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Systemic antimicrobials adjunctive to a repeated mechanical and antiseptic therapy for aggressive periodontitis: a 6-month randomized controlled trial.

Author(s): Varela VM, Heller D, Silva-Senem MX, Torres MC, Colombo AP, Feres-Filho EJ

Affiliation(s): Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, RJ, Brazil.

Publication date & source: 2011-08, J Periodontol., 82(8):1121-30. Epub 2011 Jan 14.

Publication type: Research Support, Non-U.S. Gov't

BACKGROUND: The purpose of this study is to compare the additional benefit of systemic antimicrobials versus placebos to a repeated mechanical instrumentation combined with comprehensive local chemical plaque control for the periodontal treatment of generalized aggressive periodontitis (GAgP). METHODS: This was a 6-month randomized, double-masked, placebo-controlled clinical trial. All GAgP patients received full-mouth disinfection followed by staged scaling and root planing without (placebo group; n = 17) or with (test group; n = 18) systemic antimicrobials (500 mg amoxicillin [AMX] + 250 mg metronidazole [MET]; three times a day for 10 days). Clinical parameters were measured at baseline and 3 and 6 months post-therapy. Significant differences between groups at baseline were sought by using the Mann-Whitney U test, whereas comparisons over time were examined by using a general linear model repeated measures procedure. RESULTS: Both groups demonstrated similar improvements in most parameters over time. The test group presented a greater mean probing depth (PD) reduction and clinical attachment level (CAL) gain at sites with initially moderate PD at 6 months (P <0.03). No differences were seen between groups regarding mean reductions and mean gains, respectively, for PD and CAL initially >/=7 mm. The test group presented a higher percentage of sites that improved >/=2 mm and ended up with PD </=4 mm or a lower percentage of sites that worsened >/=2 mm and remained with PD >4 mm at 3 months (P <0.01). No differences were noticed between groups for these parameters at 6 months. CONCLUSION: AMX + MET brought additional clinical effects to the repeated mechanical and antiseptic treatment of GAgP in a very short time (3 months), which tended to fade away over time (6 months).

Page last updated: 2011-12-09

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