Full-mouth ultrasonic debridement associated with two different antibiotic protocols to treat generalized aggressive periodontitis: randomized controlled clinical trial

Author(s)

Cássia Fernandes Araujo

• Document type: Master's Dissertation
• Press: São José dos Campos. 2017-01-24.
• Institution: Universidade Estadual Paulista (Unesp). Instituto de Ciência e Tecnologia. São José dos Campos
• Defense date: 2017-01-17
• Advisor: Mauro Pedrine Santamaria

Abstract

Generalized aggressive periodontitis is a periodontal condition that may require the association of mechanical therapy - scaling and root planning (SRP) - with the use of antimicrobial agents to obtain a better result in treating the disease. Several studies show the effectiveness of the use of amoxicillin (AMX) and metronidazole (MET) associated with SRP. However, the literature has already pointed that the extensive use of these antimicrobials could generate bacterial resistance. In order to evaluate new approaches, the present controlled randomized clinical trial aimed to assess the periodontal clinical response and the possible adverse effects of AMX + MET versus clarithromycin (CLM) combined to full-mouth ultrasonic debridement (FMUD) in the treatment of patients with generalized aggressive periodontitis (GAgP). To this, forty-six (46) patients with GAgP were selected and randomly assigned into two groups: AMX + MET group (n=23): FMUD associated with amoxicillin (500 mg – 8/8 h) and metronidazole (400 mg – 8/8 h) for 7 days; and CLM group (n=23): FMUD associated with clarithromycin (500 mg – 12/12 h) for 7 days. Probing depth (PD), clinical attachment level (CAL), gingival recession (GR), gingival index (GI) and full-mouth plaque index (FMPI) were evaluated at baseline, 3 and 6 months post-operatively. The adverse effects resulted from antibiotic intake were also evaluated. The results revealed that both treatments led to statistically significant improvement in all clinical parameters compared to baseline, with no difference regarding the occurrence of advese effects. Thus, it can be inferred that CLM has the same efficacy than the AMX + MET association and may be an alternative in the treatment of generalized aggressive periodontitis. (ClinicalTrials.gov: NCT02969928) (AU)

• FAPESP's process: 14/22078-4 - Periodontal debridement associated with two different antibiotic agents to treat generalized aggressive periodontitis: randomized clinical trial
• Grantee: Cássia Fernandes Araujo
• Support Opportunities: Scholarships in Brazil - Master