Metronidazole alone or with amoxicillin as adjuncts to non-surgical treatment of chronic periodontitis: a 1-year double-blinded, placebo-controlled, randomized clinical trial

• Published in: Journal of clinical periodontology Vol. 39; no. 12; pp. 1149 - 1158
• Main Authors: Feres, Magda, Soares, Geisla Mary Silva, Mendes, Juliana Alethusa Velloso, Silva, Maike Paulino, Faveri, Marcelo, Teles, Ricardo, Socransky, Sigmund S., Figueiredo, Luciene Cristina
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.12.2012; Blackwell
• Subjects: Adult; amoxicillin; Amoxicillin - adverse effects; Amoxicillin - therapeutic use; Analysis of Variance; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antiparasitic agents; Biological and medical sciences; Chemotherapy, Adjuvant; Chlorhexidine - therapeutic use; chronic periodontitis; Chronic Periodontitis - drug therapy; Clinical outcomes; Dental Scaling; Dentistry; Double-Blind Method; Drug Combinations; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Humans; Logistic Models; Longitudinal Studies; Male; Medical sciences; metronidazole; Metronidazole - therapeutic use; Middle Aged; Mouthwashes - therapeutic use; Non tumoral diseases; Otorhinolaryngology. Stomatology; periodontal disease; Periodontal Index; Periodontal Pocket - drug therapy; Periodontal Pocket - pathology; periodontal treatment; Pharmacology. Drug treatments; scaling and root planing; Statistics, Nonparametric; Treatment Outcome; Nitro compound; Imidazole derivatives; scaling and root planing; Stomatology; β-Lactams; chronic periodontitis; periodontal treatment; Dentistry; Penicillin derivatives; Tooth root; Antiprotozoal agent; Antibiotic; Antifungal agent; Chronic; Periodontal disease; Treatment; Periodontitis; Surgery; Amoxicillin; Parasiticide; Clinical trial; Metronidazole; Antibacterial agent
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.12004

Aim To evaluate the effects of the adjunctive use of metronidazole (MTZ) or MTZ + amoxicillin (AMX) in the treatment of generalized chronic periodontitis (ChP). A secondary aim was to examine a possible added effect of chlorhexidine to these therapies. Methods One hundred and eighteen subjects received scaling and root planing (SRP) only or with MTZ [400 mg/thrice a day (TID)] or MTZ+AMX (500 mg/TID) for 14 days. Half of the subjects in each group rinsed with 0.12% chlorhexidine twice a day (BID) for 2 months. Subjects were clinically monitored at baseline, 3, 6 and 12‐months post‐therapy. Results The two antibiotic groups showed lower mean number of sites with probing depth (PD) ≥5 mm and fewer subjects exhibiting ≥9 of these sites at 1‐year post‐treatment. Logistic regression analysis showed that antibiotics were the only significant predictors of subjects presenting ≤4 sites with PD ≥5 mm at 1 year (MTZ+AMX: OR, 13.33; 95%CI, 3.75‐47.39/p = 0.0000; MTZ: OR, 7.26; 95%CI, 2.26‐23.30/p = 0.0004). The frequency of adverse events did not differ between the two antibiotic treatments (p > 0.05). The chlorhexidine subgroups showed a trend (p > 0.05) to present fewer residual sites ≥5 mm compared with the placebo subgroups at 1 year. Conclusion Treatment of generalized ChP is significantly improved by the adjunctive use of MTZ+AMX and MTZ. View the pubcast on this paper at http://scivee-1.sdsc.edu/node/55261