Two different antibiotic protocols as adjuncts to one‐stage full‐mouth ultrasonic debridement to treat generalized aggressive periodontitis: A pilot randomized controlled clinical trial

Abstract

Background To assess the clinical and microbiological responses of amoxicillin + metronidazole (AMX + MET) versus clarithromycin (CLM) as adjuncts to one‐stage full‐mouth ultrasonic debridement (FMUD) in the treatment of generalized aggressive periodontitis (GAgP). Methods For this parallel, double‐masked, pilot randomized clinical trial, 46 patients with GAgP were selected and randomly assigned into two groups: AMX+MET group (n = 23): FMUD associated with AMX (500 mg three times a day) and MET (400 mg three times a day) for 7 days; and CLM group (n = 23): FMUD associated with CLM (500 mg twice a day) for 7 days. Clinical parameters were evaluated at baseline, 3, and 6 months post‐treatment. The levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum from subgingival biofilm were determined by quantitative polymerase chain reaction. Results Both treatments significantly improved all clinical parameters compared with baseline and promoted a significant reduction of A. actinomycetemcomitans and P. gingivalis counts (P > 0.05). CLM succeeded in decreasing T. forsythia at 6 months (P < 0.05), but no antibiotic was able to reduce F. nucleatum. There was no difference between the two protocols regarding the reported adverse effects (P > 0.05). Conclusions The results suggest that CLM is not superior than AMX + MET in the treatment of GAgP. However, this antibiotic led to good clinical outcomes and may be a possible alternative to AMX+MET in the treatment of severe periodontitis in young patients. Future studies with larger sample sizes are needed to confirm this statement (NCT02969928).

Omega‐3 PUFA and aspirin as adjuncts to periodontal debridement in patients with periodontitis and type 2 diabetes mellitus: Randomized clinical trial

“…Patients who fulfilled the inclusion criteria were invited to participate in the study. Inclusion criteria were: Stages III and IV, Grades B and C periodontitis with at least six sites with PD and CAL ≥ 5 mm and bleeding on probing (BoP); 26,27 ≥15 teeth; aged ≥35; diagnosis of type 2 diabetes for ≥5 years, under treatment for diabetes with oral hypoglycemic agents; and/or insulin, with glycated hemoglobin (HbA1c) levels ≥6.5% to ≤11%. Exclusion criteria were: need for prophylactic antimicrobial coverage; SRP in the previous 6 months; antimicrobial therapy in the previous 6 months; systemic conditions (other than diabetes) that could affect the progression of periodontitis; long-term use of medication that could interfere with periodontal response; pregnancy or lactation; smoking; allergy to fish/seafood or ASA.…”

Adjunctive Application of Systemic Antibiotics in Non-surgical Aggressive Periodontitis Treatment: Clinical and Microbiological Findings

“…Since different antibiotics have provided distinctive outcomes in AgP treatment, the disagreements mainly occur regarding the type of antibiotics that should be used as a supplementation to APT [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19]. The use of amoxicillin (AMX) and metronidazole (MET) together (AMX-MET) is considered to be the most efficient, since the PPs of red and orange complexes, as well as A.a. are sensitive to both antibiotics [20], [21].…”

Effects of eradication of Helicobacter pylori on oral malodor and the oral environment: a single-center observational study

“…Prior studies assessed subjective symptoms of oral malodor using questionnaires and interviews; however, it is difficult for an individual to evaluate their own oral malodor accurately [13,14]. Second, it is necessary to clarify the effects of the antibiotics used for H. pylori eradication on the oral microbiota, since those antibiotics are reportedly effective against periodontal disease [15,16].…”