title: The effect of metronidazole on the presence of P. gingivalis and T. forsythia at 3 and 12 months after different periodontal treatment strategies evaluated in a randomized, clinical trial.
abstract: OBJECTIVE
  The benefit of full-mouth disinfection (FDIS) over traditional scaling and root planing (SRP) in the treatment of chronic, destructive periodontitis remains equivocal and it is not known whether the use of adjunctive antibiotics may enhance the effect of FDIS. Therefore, the aim of this study was to evaluate the effect of conventional SRP completed over 21 days or 1-day FDIS, with or without systemically delivered adjunctive metronidazole (MET) on the presence of P. gingivalis and T. forsythia after 3 and 12 months.
  
  
  METHODS
  One hundred and eighty-four patients with moderate-to-severe periodontitis were randomly allocated to one of four treatment groups; (1) FDIS+MET; (2) FDIS+placebo; (3) SRP+MET; (4) SRP+placebo. Prior to treatment, pooled subgingival samples were obtained from the five deepest pockets. The same sites were sampled again 3 and 12 months after treatment. All samples were analyzed for P. gingivalis and T. forsythia by PCR, whereas A. actinomycetemcomitans and other bacteria were identified by culture techniques.
  
  
  RESULTS
  At baseline, 47% of the samples were positive for P. gingivalis, while almost all samples were positive for T. forsythia. The occurrence of P. gingivalis and T. forsythia was significantly reduced at 3 and 12 months after treatment in the FDIS+MET group, but not in the other treatment groups.
  
  
  CONCLUSIONS
  FDIS+MET had a significant effect in patients with P. gingivalis and T. forsythia, resulting in a significant reduction in number of patients where these micro-organisms could be detected at 3 and 12 months post-therapy.
authors.affiliation: Department of Periodontology, Institute of Clinical Odontology.
authors.forename: Hans R
authors.initials: HR
authors.lastname: Preus
authors.forename: Per
authors.initials: P
authors.lastname: Gjermo
authors.forename: Anne Aamdal
authors.initials: AA
authors.lastname: Scheie
authors.forename: Vibeke
authors.initials: V
authors.lastname: Baelum
mesh_terms: D000328:Adult; D000368:Aged; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001439:Bacteroides / Q000187:drug effects*; D002710:Chlorhexidine / Q000627:therapeutic use; D055113:Chronic Periodontitis / Q000382:microbiology / Q000628:therapy*; D003131:Combined Modality Therapy; D012534:Dental Scaling / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D010514:Periodontal Pocket / Q000382:microbiology / Q000628:therapy; D010919:Placebos; D016966:Porphyromonas gingivalis / Q000187:drug effects*; D016745:Root Planing / Q000379:methods
chemical_list: D000890:Anti-Infective Agents; D000891:Anti-Infective Agents, Local; D010919:Placebos; D008795:Metronidazole; D002710:Chlorhexidine
keywords: RCT; antibiotics; full mouth disinfection; microbial diagnosis; one-day treatment; scaling and root planing