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Clinical and Microbiologic Evaluation of Scaling and Root Planing per Quadrant and One‐Stage Full‐Mouth Disinfection Associated With Azithromycin or Chlorhexidine: A Clinical Randomized Controlled Trial
Author(s) -
Fonseca Douglas Campideli,
Cortelli José Roberto,
Cortelli Sheila Cavalca,
Miranda Cota Luís Otávio,
Machado Costa Lidiane Cristina,
Moreira Castro Marcos Vinicius,
Oliveira Azevedo Andréa Mara,
Costa Fernando Oliveira
Publication year - 2015
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 - 10.1902/jop.2015.150227
Subject(s) - tannerella forsythia , treponema denticola , medicine , chlorhexidine , scaling and root planing , streptococcus oralis , aggregatibacter actinomycetemcomitans , porphyromonas gingivalis , dentistry , chronic periodontitis , azithromycin , adjuvant , randomized controlled trial , periodontitis , quadrant (abdomen) , streptococcus , surgery , pathology , microbiology and biotechnology , antibiotics , traditional chinese medicine , honeysuckle , alternative medicine , biology , bacteria , genetics
Background: Conflicting data about the protocol of choice for non‐surgical periodontal therapy with adjuvant use are still reported. This study aims to evaluate, through clinical and microbiologic parameters, the systemic use of azithromycin (AZ) and chlorhexidine (CHX) as adjuvants to non‐surgical periodontal treatment performed by one‐stage full‐mouth disinfection (FMD) within 24 hours or conventional quadrant scaling (QS) in four weekly sections. Methods: In this randomized controlled trial, 85 patients diagnosed with chronic periodontitis underwent different treatment protocols, in six groups: three FMD groups and three QS groups, each with no adjuvants, with CHX, and with AZ. Clinical periodontal parameters were recorded, and total and quantitative bacterial counts of Aggregatibacter actinomycetemcomitans , Porphyromonas gingivalis , Tannerella forsythia , Treponema denticola , and Streptococcus oralis were measured with real‐time polymerase chain reaction at baseline and 90 and 180 days after treatment. Results: In all groups, a significant reduction was observed in the percentage of periodontal diseased sites, gingival index, plaque index, and clinical attachment level gain at 90 days, demonstrating effectiveness of the treatment, independently of the adjuvant. The FMD with CHX group showed higher reduction in probing depth and percentage of periodontal diseases sites, as well as lower total bacterial count, than all the other groups at 180 days. Conclusions: The adjuvant use of AZ did not provide any significant benefit, independently of the treatment protocol. The adjuvant use of CHX showed a more expressive and significant improvement in clinical and microbiologic parameters, especially in the FMD protocol, followed by QS.