Thursday at EuroPerio9: antibiotic resistance, the global disease burden … and a Dutch astronaut

The second day of EuroPerio9 starts in a rather unusual way – a lecture by someone well beyond the world of periodontology and implant dentistry. Indeed, someone who has been beyond the world itself – Dutch astronaut André Kuipers, who will talk about technology and innovation.

After the Kuipers lecture (09.00-09.45) there will be another special event, the premiere of the film Peri-implantitis and its Prevention produced by Cell-to-Cell Communication, which will offer insights into one of the most important challenges faced by periodontists in their everyday practice (09.45-10.00).

Antibiotics are another huge challenge, given the growing threat of antibacterial resistance. This is the subject of one of the most eagerly awaited events at EuroPerio9, the debate on the use of adjunctive systemic antimicrobials in periodontal therapy (10.30-12.00).

The debate is one of the innovative and interactive session formats created by the EuroPerio9 organising committee and members of the audience will be able to vote by using the EuroPerio9 App.

After an introductory lecture from Constance Schultz (Netherlands) on the global threat of antibiotic resistance and comments from Björn Klinge (Sweden) on antibiotics as an adjunct to mechanical periodontal therapy, the debate proper gets under way.

David Herrera (Spain) will argue that the use of adjunctive systemic antimicrobials is problematic because “adverse effects are frequent and significant alterations of the microbiome can be expected” at the individual level and “the increase in bacterial resistance represents an enormous problem” at the public-health level. He will argue that “a very responsible and cautious use of systemic antimicrobials must be recommended, limiting their use to very specific situations and under the most optimal conditions.”

Andrea Mombelli (Switzerland) will counter that too many periodontally compromised teeth are extracted because of a “lack of trust in non-surgical, cause-related periodontal therapy” and that most of these teeth could be saved through “a very efficient and efficacious treatment: thorough scaling and root planing plus amoxicillin and metronidazole.”

While he will argue that systemic antibiotics in the non-surgical treatment phase “reduce the need and extent of surgery”, he will also criticise the frequent prescription of these drugs for prophylactic reasons in surgical procedures where they are given in the hope that they reduce the risk of infection.

“The use of adjunctive systemic antimicrobials is one of the most controversial issues in periodontology today, and this session will give us a most current update on the evidence,” said Søren Jepsen, scientific chair of EuroPerio9. “Plans are under way by the EFP to develop guidelines in a European workshop in 2019.”

Global burden

Also looking at matters from a global perspective will be the session on the Global burden of disease: understanding periodontitis and peri-implantitis (10.30-12.00). After an introduction from session chair Ola Norderyd (Sweden), Thomas Kocher (Germany) will analyse contrasting trend studies and provide an answer the question of whether the prevalence of periodontitis is declining. Jan Derks (Sweden) will then consider the prevalence of peri-implantitis, focusing on the diagnostic principles of peri-implant disease, their prevalence, and associated risk factors. He will present results of the largest observational study so far carried out on this topic.

Other highlights among the sessions at RAI Amsterdam on Thursday include:

• The human microbiome: role in health and disease (14.30-16.00) with Phil Marsh (UK) on the human microbiome, Max Nieuwdorp (Netherlands) on the gut microbiome, and Egija Zaura (Netherlands) on the oral microbiome.
• The team session on Effective prevention of peri-implantitis (14.30-16.00) with Elena Figuero (Spain), Nicola Zitzmann (Switzerland), and Giovanni Salvi (Italy), which will look at prosthetic considerations and the treatment of mucositis and incipient peri-implantitis.
• Physical activity: Protective or harmful to periodontitis? (14.30-16.00), in which Ian Needleman (UK) will discuss the impact of elite sport on oral health, Joerg Eberhard (Australia) will address physical activity and periodontitis, Alpdogan Kantarci (USA) will talk about how physical activity modulates inflammation and Eduardo Tinoco (Brazil) will give a presentation on oral health at the Rio Olympic Games 2016.
• The perio-ortho interface (16.30-18.00), chaired by Monique Danser (Netherlands), in which Karin Jepsen (Germany) will consider recession and pathologic tooth migration, France Lambert (Belgium) will address innovations in perio-facilitated orthodontics, and Daniele Cardaropoli (Italy) will highlight the timing of ortho-regenerative perio in advanced cases.