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

Cássia F. Araujo, Naira M.R.B. Andere, Nídia C.Castro Dos Santos, Ingrid F. Mathias-Santamaria, Aurélio A. Reis, Luciane D. de Oliveira, Maria A.N. Jardini, Renato C.V. Casarin, Mauro P. Santamaria

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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).

Original languageEnglish
Pages (from-to)1431-1440
Number of pages10
JournalJournal of Periodontology
Volume90
Issue number12
DOIs
StatePublished - 2019

Bibliographical note

Funding Information:
The authors appreciate the financial support provided by grants #2014/22078-4 and #2018/02161-5 from São Paulo Research Foundation (FAPESP), Brazil, and #301102/2016-3 from National Council for Scientific and Technological Development (CNPq), Brazil, for supporting Dr. Mauro P. Santamaria. The authors report no conflicts of interest related to this study.

Publisher Copyright:
© John Wiley and Sons Inc. All rights reserved.

Keywords

  • aggressive periodontitis
  • amoxicillin
  • anti-infective agents
  • clarithromycin
  • metronidazole
  • periodontal debridement

ASJC Scopus subject areas

  • Periodontics

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