Clinical and microbiological effects of egg yolk antibody against Porphyromonas gingivalis as an adjunct in the treatment of moderate to severe chronic periodontitis: a randomized placebo-controlled clinical trial

Abstract

Purpose: To evaluate the clinical and microbiological effects of the local use of egg yolk immunoglobulin against Porphyromonas gingivalis (anti-P.g. IgY) as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe chronic periodontitis.

Methods: This was a randomized, placebo-controlled, double-blind trial involving 60 systematically healthy patients with moderate to severe chronic periodontitis. Subjects (n=20/group) were randomly assigned to receive SRP combined with subgingival irrigation of anti-P.g. IgY and anti-P.g. IgY mouthwash, subgingival irrigation of 0.2% chlorhexidine and 0.2% chlorhexidine mouthwash, or subgingival irrigation of placebo and placebo mouthwash for 4 weeks. Probing pocket depth, clinical attachment level, bleeding on probing, and the plaque index were evaluated at baseline and at 4 weeks. Subgingival plaque, gingival crevicular fluid, and saliva were simultaneously collected for microbiological analysis.

Results: Our results showed that anti-P.g. IgY mouthwash was as effective as chlorhexidine at improving clinical parameters over a 4-week period. All the groups showed a significant reduction in levels of P.g. at 4 weeks. No significant difference was observed in the test group when compared to placebo regarding the reduction in the levels of P.g. Anti-P.g. IgY significantly suppressed the numbers of red complex bacteria (RCB) in subgingival plaque and saliva in comparison with placebo. No adverse effects were reported in any of the subjects.

Conclusions: Within the limitations of the study, the present investigation showed that passive immunization with anti-P.g. IgY may prove to be effective in the treatment of chronic periodontitis due to its ability to improve clinical parameters and to reduce RCB. No significant differences were found between the anti-P.g. IgY and placebo groups in the reduction of P.g.

Keywords: Chlorhexidine; Passive immunization; Periodontitis; Porphyromonas gingivalis; Therapeutics.

Figure 1

Flow diagram of the study. SRP: scaling and root planing, anti-P.g. IgY: egg yolk immunoglobulin against Porphyromonas gingivalis.

Figure 2

Box blots showing the percentages of each periodontopathic bacterium in the total bacteria at baseline and 4 weeks. (A) Porphyromonas gingivalis. (B) Tannerella forsythia. (C) Treponema denticola. Anti-P.g. IgY: egg yolk immunoglobulin against Porphyromonas gingivalis. ^a)Statistically significant intragroup difference compared to baseline (Wilcoxon signed-rank test).

Figure 3

Comparison in the number of RCB at baseline and 4 weeks in (A) subgingival plaque, (B) gingival crevicular fluid, and (C) saliva. RCB: red complex bacteria, anti-P.g. IgY: egg yolk immunoglobulin against Porphyromonas gingivalis, BANA: N-Benzoyl-DL-arginine-naphthylamide. ^a)Statistically significant intragroup difference compared to baseline; ^b)Statistically significant difference between the different treatment groups.