Amoxicillin and metronidazole as an adjunct to full-mouth scaling and root
planing of chronic periodontitis.
Author(s): Cionca N, Giannopoulou C, Ugolotti G, Mombelli A.
Affiliation(s): Department of Periodontology, University of Geneva, Geneva, Switzerland.
norbert.cionca@unige.ch
Publication date & source: 2009, J Periodontol. , 80(3):364-71
BACKGROUND: It has been suggested that scaling and root planing of all pockets
within a few hours and chlorhexidine treatments (full-mouth disinfection) may
reduce the need for supplementary therapies. The aim of this study was to
evaluate the clinical benefit of amoxicillin and metronidazole administered
immediately after completion of full-mouth periodontal debridement in patients
with chronic periodontitis.
METHODS: This was a single-center, double-masked, placebo-controlled, randomized
longitudinal study of 6 months' duration. Fifty-one patients received full-mouth
periodontal debridement, performed within 48 hours. Twenty-five subjects received
metronidazole, 500 mg, and amoxicillin, 375 mg, three times a day for 7 days; 26
subjects received a placebo.
RESULTS: Forty-seven patients could be followed up to month 6. No differences in
clinical parameters were noted before treatment. The overall mean probing depth
decreased from 4.3 +/- 0.4 mm to 3.0 +/- 0.2 mm in the test group and from 4.4
+/- 0.4 mm to 3.1 +/- 0.3 mm in the control group (P = 0.05, difference between
groups). More importantly, test subjects had a significantly lower mean number of
persisting pockets >4 mm and bleeding on probing that required further treatment
(P = 0.005): 6 months after full-mouth debridement plus antibiotics, only 0.4 +/-
0.8 persisting pockets were still present, whereas 3.0 +/- 4.3 persisting pockets
were still present in the control group. The protective risk of the antibiotics
for having more than one pocket deeper than 4 mm and bleeding on probing per
subject after 6 months was 8.85.
CONCLUSION: Systemic metronidazole and amoxicillin significantly improved the
6-month clinical outcomes of full-mouth non-surgical periodontal debridement,
thus significantly reducing the need for additional therapy.
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