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Clinical and microbiological benefits of systemic metronidazole and amoxicillin in the treatment of smokers with chronic periodontitis: a randomized placebo‐controlled study
Author(s) -
Matarazzo Flavia,
Figueiredo Luciene Cristina,
Cruz Sergio Eduardo Braga,
Faveri Marcelo,
Feres Magda
Publication year - 2008
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.2008.01304.x
Subject(s) - tannerella forsythia , medicine , chronic periodontitis , scaling and root planing , metronidazole , amoxicillin , treponema denticola , placebo , periodontitis , randomized controlled trial , porphyromonas gingivalis , gastroenterology , antibiotics , clinical trial , dentistry , microbiology and biotechnology , biology , pathology , honeysuckle , alternative medicine , traditional chinese medicine
Aim: The aim of this study was to evaluate the clinical and microbiological effects of scaling and root planing (SRP) alone or combined with metronidazole (MTZ) or with MTZ and amoxicillin (AMX) in the treatment of smokers with chronic periodontitis. Methods: A double‐blind, placebo‐controlled, randomized clinical trial was conducted in 43 subjects who received SRP alone ( n =15) or combined with MTZ (400 mg 3 × per day, n =14) or with MTZ+AMX (500 mg 3 × per day, n =14) for 14 days. Clinical and microbiological examinations were performed at baseline and 3 months post‐therapy. Subgingival samples were analysed by checkerboard DNA–DNA hybridization. Results: Subjects receiving MTZ+AMX showed the greatest improvements in mean probing depth and clinical attachment level. Both antibiotic therapies led to additional clinical benefits over SRP alone in initially shallow, intermediate, and deep sites. The SRP+MTZ+AMX therapy led to the most beneficial changes in the subgingival microbial profile. These subjects showed significant reductions in the mean counts and proportions of periodontal pathogens such as Tannerella forsythia, Porphyromonas gingivalis and Treponema denticola , and the greatest increase in proportions of host‐compatible species. Conclusion: Significant advantages are observed when systemic antibiotics are combined with SRP in the treatment of smokers with chronic periodontitis. The greatest benefits in clinical and microbiological parameters are achieved with the use of SRP+MTZ+AMX.