title: Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: a randomized placebo-controlled clinical trial.
abstract: OBJECTIVE
  To evaluate the effects of the adjunctive use of metronidazole (MTZ) or MTZ+amoxicillin (AMX) in the treatment of generalized chronic periodontitis (ChP).
  
  
  METHODS
  Fifty-one subjects (n=17/group) were randomly assigned to receive scaling and root planing (SRP) only or combined with MTZ (400 mg t.i.d.) or MTZ+AMX (500 mg t.i.d.) for 14 days. Clinical and microbiological examinations were performed at baseline and 3 months post-SRP. Nine plaque samples/subject were analysed by checkerboard DNA-DNA hybridization for 40 bacterial species.
  
  
  RESULTS
  Subjects receiving MTZ+AMX exhibited a greater mean gain of clinical attachment, reduction in probing depth (PD) in intermediate and deep sites and a lower percentage of sites with PD5 mm at 3 months, in comparison with those treated with SRP only (p<0.05). The major benefit from the adjunctive use of MTZ was a greater reduction in PD in deep sites. SRP+MTZ+AMX was the only treatment that significantly reduced the levels and proportions of all red complex pathogens and elicited a significantly greater beneficial change in the microbial profile in comparison with SRP only.
  
  
  CONCLUSIONS
  The adjunctive use of MTZ+AMX offers short-term clinical and microbiological benefits, over SRP alone, in the treatment of non-smokers subjects with generalized ChP. The added benefits of MTZ were less evident.
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Maike Paulino
authors.initials: MP
authors.lastname: Silva
authors.forename: Magda
authors.initials: M
authors.lastname: Feres
authors.forename: Tatiana Alves Oliveira
authors.initials: TA
authors.lastname: Sirotto
authors.forename: Geisla Mary Silva
authors.initials: GM
authors.lastname: Soares
authors.forename: Juliana Alethusa Velloso
authors.initials: JA
authors.lastname: Mendes
authors.forename: Marcelo
authors.initials: M
authors.lastname: Faveri
authors.forename: Luciene Cristina
authors.initials: LC
authors.lastname: Figueiredo
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects; D017024:Chemotherapy, Adjuvant; D055113:Chronic Periodontitis / Q000188:drug therapy* / Q000382:microbiology / Q000628:therapy; D004269:DNA, Bacterial / Q000032:analysis; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D061366:Numbers Needed To Treat; D015588:Observer Variation; D010514:Periodontal Pocket / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy; D018709:Statistics, Nonparametric
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004338:Drug Combinations; D008795:Metronidazole; D000658:Amoxicillin