| Summary: |
Aim: To evaluate and compare the effects of adjunctive metronidazole plus
amoxicillin, doxycycline and metronidazole on clinical and microbiological
parameters in patients with generalized aggressive periodontitis.
Material and Methods: Forty-three patients participated in this randomized clinical
trial divided into four groups. Six weeks after scaling and root planning (SRP), groups
1–3 received adjunctive metronidazole, plus amoxicillin, doxycycline and
metronidazole respectively, and group 4 acted as controls. Clinical recordings
concerning probing depth, probing attachment level and bleeding on probing were
performed at baseline, 6 weeks after SRP and 6 months from baseline. Subgingival
samples were analysed using the ‘checkerboard’ DNA–DNA hybridization for
Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Tannerella
forsythia and Treponema denticola.
Results: All treatments resulted in improvement of clinical parameters (ANOVA
p40.05). Systemic administration of metronidazole plus amoxicillin or
metronidazole resulted in statistically significant greater reduction of the proportion of
sites 4 6mm than SRP (z-test, po0.05). These antimicrobials yielded a significant
effect on levels of important periodontal pathogens for 6 months.
Conclusion: Adjunctive metronidazole plus amoxicillin or metronidazole alone
(when A.actinomycetemcomitans is not involved) is effective in deep pockets of
aggressive periodontitis patients.
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