title: Metronidazole alone or with amoxicillin as adjuncts to non-surgical treatment of chronic periodontitis: a 1-year double-blinded, placebo-controlled, randomized 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). A secondary aim was to examine a possible added effect of chlorhexidine to these therapies.
  
  
  METHODS
  One hundred and eighteen subjects received scaling and root planing (SRP) only or with MTZ [400 mg/thrice a day (TID)] or MTZ+AMX (500 mg/TID) for 14 days. Half of the subjects in each group rinsed with 0.12% chlorhexidine twice a day (BID) for 2 months. Subjects were clinically monitored at baseline, 3, 6 and 12-months post-therapy.
  
  
  RESULTS
  The two antibiotic groups showed lower mean number of sites with probing depth (PD) ≥5 mm and fewer subjects exhibiting ≥9 of these sites at 1-year post-treatment. Logistic regression analysis showed that antibiotics were the only significant predictors of subjects presenting ≤4 sites with PD ≥5 mm at 1 year (MTZ+AMX: OR, 13.33; 95%CI, 3.75-47.39/p = 0.0000; MTZ: OR, 7.26; 95%CI, 2.26-23.30/p = 0.0004). The frequency of adverse events did not differ between the two antibiotic treatments (p > 0.05). The chlorhexidine subgroups showed a trend (p > 0.05) to present fewer residual sites ≥5 mm compared with the placebo subgroups at 1 year.
  
  
  CONCLUSIONS
  Treatment of generalized ChP is significantly improved by the adjunctive use of MTZ+AMX and MTZ.
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Magda
authors.initials: M
authors.lastname: Feres
authors.forename: Geisla Mary Silva
authors.initials: GM
authors.lastname: Soares
authors.forename: Juliana Alethusa Velloso
authors.initials: JA
authors.lastname: Mendes
authors.forename: Maike Paulino
authors.initials: MP
authors.lastname: Silva
authors.forename: Marcelo
authors.initials: M
authors.lastname: Faveri
authors.forename: Ricardo
authors.initials: R
authors.lastname: Teles
authors.forename: Sigmund S
authors.initials: SS
authors.lastname: Socransky
authors.forename: Luciene Cristina
authors.initials: LC
authors.lastname: Figueiredo
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000009:adverse effects / Q000627:therapeutic use*; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002710:Chlorhexidine / Q000627:therapeutic use; D055113:Chronic Periodontitis / Q000188:drug therapy*; D012534:Dental Scaling; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy / Q000473:pathology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D009067:Mouthwashes; D008795:Metronidazole; D000658:Amoxicillin; D002710:Chlorhexidine