Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No <i>Aggregatibacter actinomycetemcomitans</i> Is Detected—A Randomized Clinical Trial
Background: The aim was to compare two different systemic antibiotics regimens adjunctive to non-surgical periodontal therapy when <i>Aggregatibacter actinomycetemcomitans</i> was not detected in the subgingival biofilm. Methods: A total of 58 patients with periodontitis and with no <...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-10-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/9/10/686 |
| _version_ | 1827704632268292096 |
|---|---|
| author | Holger F. R. Jentsch Martin Dietrich Sigrun Eick |
| author_facet | Holger F. R. Jentsch Martin Dietrich Sigrun Eick |
| author_sort | Holger F. R. Jentsch |
| collection | DOAJ |
| description | Background: The aim was to compare two different systemic antibiotics regimens adjunctive to non-surgical periodontal therapy when <i>Aggregatibacter actinomycetemcomitans</i> was not detected in the subgingival biofilm. Methods: A total of 58 patients with periodontitis and with no <i>A. actinomycetemcomitans</i> in the subgingival biofilm were treated with full-mouth subgingival instrumentation and either metronidazole (MET; <i>n</i> = 29) or amoxicillin/metronidazole (AMX/MET; <i>n</i> = 29). Probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) were recorded at baseline, as well as after three and six months. Subgingival biofilm and gingival crevicular fluid were collected and analyzed for major periodontopathogens and biomarkers. Results: PD, CAL and BOP improved at 3 and 6 months (each <i>p</i> < 0.001 vs. baseline) with no difference between the groups. Sites with initial PD ≥ 6 mm also improved in both groups after 3 and 6 months (<i>p</i> < 0.001) with a higher reduction of PD in the AMX/MET group (<i>p</i> < 0.05). T. forsythia was lower in the AMX/MET group after 3 months (<i>p</i> < 0.05). MMP-8 and IL-1β were without significant changes and differences between the groups. Conclusion: When <i>A. actinomycetemcomitans</i> was not detected in the subgingival biofilm, the adjunctive systemic use of amoxicillin/metronidazole results in better clinical and microbiological outcomes of non-surgical periodontal therapy when the application of systemic antibiotics is scheduled. |
| first_indexed | 2024-03-10T15:45:59Z |
| format | Article |
| id | doaj.art-a8720ae4266344c595c9272701c5ce3b |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T15:45:59Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-a8720ae4266344c595c9272701c5ce3b2023-11-20T16:29:55ZengMDPI AGAntibiotics2079-63822020-10-0191068610.3390/antibiotics9100686Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No <i>Aggregatibacter actinomycetemcomitans</i> Is Detected—A Randomized Clinical TrialHolger F. R. Jentsch0Martin Dietrich1Sigrun Eick2Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Liebigstr. 12, Haus 1, D-04103 Leipzig, GermanyPrivate Dental Practice, Borngasse 12, D-99084 Erfurt, GermanyDepartment of Periodontology, Laboratory of Oral Microbiology, School of Dental Medicine, University of Bern, Freiburgstr. 7, CH-3010 Bern, SwitzerlandBackground: The aim was to compare two different systemic antibiotics regimens adjunctive to non-surgical periodontal therapy when <i>Aggregatibacter actinomycetemcomitans</i> was not detected in the subgingival biofilm. Methods: A total of 58 patients with periodontitis and with no <i>A. actinomycetemcomitans</i> in the subgingival biofilm were treated with full-mouth subgingival instrumentation and either metronidazole (MET; <i>n</i> = 29) or amoxicillin/metronidazole (AMX/MET; <i>n</i> = 29). Probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) were recorded at baseline, as well as after three and six months. Subgingival biofilm and gingival crevicular fluid were collected and analyzed for major periodontopathogens and biomarkers. Results: PD, CAL and BOP improved at 3 and 6 months (each <i>p</i> < 0.001 vs. baseline) with no difference between the groups. Sites with initial PD ≥ 6 mm also improved in both groups after 3 and 6 months (<i>p</i> < 0.001) with a higher reduction of PD in the AMX/MET group (<i>p</i> < 0.05). T. forsythia was lower in the AMX/MET group after 3 months (<i>p</i> < 0.05). MMP-8 and IL-1β were without significant changes and differences between the groups. Conclusion: When <i>A. actinomycetemcomitans</i> was not detected in the subgingival biofilm, the adjunctive systemic use of amoxicillin/metronidazole results in better clinical and microbiological outcomes of non-surgical periodontal therapy when the application of systemic antibiotics is scheduled.https://www.mdpi.com/2079-6382/9/10/686scaling and root planingantibioticsperiodontitisnon-surgical treatment |
| spellingShingle | Holger F. R. Jentsch Martin Dietrich Sigrun Eick Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No <i>Aggregatibacter actinomycetemcomitans</i> Is Detected—A Randomized Clinical Trial Antibiotics scaling and root planing antibiotics periodontitis non-surgical treatment |
| title | Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No <i>Aggregatibacter actinomycetemcomitans</i> Is Detected—A Randomized Clinical Trial |
| title_full | Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No <i>Aggregatibacter actinomycetemcomitans</i> Is Detected—A Randomized Clinical Trial |
| title_fullStr | Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No <i>Aggregatibacter actinomycetemcomitans</i> Is Detected—A Randomized Clinical Trial |
| title_full_unstemmed | Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No <i>Aggregatibacter actinomycetemcomitans</i> Is Detected—A Randomized Clinical Trial |
| title_short | Non-Surgical Periodontal Therapy with Adjunctive Amoxicillin/Metronidazole or Metronidazole When No <i>Aggregatibacter actinomycetemcomitans</i> Is Detected—A Randomized Clinical Trial |
| title_sort | non surgical periodontal therapy with adjunctive amoxicillin metronidazole or metronidazole when no i aggregatibacter actinomycetemcomitans i is detected a randomized clinical trial |
| topic | scaling and root planing antibiotics periodontitis non-surgical treatment |
| url | https://www.mdpi.com/2079-6382/9/10/686 |
| work_keys_str_mv | AT holgerfrjentsch nonsurgicalperiodontaltherapywithadjunctiveamoxicillinmetronidazoleormetronidazolewhennoiaggregatibacteractinomycetemcomitansiisdetectedarandomizedclinicaltrial AT martindietrich nonsurgicalperiodontaltherapywithadjunctiveamoxicillinmetronidazoleormetronidazolewhennoiaggregatibacteractinomycetemcomitansiisdetectedarandomizedclinicaltrial AT sigruneick nonsurgicalperiodontaltherapywithadjunctiveamoxicillinmetronidazoleormetronidazolewhennoiaggregatibacteractinomycetemcomitansiisdetectedarandomizedclinicaltrial |