Two different antibiotic protocols as adjuncts to one-stage full-mouth ultrasonic debridement to treat generalized aggressive periodontitis: A pilot randomized controlled clinical trial

Author(s)

Araujo, Cassia F. ; Andere, Naira M. R. B. ; Castro dos Santos, Nidia C. ; Mathias-Santamaria, Ingrid F. ; Reis, Aurelio A. ; de Oliveira, Luciane D. ; Jardini, Maria A. N. ; Casarin, Renato C. V. ; Santamaria, Mauro P.

• Document type: Journal article
• Source: Journal of Periodontology; v. 90, n. 12, p. 10-pg., 2019-12-01.

Abstract

BackgroundTo assess the clinical and microbiological responses of amoxicillin + metronidazole (AMX + MET) versus clarithromycin (CLM) as adjuncts to one-stage full-mouth ultrasonic debridement (FMUD) in the treatment of generalized aggressive periodontitis (GAgP). MethodsFor this parallel, double-masked, pilot randomized clinical trial, 46 patients with GAgP were selected and randomly assigned into two groups: AMX+MET group (n = 23): FMUD associated with AMX (500 mg three times a day) and MET (400 mg three times a day) for 7 days; and CLM group (n = 23): FMUD associated with CLM (500 mg twice a day) for 7 days. Clinical parameters were evaluated at baseline, 3, and 6 months post-treatment. The levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum from subgingival biofilm were determined by quantitative polymerase chain reaction. ResultsBoth treatments significantly improved all clinical parameters compared with baseline and promoted a significant reduction of A. actinomycetemcomitans and P. gingivalis counts (P > 0.05). CLM succeeded in decreasing T. forsythia at 6 months (P < 0.05), but no antibiotic was able to reduce F. nucleatum. There was no difference between the two protocols regarding the reported adverse effects (P > 0.05). ConclusionsThe results suggest that CLM is not superior than AMX + MET in the treatment of GAgP. However, this antibiotic led to good clinical outcomes and may be a possible alternative to AMX+MET in the treatment of severe periodontitis in young patients. Future studies with larger sample sizes are needed to confirm this statement (NCT02969928). (AU)

• FAPESP's process: 18/02161-5 - Effect of omega-3 polyunsaturated fatty acids plus low-dose aspirin daily supplementation on inflammatory parameters of patients with generalized aggressive periodontitis: pilot study
• Grantee: Tayná Lopes da Silva
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• 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