The influence of supragingival plaque control on clinical and microbial outcomes following the use of antibiotics for the treatment of periodontitis.
Although supragingival plaque control is essential to successful periodontal therapy, the role of plaque control following systemic antibiotic use in periodontal disease has not been well defined. This study evaluated, following antibiotic use, which clinical and microbial parameters appeared to be influenced primarily by the antibiotics, independent of plaque control, and which outcomes appeared to be dependent on plaque control. Two hundred thirty-six patients (236) with moderate to severe periodontitis were clinically evaluated and microbial samples were taken by their private-practice periodontists. All patients were treated with scaling and root planing and a variety of systemic antibiotics, which were selected based on the microbial and clinical profile of the patient. Three months after therapy, patients were reevaluated and grouped by post-treatment plaque control, as either having very good oral hygiene (LoPl: N = 143; < or = 10% plaque-covered surfaces) or poor oral hygiene (HiPl: N = 93; > or = 25% plaque-covered surfaces). The two groups had different plaque and bleeding scores initially, but similar numbers of pockets probing > 5 mm and similar microbial patterns. Although the LoPl group had a significantly greater reduction in plaque than the HiPl group, bleeding scores and probing depths changed comparably in both groups after antibiotic therapy. Plaque control influenced outcomes significantly, but in a complex manner. The LoPl group exhibited a significantly greater reduction in certain bacteria, for example P. gingivalis. Interactions between plaque control and specific microbial parameters significantly affected clinical outcomes, although neither alone was sufficient to predict outcomes following antibiotic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Kornman
K S
KS
University of Texas Health Science Center, San Antonio.
Newman
M G
MG
Moore
D J
DJ
Singer
R E
RE
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D015169:Colony Count, Microbial; D003131:Combined Modality Therapy; D003773:Dental Plaque / Q000517:prevention & control* / Q000628:therapy; D012534:Dental Scaling; D005500:Follow-Up Studies; D005544:Forecasting; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D009910:Oral Hygiene; D010514:Periodontal Pocket / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy; D010518:Periodontitis / Q000188:drug therapy* / Q000382:microbiology* / Q000628:therapy; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000302:isolation & purification; D016745:Root Planing; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents