Clinical and microbiological effects of systemic ciprofloxacin and metronidazole in Aggregatibacter actinomycetemcomitans-associated periodontitis

Destructive periodontal disease is a concern because of the potential damage to the dentition and the financial burden of treatment. It is generally agreed that the microorganisms residing in periodontal pockets are responsible for periodontitis. Approximately 500 bacterial taxa inhabit periodontal pockets. Association between Aggregatibacter actinomycetemcomitans and destructive and progressive forms of periodontitis has been demonstrated by many authors. The aim of this study was to evaluate the microbiological and clinical effects of systemic metronidazole-ciprofloxacin therapy. In this triple-blind controlled clinical randomized trial, 24 patients with at least 4 sites with ≥4 mm of clinical attachment loss and detection of A. actinomycetemcomitans were included. The patients were randomly divided into two groups. The patients in the test group received scaling/root planning (S/RP) and ciprofloxacin plus metronidazole, and the patients in the control group received S/RP and placebo representing the aforementioned antibiotics. Bacteria culturing and recording of clinical Att. loss (CAL), gingival index (GI), plaque index (PI) and bleeding on probing (BOP) were done at the baseline, 10 days, 3 and 6 months after the mechanical therapy. There was no significant difference between test and control groups in A. actinomycetemcomitans colony count, CAL, GI, PI and BOP at the baseline. A significant difference was seen in each group between baseline and each of the other research stages for all the recorded parameters. Test group showed a significant difference in A. actinomycetemcomitans colony count, BOP and GI on 3rd and 6th months of research as compared to the baseline. No significant difference was seen between two groups in CAL and PI. Application of ciprofloxacin plus metronidazole as an adjunctive to mechanical therapy has significant effects on periodontal clinical parameters and eradication of A. actinomycetemcomitans from periodontal tissues. Key words: Ciprofloxacin, metronidazole, periodontitis, Aggregatibacter actinomycetemcomitans.