ADJUNCTIVE USE OF SYSTEMIC ANTIBIOTICS (AMOXICILLIN 500 MG PLUS METRONIDAZOLE 500 MG 3 TIMES A DAY FOR 3 OR 7 DAYS) TO NONSURGICAL PERIODONTAL THERAPY MAY IMPROVE CLINICAL OUTCOMES IN TREATING SEVERE CHRONIC PERIODONTITIS

作者：Oh Tae Ju^*

来源：Journal of Evidence-Based Dental Practice, 2017, 17(1): 62-64.

DOI：10.1016/j.jebdp.2017.01.004

Subjects
The study included 102 systemically healthy patients (older than 30 years) who had one or more site per quadrant with probing depth (PD) >= 6 mm and radiographic signs of generalized severe chronic periodontitis.
Subjects who had the following conditions were excluded from the study:
Nonsurgical periodontal therapy within the previous 12 months.
Systemic or local use of antibiotics within the previous 3 months.
Medication that could interact with amoxicillin (AMX) or metronidazole (MET).
Medication with a possible influence on the periodontium.
Pregnancy or lactation.
Key Exposure/Study Factor
The study subjects were randomly assigned to the following 3 treatment groups:
1. Scaling and root planing (SRP) + placebo pills for 7 days (group A, n = 34).
2. SRP + AMX + MET (both 500 mg 3 times a day for 3 days followed by placebo pills for the next 4 days; group B, n = 34).
3. SRP + AMX + MET (both 50 mg 3 times a day for 7 days; group C, n = 34).
At baseline (before SRP) and at 3 and 6 months after SRP, a blinded examiner performed clinical measurements, which included PD, clinical attachment level (CAL), bleeding on probing, full-mouth plaque score, and gingival bleeding index.
Main Outcome Measure
The primary outcome measure was the difference in the number of pockets with PD >= 6 mm between baseline and 6 months after treatment as well as between the groups (A, B, and C) at 3 and 6 months.
Main Results
Among the 102 subjects, 91 patients (30 in group A, 30 in group B, and 31 in group C) completed the study. At 3 and months, statistically significant improvements were observed in all investigated parameters compared with the baseline in all treatment groups (P < .001, paired t test and Wilcoxon signed rank test). Also, at both 3 and 6 months, statistically significantly greater improvements (P < .05) were observed in the antibiotics groups (B and C) compared with the placebo group (A) in several clinical parameters, such as PD, CAL, and the number of remaining pockets with PD >= 6 mm.
Conclusions
In patients with severe chronic periodontitis, adjunctive use of AMX and MET with SRP may be beneficial in improving clinical outcomes compared with SRP alone.

• 出版日期2017-3