title: Systemic antimicrobials adjunctive to a repeated mechanical and antiseptic therapy for aggressive periodontitis: a 6-month randomized controlled trial.
abstract: BACKGROUND
  The purpose of this study is to compare the additional benefit of systemic antimicrobials versus placebos to a repeated mechanical instrumentation combined with comprehensive local chemical plaque control for the periodontal treatment of generalized aggressive periodontitis (GAgP).
  
  
  METHODS
  This was a 6-month randomized, double-masked, placebo-controlled clinical trial. All GAgP patients received full-mouth disinfection followed by staged scaling and root planing without (placebo group; n = 17) or with (test group; n = 18) systemic antimicrobials (500 mg amoxicillin [AMX] + 250 mg metronidazole [MET]; three times a day for 10 days). Clinical parameters were measured at baseline and 3 and 6 months post-therapy. Significant differences between groups at baseline were sought by using the Mann-Whitney U test, whereas comparisons over time were examined by using a general linear model repeated measures procedure.
  
  
  RESULTS
  Both groups demonstrated similar improvements in most parameters over time. The test group presented a greater mean probing depth (PD) reduction and clinical attachment level (CAL) gain at sites with initially moderate PD at 6 months (P <0.03). No differences were seen between groups regarding mean reductions and mean gains, respectively, for PD and CAL initially ≥7 mm. The test group presented a higher percentage of sites that improved ≥2 mm and ended up with PD ≤4 mm or a lower percentage of sites that worsened ≥2 mm and remained with PD >4 mm at 3 months (P <0.01). No differences were noticed between groups for these parameters at 6 months.
  
  
  CONCLUSIONS
  AMX + MET brought additional clinical effects to the repeated mechanical and antiseptic treatment of GAgP in a very short time (3 months), which tended to fade away over time (6 months).
authors.affiliation: Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, RJ, Brazil.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Varela
authors.forename: Débora
authors.initials: D
authors.lastname: Heller
authors.forename: Mayra X
authors.initials: MX
authors.lastname: Silva-Senem
authors.forename: Maria Cynésia M B
authors.initials: MC
authors.lastname: Torres
authors.forename: Ana Paula V
authors.initials: AP
authors.lastname: Colombo
authors.forename: Eduardo J
authors.initials: EJ
authors.lastname: Feres-Filho
mesh_terms: D000328:Adult; D010520:Aggressive Periodontitis / Q000150:complications / Q000628:therapy*; D000658:Amoxicillin / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003773:Dental Plaque / Q000150:complications / Q000517:prevention & control*; D012534:Dental Scaling; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D019233:Retreatment; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D004338:Drug Combinations; D008795:Metronidazole; D000658:Amoxicillin