Amoxicillin and metronidazole as an adjunctive treatment in generalized aggressive periodontitis at initial therapy or re-treatment: a randomized controlled clinical trial.
BACKGROUND
Previously, we showed that systemic metronidazole and amoxicillin significantly improved the outcomes of non-surgical debridement in generalized aggressive periodontitis patients. This study aimed to observe whether re-treatment with adjunctive antimicrobials would give the placebo group benefits comparable with the test group.


METHODS
Thirty-eight of 41 subjects, from the initial 6-month trial, completed the second phase, re-treatment of sites with remaining pockets 5 mm. Subjects on placebo in phase one, received adjunctive antibiotics for 7 days. Clinical parameters were collected at 2 months posttreatment (8 months from baseline).


RESULTS
Patients who received antibiotics at initial therapy, showed statistically significant improvement in pocket depth reduction and in the % of sites improving above clinically relevant thresholds, compared with patients who received antibiotics at re-treatment. In deep pockets (7 mm), the mean difference was 0.9 mm (p=0.003) and in moderate pockets (4-6 mm) it was 0.4 mm (p=0.036). For pockets converting from 5 to 4 mm, this was 83% compared with 67% (p=0.041) and pockets converting from 4 to 3 mm was 63% compared with 49% (p=0.297).


CONCLUSIONS
At 8 months, patients who had antibiotics at initial therapy showed statistically significant benefits compared with those who had antibiotics at re-treatment.
University of Sheffield, Academic Unit of Restorative Dentistry, Sheffield, UK. g.s.griffiths@sheffield.ac.uk
Gareth S
GS
Griffiths
Rasidah
R
Ayob
Adrian
A
Guerrero
Luigi
L
Nibali
Jean
J
Suvan
David R
DR
Moles
Maurizio S
MS
Tonetti
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D010520:Aggressive Periodontitis / Q000188:drug therapy*; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D000704:Analysis of Variance; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D057747:Periodontal Debridement; D019233:Retreatment; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
D000890:Anti-Infective Agents; D008795:Metronidazole; D000658:Amoxicillin