Serial Doxycycline and Metronidazole in Prevention of Recurrent Periodontitis in High‐Risk Patients

Abstract

The efficacy of metronidazole and doxycycline in preventing recurrent periodontitis was studied in 23 patients. After treatment in the previous 7 months with either bimonthly scaling and 3 weeks of systemic doxycycline (11 subjects) or scaling and placebo (12 subjects), patients were monitored for recurrent periodontitis and were scaled every 2 months. When either a periodontal abscess or greater than 2 mm loss of gingival attachment was observed, metronidazole was administered (250 mg every 8 hours) for 10 days. In the placebo plus metronidazole group, 5 patients (42%) exhibited recurrent periodontitis after the metronidazole regimen compared with only one (9%) in the doxycycline plus metronidazole group (P less than 0.096). Subgingival plaque samples at study and healthy control sites were screened for the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Eikenella corrodens, and Fusobacterium nucleatum by immunofluorescence and for spirochetes using Ryu's stain. Presence/absence analysis of the sum of scores of the 6 individual pathogens demonstrated large reductions (P less than 0.005) in the frequency of detection of pathogens in the former doxycycline compared with the placebo plus metronidazole group at both study and control sites before and one month after metronidazole. By 7 months after metronidazole, there was no detectable difference between groups. These results indicate that prevention of recurrent periodontitis with metronidazole may be enhanced by previous treatment with doxycycline.

Relationship of tooth mortality and implant treatment in Type 2 diabetes mellitus patients in Korean adults

“…As people ages, the ability of host defense mechanism may decrease with increase in the influence of accumulated periodontal destruction resulting in gradual tooth loss. Another epidemiologic study also suggested that specific bacteria played an important role in older adults with periodontal disease 26. In both univariate and multivariate logistic regression analysis of this study, old age groups showed significantly higher odds ratios and higher tooth loss rate.…”

Clinical and microbiological effects of different antimicrobials on generalized aggressive periodontitis

“…In contrast, the administration of metronidazole did not enhance the effects of SRP on A. actinomycetemcomitans in this group and the levels of this species did not differ at 6 months compared with baseline. Metronidazole has been proven effective against anaerobic periodontal pathogens in several studies (Loesche et al 1984, 1991, Feres et al 2001, Sigusch et al 2001) but its effects on A. actinomycetemcomitans are somewhat controversial (Aitken et al 1992, Loesche et al 1992, Saxen & Asikainen 1993).…”

Effects of nonsurgical periodontal therapy on the microbiota

“…Metronidazole has been the focus of research in many years due to its antimicrobial activity against gram‐positive and gram‐negative anaerobes (68, 108). It can suppress subgingival pathogens like spirochetes, motile rods, P. intermedia, and P. gingivalis , and is effective in various forms of periodontitis (2, 38, 89–91, 120, 162, 210). However, there have been reports of reappearance with time of pathogenic bacteria after systemic metronidazole therapy (53, 108).…”