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Adjunctive benefits of systemic amoxicillin and metronidazole in non‐surgical treatment of generalized aggressive periodontitis: a randomized placebo‐controlled clinical trial
Author(s) -
Guerrero Adrian,
Griffiths Gareth S.,
Nibali Luigi,
Suvan Jean,
Moles David R.,
Laurell Lars,
Tonetti Maurizio S.
Publication year - 2005
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/j.1600-051x.2005.00814.x
Subject(s) - medicine , placebo , metronidazole , amoxicillin , randomized controlled trial , periodontitis , adjunctive treatment , confidence interval , gingival and periodontal pocket , clinical trial , aggressive periodontitis , surgery , antibiotics , anesthesia , alternative medicine , pathology , microbiology and biotechnology , biology
Background: The objective of this study was to assess the adjunctive clinical effect of the administration of systemic amoxicillin and metronidazole in the non‐surgical treatment of generalized aggressive periodontitis (GAP). Methods: Forty‐one systemically healthy subjects with GAP were included in this 6‐month double‐blind, placebo‐controlled, randomized clinical trial. Patients received a course of full‐mouth non‐surgical periodontal treatment delivered over a 24 h period using machine‐driven and hand instruments. Test subjects received an adjunctive course of systemic antibiotic consisting of 500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days. Clinical parameters were collected at baseline, and at 2 and 6 months post‐treatment. Results: In both the test and the placebo groups, all clinical parameters improved at 2 and 6 months. In deep pockets (7 mm), the test treatment resulted in an additional 1.4 mm (95% confidence interval 0.8, 2.0 mm) in full‐mouth probing pocket depth (PPD) reduction and 1 mm (0.7, 1.3 mm) of life cumulative attachment loss (LCAL) gain at 6 months. In moderate pockets (4–6 mm), the adjunctive benefit was smaller in magnitude: PPD reduction was 0.4 mm (0.1, 0.7 mm) and LCAL gain was 0.5 mm (0.2, 0.8 mm). In addition, the 6‐month data showed LCAL gains 2 mm at 25% of sites in test patients compared with 16% in placebo ( p =0.028). Similarly, PPD reductions of 2 mm or more were observed in 30% of sites in test and 21% of sites in placebo patients. Seventy‐four percent of pockets with PPD 5 mm at baseline were 4 mm or shallower at 6 months in the test group. This compared with 54% in the placebo group ( p =0.008). Disease progression at 6 months was observed at 1.5% of test and 3.3% of sites in test and placebo, respectively ( p =0.072). Conclusions: These data indicate that a 7‐day adjunctive course of systemic metronidazole and amoxicillin significantly improved the short‐term clinical outcomes of full‐mouth non‐surgical periodontal debridement in subjects with GAP.