Full-mouth disinfection and systemic antimicrobial therapy in generalized aggressive periodontitis: a randomized, placebo-controlled trial.
OBJECTIVE
The present investigation aimed to analyse clinical and microbiological effects of systemic administration of metronidazole and amoxicillin combined with the One-Stage-Full-Mouth-Disinfection protocol (OSFMD) in generalized aggressive periodontitis patients (G-AgP).


METHODS
Thirty-nine systemically healthy patients with G-AgP were consecutively included. The test group (n = 19) received amoxicillin-metronidazole combination (500 mg of each, three times a day for 7 days) and the OSFMD, the control group (n = 20) received the OSFMD and a placebo. In addition to clinical parameters subgingival plaque samples from moderate (4-5 mm) and deep (≥ 6 mm) pocket sites were analysed for the presence of Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola using polymerase chain reaction.


RESULTS
Both therapies led to a statistically significant decrease in clinical and microbiological parameters compared to baseline (p < 0.001). The most beneficial changes were observed in the test group which showed significantly greater improvements in probing depth and clinical attachment level and a lower prevalence of Aggregatibacter actinomycetemcomitans, Treponema denticola, and Tannerella forsythia compared to the control one (p < 0.05).


CONCLUSIONS
Systemic administration of metronidazole and amoxicillin as an adjunct to OSFMD therapy significantly improved clinical and microbiological outcomes in patients with G-AgP over a 6-month period.
Department of Biomedical Sciences and Human Oncology, Division of Periodontology, University of Torino, Italy. mario.aimetti@unito.it
Mario
M
Aimetti
Federica
F
Romano
Nicoletta
N
Guzzi
Gianfranco
G
Carnevale
D000284:Administration, Oral; D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D010520:Aggressive Periodontitis / Q000188:drug therapy*; D000658:Amoxicillin / Q000008:administration & dosage*; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001439:Bacteroides / Q000187:drug effects; D016009:Chi-Square Distribution; D002710:Chlorhexidine / Q000627:therapeutic use; D003773:Dental Plaque / Q000382:microbiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*; D009067:Mouthwashes / Q000627:therapeutic use; D010512:Periodontal Index; D018709:Statistics, Nonparametric; D048373:Treponema denticola / Q000187:drug effects
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D008795:Metronidazole; D000658:Amoxicillin; D002710:Chlorhexidine