title: Metronidazole and amoxicillin as adjuncts to scaling and root planing for the treatment of type 2 diabetic subjects with periodontitis: 1-year outcomes of a randomized placebo-controlled clinical trial.
abstract: OBJECTIVE
  To evaluate the clinical and microbiological effects of the use of metronidazole (MTZ) + amoxicillin (AMX) as adjuncts to scaling and root planing (SRP) for the treatment of chronic periodontitis (ChP) in type 2 diabetic subjects.
  
  
  METHODS
  Fifty-eight type 2 diabetic subjects (n = 29/group) with generalized ChP were randomly assigned to receive SRP alone or with MTZ [400 mg/thrice a day (TID)]+AMX (500 mg/TID) for 14 days. Subgingival biofilm samples were analyzed by qPCR for the presence of seven periodontal pathogens. Subjects were monitored at baseline, 3, 6 and 12 months post-therapies.
  
  
  RESULTS
  The group receiving SRP+MTZ+AMX presented greater mean probing depth (PD) reduction and clinical attachment gain, a lower number of sites with PD ≥5 mm (primary outcome variable) and a reduced number of subjects with ≥9 of these residual pockets than the control group at 1-year post-therapy (p < 0.05). The antibiotic-treated group also presented reduced levels and greater decreases of the three red complex species, Eubacterium nodatum and Prevotella intermedia, compared to the control group at 1 year (p < 0.05).
  
  
  CONCLUSIONS
  The adjunctive use of MTZ+AMX significantly improved the clinical and microbiological outcomes of SRP in the treatment of type 2 diabetic subjects with ChP.
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil.
authors.forename: Tamires Szeremeske
authors.initials: TS
authors.lastname: Miranda
authors.forename: Magda
authors.initials: M
authors.lastname: Feres
authors.forename: Paula Juliana
authors.initials: PJ
authors.lastname: Perez-Chaparro
authors.forename: Marcelo
authors.initials: M
authors.lastname: Faveri
authors.forename: Luciene Cristina
authors.initials: LC
authors.lastname: Figueiredo
authors.forename: Neila Sumie
authors.initials: NS
authors.lastname: Tamashiro
authors.forename: Marta Ferreira
authors.initials: MF
authors.lastname: Bastos
authors.forename: Poliana Mendes
authors.initials: PM
authors.lastname: Duarte
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D018441:Biofilms / Q000187:drug effects; D055113:Chronic Periodontitis / Q000150:complications / Q000382:microbiology / Q000628:therapy*; D003131:Combined Modality Therapy; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004311:Double-Blind Method; D004338:Drug Combinations; D005051:Eubacterium / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000382:microbiology / Q000628:therapy; D010514:Periodontal Pocket / Q000382:microbiology / Q000628:therapy; D010919:Placebos; D018713:Prevotella intermedia / Q000187:drug effects / Q000302:isolation & purification; D011446:Prospective Studies; D016745:Root Planing / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D004338:Drug Combinations; D010919:Placebos; D008795:Metronidazole; D000658:Amoxicillin
keywords: amoxicillin; chronic periodontitis; dental scaling; diabetes mellitus; metronidazole; real-time polymerase chain reaction; root planing