The Combination of Amoxicillin and Metronidazole Improves Clinical and Microbiologic Results of One‐Stage, Full‐Mouth, Ultrasonic Debridement in Aggressive Periodontitis Treatment

• Published in: Journal of periodontology (1970) Vol. 83; no. 8; pp. 988 - 998
• Main Authors: Casarin, Renato C.V., Peloso Ribeiro, Érica Del, Sallum, Enilson A., Nociti, Francisco H., Gonçalves, Reginaldo B., Casati, Márcio Z.
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Academy of Periodontology 01-08-2012
• Subjects: Adult; Aggregatibacter actinomycetemcomitans - drug effects; Aggressive periodontitis; Aggressive Periodontitis - microbiology; Aggressive Periodontitis - therapy; Amoxicillin - administration & dosage; Amoxicillin - therapeutic use; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Anti-Infective Agents - administration & dosage; Anti-Infective Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; anti‐infective agents; Bacterial Load - drug effects; Bacteroides - drug effects; Biological and medical sciences; debridement; Dental Plaque Index; Dentistry; Drug Combinations; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Follow-Up Studies; Gingival Crevicular Fluid - immunology; Gingival Hemorrhage - therapy; Gingival Recession - therapy; Humans; Interleukin-10 - analysis; Interleukin-1beta - analysis; Male; Medical sciences; Metronidazole - administration & dosage; Metronidazole - therapeutic use; Non tumoral diseases; Otorhinolaryngology. Stomatology; Periodontal Attachment Loss - therapy; Periodontal Debridement - methods; Periodontal Index; Periodontal Pocket - therapy; Pharmacology. Drug treatments; Placebos; Porphyromonas gingivalis - drug effects; randomized clinical trial; Single-Blind Method; Treatment Outcome; ultrasonic; Ultrasonic Therapy - methods; Nitro compound; Imidazole derivatives; debridement; ultrasonic; Penicillin derivatives; Antiprotozoal agent; Antifungal agent; Clinical trial; Antiinfectious; Stomatology; β-Lactams; randomized clinical trial; Dentistry; Aggressive periodontitis; Oral cavity; Periodontal disease; Antibiotic; Treatment; Periodontitis; Debridment; Amoxicillin; anti-infective agents; Parasiticide; Metronidazole; Antibacterial agent
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1902/jop.2012.110513

Background: The aim of the present study is to assess clinical, microbiologic, and immunologic benefits of amoxicillin/metronidazole (AM) when performing full‐mouth ultrasonic debridement (FMUD) in generalized aggressive periodontitis (GAgP) treatment.
Methods: Twenty‐four GAgP patients were divided into two groups: the FMUD group (n = 12), which received FMUD plus placebo, and the FMUD+AM group (n = 12), which received FMUD and 375 mg amoxicillin plus 250 mg metronidazole for 7 days. The following clinical outcomes were tested: plaque and bleeding on probing indices, pocket probing depth (PD), relative gingival margin position (GMP), and relative clinical attachment level (CAL). Total amount of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Tannerella forsythia (Tf), and gingival crevicular fluid (GCF) concentration of interleukin (IL)‐10 and IL‐1β were also determined. All clinical, microbiologic, and immunologic parameters were assessed at baseline and at 3 and 6 months post‐therapy. The ANOVA/Tukey test was used for statistical analysis (α = 5%).
Results: Amoxicillin/metronidazole used as an adjunct to the FMUD protocol added clinical and microbiologic benefits to GAgP treatment (P <0.05). FMUD+AM groups presented an additional PD reduction in initially deep PDs at the 3‐month follow‐up (3.99 ± 1.16 mm and 3.09 ± 0.78 mm for FMUD+AM and FMUD, respectively; P <0.05), a lower number of residual pockets at the 3‐ and 6‐month follow‐ups, and a statistical reduction in amounts of Aa (P <0.05). Analysis of Tf and Pg amounts, as well as IL‐10 and IL‐1β GCF concentrations failed to demonstrate a difference between the groups (P >0.05).
Conclusion: It may be concluded that amoxicillin/metronidazole improves clinical and microbiologic results of FMUD in GAgP treatment.