title: Clinical and Microbiologic Evaluation of Scaling and Root Planing per Quadrant and One-Stage Full-Mouth Disinfection Associated With Azithromycin or Chlorhexidine: A Clinical Randomized Controlled Trial.
abstract: BACKGROUND
  Conflicting data about the protocol of choice for non-surgical periodontal therapy with adjuvant use are still reported. This study aims to evaluate, through clinical and microbiologic parameters, the systemic use of azithromycin (AZ) and chlorhexidine (CHX) as adjuvants to non-surgical periodontal treatment performed by one-stage full-mouth disinfection (FMD) within 24 hours or conventional quadrant scaling (QS) in four weekly sections.
  
  
  METHODS
  In this randomized controlled trial, 85 patients diagnosed with chronic periodontitis underwent different treatment protocols, in six groups: three FMD groups and three QS groups, each with no adjuvants, with CHX, and with AZ. Clinical periodontal parameters were recorded, and total and quantitative bacterial counts of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Streptococcus oralis were measured with real-time polymerase chain reaction at baseline and 90 and 180 days after treatment.
  
  
  RESULTS
  In all groups, a significant reduction was observed in the percentage of periodontal diseased sites, gingival index, plaque index, and clinical attachment level gain at 90 days, demonstrating effectiveness of the treatment, independently of the adjuvant. The FMD with CHX group showed higher reduction in probing depth and percentage of periodontal diseases sites, as well as lower total bacterial count, than all the other groups at 180 days.
  
  
  CONCLUSIONS
  The adjuvant use of AZ did not provide any significant benefit, independently of the treatment protocol. The adjuvant use of CHX showed a more expressive and significant improvement in clinical and microbiologic parameters, especially in the FMD protocol, followed by QS.
authors.affiliation: Department of Periodontology, University Center of Lavras, Lavras, Minas Gerais, Brazil.|Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte, Brazil.
authors.forename: Douglas Campideli
authors.initials: DC
authors.lastname: Fonseca
authors.affiliation: Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil.
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Cortelli
authors.affiliation: Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil.
authors.forename: Sheila Cavalca
authors.initials: SC
authors.lastname: Cortelli
authors.affiliation: Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil.
authors.forename: Luís Otávio
authors.initials: LO
authors.lastname: Miranda Cota
authors.affiliation: Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil.
authors.forename: Lidiane Cristina
authors.initials: LC
authors.lastname: Machado Costa
authors.affiliation: Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil.
authors.forename: Marcos Vinicius
authors.initials: MV
authors.lastname: Moreira Castro
authors.affiliation: Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte, Brazil.
authors.forename: Andréa Mara
authors.initials: AM
authors.lastname: Oliveira Azevedo
authors.affiliation: Department of Dental Clinics, Oral Pathology, and Dental Surgery; Dentistry School; Federal University of Minas Gerais; Belo Horizonte, Brazil.
authors.forename: Fernando Oliveira
authors.initials: FO
authors.lastname: Costa
mesh_terms: D016976:Aggregatibacter actinomycetemcomitans; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D012534:Dental Scaling; D004203:Disinfection; D005500:Follow-Up Studies; D006801:Humans; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy; D016745:Root Planing
chemical_list: D000891:Anti-Infective Agents, Local; D017963:Azithromycin; D002710:Chlorhexidine
keywords: Azithromycin; chlorhexidine; chronic periodontitis; dental scaling; randomized controlled trial; root planing