title: The combination of amoxicillin and metronidazole improves clinical and microbiologic results of one-stage, full-mouth, ultrasonic debridement in aggressive periodontitis treatment.
abstract: BACKGROUND
  The aim of the present study is to assess clinical, microbiologic, and immunologic benefits of amoxicillin/metronidazole (AM) when performing full-mouth ultrasonic debridement (FMUD) in generalized aggressive periodontitis (GAgP) treatment.
  
  
  METHODS
  Twenty-four GAgP patients were divided into two groups: the FMUD group (n = 12), which received FMUD plus placebo, and the FMUD+AM group (n = 12), which received FMUD and 375 mg amoxicillin plus 250 mg metronidazole for 7 days. The following clinical outcomes were tested: plaque and bleeding on probing indices, pocket probing depth (PD), relative gingival margin position (GMP), and relative clinical attachment level (CAL). Total amount of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Tannerella forsythia (Tf), and gingival crevicular fluid (GCF) concentration of interleukin (IL)-10 and IL-1β were also determined. All clinical, microbiologic, and immunologic parameters were assessed at baseline and at 3 and 6 months post-therapy. The ANOVA/Tukey test was used for statistical analysis (α = 5%).
  
  
  RESULTS
  Amoxicillin/metronidazole used as an adjunct to the FMUD protocol added clinical and microbiologic benefits to GAgP treatment (P <0.05). FMUD+AM groups presented an additional PD reduction in initially deep PDs at the 3-month follow-up (3.99 ± 1.16 mm and 3.09 ± 0.78 mm for FMUD+AM and FMUD, respectively; P <0.05), a lower number of residual pockets at the 3- and 6-month follow-ups, and a statistical reduction in amounts of Aa (P <0.05). Analysis of Tf and Pg amounts, as well as IL-10 and IL-1β GCF concentrations failed to demonstrate a difference between the groups (P >0.05).
  
  
  CONCLUSIONS
  It may be concluded that amoxicillin/metronidazole improves clinical and microbiologic results of FMUD in GAgP treatment.
authors.affiliation: Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
authors.forename: Renato C V
authors.initials: RC
authors.lastname: Casarin
authors.forename: Erica Del
authors.initials: ED
authors.lastname: Peloso Ribeiro
authors.forename: Enilson A
authors.initials: EA
authors.lastname: Sallum
authors.forename: Francisco H
authors.initials: FH
authors.lastname: Nociti
authors.forename: Reginaldo B
authors.initials: RB
authors.lastname: Gonçalves
authors.forename: Márcio Z
authors.initials: MZ
authors.lastname: Casati
mesh_terms: D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D010520:Aggressive Periodontitis / Q000382:microbiology / Q000628:therapy*; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects; D001439:Bacteroides / Q000187:drug effects; D003774:Dental Plaque Index; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000276:immunology; D005884:Gingival Hemorrhage / Q000628:therapy; D005889:Gingival Recession / Q000628:therapy; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D017622:Periodontal Attachment Loss / Q000628:therapy; D057747:Periodontal Debridement / Q000379:methods*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy; D010919:Placebos; D016966:Porphyromonas gingivalis / Q000187:drug effects; D016037:Single-Blind Method; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D004338:Drug Combinations; D053583:Interleukin-1beta; D010919:Placebos; D016753:Interleukin-10; D008795:Metronidazole; D000658:Amoxicillin