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Clinical and microbiological effects of systemic antimicrobials combined to an anti-infective mechanical debridement for the management of aggressive periodontitis: a 12-month randomized controlled trial.

AbstractAIM:
To compare the 1-year clinical and microbiological outcomes of an enhanced anti-infective therapy with versus without systemic antimicrobials in patients with generalized aggressive periodontitis (GAP).
METHODS:
In this 12-month randomized, double-blinded, placebo-controlled trial, 35 individuals assigned to a control (n = 17) or test group (n = 18) received full-mouth supra and subgingival ultrasonic debridement followed by scaling and root planing with chlorhexidine rinsing, brushing, and irrigation. Subjects received either amoxicillin (AMX, 500 mg) + metronidazole (MET, 250 mg) or placebos, TID for 10 days. Subgingival samples were obtained and analysed for their composition by checkerboard. Data were subjected to non-parametric tests.
RESULTS:
Both therapeutic protocols resulted in similar significant clinical improvement for most parameters at 1 year (p < 0.01). The AMX + MET group exhibited shallower residual pockets than the placebo (p = 0.05). Most periodontal pathogens decreased, whereas beneficial bacteria increased in counts in both groups over time (p < 0.0012). High levels of some periodontal and other microbial pathogens were associated with disease persistence regardless treatment.
CONCLUSIONS:
The enhanced anti-infective mechanical therapy is comparable with its combination with systemic AMX+MET for most clinical parameters and for maintaining low levels of periodontal pathogens for up to 1 year after treatment of GAP.
AuthorsMayra Xavier E Silva-Senem, Débora Heller, Victor Macedo Varela, Maria Cynesia Barros Torres, Eduardo Jorge Feres-Filho, Ana Paula Vieira Colombo
JournalJournal of clinical periodontology (J Clin Periodontol) Vol. 40 Issue 3 Pg. 242-51 (Mar 2013) ISSN: 1600-051X [Electronic] United States
PMID23297772 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Copyright© 2012 John Wiley & Sons A/S.
Chemical References
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Anti-Infective Agents, Local
  • Drug Combinations
  • Mouthwashes
  • Placebos
  • Metronidazole
  • Amoxicillin
  • Chlorhexidine
Topics
  • Aggressive Periodontitis (drug therapy, microbiology, therapy)
  • Amoxicillin (administration & dosage, therapeutic use)
  • Anti-Bacterial Agents (administration & dosage, therapeutic use)
  • Anti-Infective Agents (administration & dosage, therapeutic use)
  • Anti-Infective Agents, Local (administration & dosage, therapeutic use)
  • Bacterial Load (drug effects)
  • Chlorhexidine (administration & dosage, therapeutic use)
  • Dental Scaling (methods)
  • Double-Blind Method
  • Drug Combinations
  • Follow-Up Studies
  • Gram-Negative Bacteria (classification, drug effects)
  • Gram-Positive Bacteria (classification, drug effects)
  • Humans
  • Metronidazole (administration & dosage, therapeutic use)
  • Mouthwashes (administration & dosage, therapeutic use)
  • Periodontal Debridement (methods)
  • Periodontal Pocket (drug therapy, microbiology, therapy)
  • Placebos
  • Root Planing (methods)
  • Therapeutic Irrigation
  • Toothbrushing (methods)
  • Treatment Outcome
  • Ultrasonic Therapy (methods)

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