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Two different antibiotic protocols as adjuncts to one‐stage full‐mouth ultrasonic debridement to treat generalized aggressive periodontitis: A pilot randomized controlled clinical trial
Author(s) -
Araujo Cássia F.,
Andere Naira M.R.B.,
Castro dos Santos Nídia C.,
MathiasSantamaria Ingrid F.,
Reis Aurélio A.,
Oliveira Luciane D.,
Jardini Maria A.N.,
Casarin Renato C.V.,
Santamaria Mauro P.
Publication year - 2019
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1002/jper.18-0399
Subject(s) - medicine , aggressive periodontitis , tannerella forsythia , aggregatibacter actinomycetemcomitans , randomized controlled trial , fusobacterium nucleatum , metronidazole , amoxicillin , adverse effect , periodontitis , chronic periodontitis , clinical trial , antibiotics , dentistry , gastroenterology , porphyromonas gingivalis , microbiology and biotechnology , pathology , biology , honeysuckle , alternative medicine , traditional chinese medicine
Abstract Background To assess the clinical and microbiological responses of amoxicillin + metronidazole (AMX + MET) versus clarithromycin (CLM) as adjuncts to one‐stage full‐mouth ultrasonic debridement (FMUD) in the treatment of generalized aggressive periodontitis (GAgP). Methods For this parallel, double‐masked, pilot randomized clinical trial, 46 patients with GAgP were selected and randomly assigned into two groups: AMX+MET group (n = 23): FMUD associated with AMX (500 mg three times a day) and MET (400 mg three times a day) for 7 days; and CLM group (n = 23): FMUD associated with CLM (500 mg twice a day) for 7 days. Clinical parameters were evaluated at baseline, 3, and 6 months post‐treatment. The levels of Aggregatibacter actinomycetemcomitans , Porphyromonas gingivalis , Tannerella forsythia , and Fusobacterium nucleatum from subgingival biofilm were determined by quantitative polymerase chain reaction. Results Both treatments significantly improved all clinical parameters compared with baseline and promoted a significant reduction of A. actinomycetemcomitans and P. gingivalis counts ( P > 0.05). CLM succeeded in decreasing T. forsythia at 6 months ( P < 0.05), but no antibiotic was able to reduce F. nucleatum . There was no difference between the two protocols regarding the reported adverse effects ( P > 0.05). Conclusions The results suggest that CLM is not superior than AMX + MET in the treatment of GAgP. However, this antibiotic led to good clinical outcomes and may be a possible alternative to AMX+MET in the treatment of severe periodontitis in young patients. Future studies with larger sample sizes are needed to confirm this statement (NCT02969928).