One-stage full-mouth versus partial-mouth scaling and root planing during the effective half-life of systemically administered azithromycin.
BACKGROUND
One-stage full-mouth scaling and root planing (FM-SRP) in combination with systemically administered azithromycin was shown to be clinically and bacteriologically effective in the treatment of chronic periodontitis. However, FM-SRP requires 2 hours for completion. Azithromycin has a long half-life. Therefore, if SRP of the full mouth is performed within 7 days while an effective concentration of azithromycin remains in the gingiva, the effects may be the same as FM-SRP. The aim of this study was to compare the clinical and bacteriologic effects of FM-SRP and partial-mouth scaling and root planing (PM-SRP) in patients with chronic periodontitis, which was performed in three sessions within 7 days, during the effective half-life of systemically administrated azithromycin.


METHODS
Thirty adult subjects with chronic periodontitis were randomly divided into three groups (FM-SRP, PM-SRP, and control). A clinical examination was conducted to record the probing depth, clinical attachment level gain, bleeding on probing, gingival index, and volume of gingival crevicular fluid; bacterial samples were obtained before treatment and 1, 3, 6, 9, and 12 months thereafter. Quantitative and qualitative analyses were performed using the polymerase chain reaction-Invader method.


RESULTS
All clinical parameters showed better improvement in FM-SRP and PM-SRP groups compared to the control group, with no significant differences between the two test groups. Periodontal bacteria were well controlled in the two test groups, but they tended to increase gradually 3 months after treatment in the control group.


CONCLUSIONS
PM- and FM-SRP demonstrated comparable clinical and bacteriologic results.
Yashima
Akihiro
A
Department of Periodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Gomi
Kazuhiro
K
Maeda
Nobuko
N
Arai
Takashi
T
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017963:Azithromycin / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001439:Bacteroides / Q000187:drug effects / Q000302:isolation & purification; D055113:Chronic Periodontitis / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy*; D012534:Dental Scaling / Q000295:instrumentation / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000378:metabolism; D005883:Gingival Crevicular Fluid / Q000737:chemistry; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000628:therapy; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D016966:Porphyromonas gingivalis / Q000187:drug effects / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000187:drug effects / Q000302:isolation & purification; D016745:Root Planing / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D048373:Treponema denticola / Q000187:drug effects / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D017963:Azithromycin