title: Effect of azithromycin, as an adjunct to nonsurgical periodontal treatment, on microbiological parameters and gingival crevicular fluid biomarkers in generalized aggressive periodontitis.
abstract: Emingil G, Han B, Özdemir G, Tervahartiala T, Vural C, Atilla G, Baylas H, Sorsa T. The effect of azithromycin, as an adjunct to nonsurgical periodontal treatment, on microbiological parameters and gingival crevicular fluid biomarkers in generalized aggressive periodontitis. J Periodont Res 2012; 47: 729-739. © 2012 John Wiley & Sons A/S Background and Objective:  To study the effectiveness of azithromycin in combination with nonsurgical periodontal therapy on clinical and microbiological parameters, and on the MMP-8 and TIMP-1 levels in gingival crevicular fluid, over a 6-mo time-period in patients with generalized aggressive periodontitis.
  
  
  METHODS
  Thirty-two patients with generalized aggressive periodontitis were included in this randomized, double-blind, placebo-controlled, parallel-arm study. They were randomly assigned to azithromycin or placebo groups (500 mg once daily for 3 d). Probing depth, clinical attachment levels, presence of bleeding on probing and plaque were recorded. Gingival crevicular fluid samples were obtained from one single-rooted tooth, while microbiological samples were obtained from two single-rooted teeth, all with a probing depth of ≥ 6 mm. Microbiological parameters were analyzed by quantitative real-time PCR for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia and total bacteria. Gingival crevicular fluid biomarkers were determined by immunofluorometric assay and ELISA.
  
  
  RESULTS
  All clinical parameters improved, and microbiological parameters and gingival crevicular fluid MMP-8 levels significantly decreased, over the 6-mo period (p < 0.05); both groups demonstrated similar improvements. The azithromycin group presented a higher percentage of deep pockets resolved (probing depth reduction of ≥ 3 mm from baseline) compared with the placebo group at 1 mo (p < 0.05).
  
  
  CONCLUSIONS
  Adjunctive azithromycin therapy provides no additional benefit over nonsurgical periodontal treatment on clinical parameters, microbiological parameters and gingival crevicular fluid biochemical markers investigated in patients with generalized aggressive periodontitis.
authors.affiliation: Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey. gemingil@yahoo.com
authors.forename: G
authors.initials: G
authors.lastname: Emingil
authors.forename: B
authors.initials: B
authors.lastname: Han
authors.forename: G
authors.initials: G
authors.lastname: Ozdemir
authors.forename: T
authors.initials: T
authors.lastname: Tervahartiala
authors.forename: C
authors.initials: C
authors.lastname: Vural
authors.forename: G
authors.initials: G
authors.lastname: Atilla
authors.forename: H
authors.initials: H
authors.lastname: Baylas
authors.forename: T
authors.initials: T
authors.lastname: Sorsa
mesh_terms: D000293:Adolescent; D000328:Adult; D010520:Aggressive Periodontitis / Q000188:drug therapy* / Q000382:microbiology* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D017963:Azithromycin / Q000494:pharmacology / Q000627:therapeutic use*; D001421:Bacteria, Anaerobic / Q000187:drug effects; D004269:DNA, Bacterial / Q000235:genetics; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling; D004311:Double-Blind Method; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D006801:Humans; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000378:metabolism; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D019715:Tissue Inhibitor of Metalloproteinase-1; D017963:Azithromycin; D020784:Matrix Metalloproteinase 8