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

Author(s)

Feres, Magda ^[1] ; Silva Soares, Geisla Mary ; Velloso Mendes, Juliana Alethusa ; Silva, Maike Paulino ; Faveri, Marcelo ; Teles, Ricardo ^{[2, 3]} ; Socransky, Sigmund S. ^[3] ; Figueiredo, Luciene Cristina

Affiliation

^[1] Univ Guarulhos, Ctr Posgrad & Pesquisa CEPPE, Dent Res Div, Dept Periodontol, BR-07023070 Guarulhos, SP - Brazil

^[2] Harvard Univ, Sch Dent Med, Dept Oral Med Infect & Immun, Boston, MA 02115 - USA

^[3] Forsyth Inst, Cambridge, MA - USA

• Document type: Journal article
• Source: JOURNAL OF CLINICAL PERIODONTOLOGY; v. 39, n. 12, p. 1149-1158, DEC 2012.
• Web of Science Citations: 51

Abstract

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. (AU)