Results of the Assessment of the Antimicrobial Resistance Profile of Pathogenic Oral Microorganisms in Patients with Chronic Generalized Periodontitis at the Pre-Implantation Stage: A Single-Center Pilot Study

Abstract

Chronic generalized periodontitis (CGP) is one of the most prevalent diseases of the dentoalveolar system and represents a significant risk factor for successful osseointegration of dental implants. The presence of pathogenic and antibiotic-resistant microorganisms within periodontal pockets increases the likelihood of postoperative complications. Despite the clinical relevance of this issue, local data on antimicrobial resistance profiles of the oral microbiota in patients with CGP remain limited.
Objective. This study aimed to determine the antimicrobial resistance profile of pathogenic oral microorganisms in patients with chronic generalized periodontitis during the preparatory phase of dental implant placement.
Materials and Methods. A prospective, single-center pilot study was conducted involving 27 patients aged 36–60 years with confirmed CGP who were scheduled for dental implant therapy. Biological samples were collected from periodontal pockets ≥4 mm and areas designated for implant placement. Aerobic and anaerobic microorganisms were identified using the automated Phoenix M50 system and API biochemical test panels. Antimicrobial susceptibility testing was performed according to EUCAST/CLSI guidelines.
Results. The highest antimicrobial activity was observed for cefepime and meropenem (sensitivity in 51.9% of isolates), followed by cefuroxime and cefotaxime (44.4%). Penicillin demonstrated effectiveness only against approximately one-third of isolates, mainly Streptococcus spp., whereas Enterobacter cloacae and Pseudomonas putida were fully resistant. Clindamycin, glycopeptides, and metronidazole showed species-dependent activity, while Prevotella spp. retained sensitivity to meropenem and β-lactam/β-lactamase inhibitor combinations.
Conclusions. Patients with CGP preparing for dental implantation exhibit a high prevalence of antimicrobial resistance among Enterobacter cloacae and Pseudomonas putida, limiting the use of penicillins, lincosamides, and glycopeptides for empirical therapy. Broad-spectrum β-lactams and carbapenems showed the greatest therapeutic potential. These findings highlight the need for multicenter studies to refine regional antimicrobial resistance profiles.