrescens were used to test susceptibility to amoxicillin, azithromycin, tetracycline and metronidazole. Statistical descriptive analysis was conducted.

Results: Most periodontal abscesses were present in patients with ongoing Chronic Periodontitis. Bleeding on probing, tumefaction and suppuration were present in almost all abscesses. Affected teeth were lower anterior teeth, upper anterior teeth and lower molars. The subgingival microbiota was composed of periodontal pathogens such as Fusobacterium spp. (75%), P. intermedia/nigrescens (60%), P. gingivalis (51%) and A. actinomycetemcomitans (30%). Some periodontopathogens showed antimicrobial resistance to tetracycline, metronidazole and amoxicillin, but not to azithromycin.

Conclusions: Periodontal abscesses showed typical clinical features associated with untreated periodontitis, and the organisms identified were important periodontopathic bacteria. Rationale use of antibiotic adjunctive therapy in abscess treatment should be taken into account.