Nonsurgical treatment of patients with periodontal disease.
OBJECTIVE
To determine whether the short-term use of systemic antimicrobials (metronidazole or doxycycline) and locally delivered antimicrobials (metronidazole, chlorhexidine) in patients with advanced forms of periodontal disease could prevent the normally necessary access surgery.


METHODS
Ninety-four patients were randomly assigned with the use of a double-blind protocol.


RESULTS
There was a 93% reduction in the need for periodontal surgery about individual teeth and an 81% reduction in the need for tooth extractions. Only 93 teeth of an initial total of 783 teeth actually needed surgery or extractions. Eighty-one percent of the patients entered into the maintenance phase of treatment without needing surgical treatments.


CONCLUSIONS
These findings indicate that a treatment paradigm based on the diagnosis and treatment of anaerobic infections is likely to be successful in those patients for whom access surgery is recommended.
Loesche
W J
WJ
University of Michigan School of Dentistry, Ann Arbor, USA.
Giordano
J
J
Soehren
S
S
Hutchinson
R
R
Rau
C F
CF
Walsh
L
L
Schork
M A
MA
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D001421:Bacteria, Anaerobic / Q000187:drug effects; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D012534:Dental Scaling; D004311:Double-Blind Method; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D015588:Observer Variation; D010510:Periodontal Diseases / Q000188:drug therapy*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D003692:Delayed-Action Preparations; D008795:Metronidazole; D004318:Doxycycline; D002710:Chlorhexidine