Full-mouth disinfection and systemic antimicrobial therapy in generalized aggressive periodontitis: a randomized, placebo-controlled trial

J Clin Periodontol. 2012 Mar;39(3):284-94. doi: 10.1111/j.1600-051X.2011.01795.x. Epub 2012 Jan 4.

Abstract

Aim: The present investigation aimed to analyse clinical and microbiological effects of systemic administration of metronidazole and amoxicillin combined with the One-Stage-Full-Mouth-Disinfection protocol (OSFMD) in generalized aggressive periodontitis patients (G-AgP).

Materials and methods: Thirty-nine systemically healthy patients with G-AgP were consecutively included. The test group (n = 19) received amoxicillin-metronidazole combination (500 mg of each, three times a day for 7 days) and the OSFMD, the control group (n = 20) received the OSFMD and a placebo. In addition to clinical parameters subgingival plaque samples from moderate (4-5 mm) and deep (≥ 6 mm) pocket sites were analysed for the presence of Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola using polymerase chain reaction.

Results: Both therapies led to a statistically significant decrease in clinical and microbiological parameters compared to baseline (p < 0.001). The most beneficial changes were observed in the test group which showed significantly greater improvements in probing depth and clinical attachment level and a lower prevalence of Aggregatibacter actinomycetemcomitans, Treponema denticola, and Tannerella forsythia compared to the control one (p < 0.05).

Conclusions: Systemic administration of metronidazole and amoxicillin as an adjunct to OSFMD therapy significantly improved clinical and microbiological outcomes in patients with G-AgP over a 6-month period.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aggregatibacter actinomycetemcomitans / drug effects
  • Aggressive Periodontitis / drug therapy*
  • Amoxicillin / administration & dosage*
  • Analysis of Variance
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Infective Agents, Local / therapeutic use*
  • Bacteroides / drug effects
  • Chi-Square Distribution
  • Chlorhexidine / therapeutic use
  • Dental Plaque / microbiology*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Metronidazole / administration & dosage*
  • Mouthwashes / therapeutic use
  • Periodontal Index
  • Statistics, Nonparametric
  • Treponema denticola / drug effects

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Mouthwashes
  • Metronidazole
  • Amoxicillin
  • Chlorhexidine