Chronic and Aggressive Periodontitis Respond Equally Well to Adjunctive Antibiotics

Objectives: The aim of this clinical trial was to compare the clinical effects of scaling and root planing (SRP) plus systemic metronidazole (MTZ) and amoxicillin (AMX) between subjects with generalized chronic (GChP) and aggressive periodontitis (GAgP).

Methods: Thirty six subjects with GChP (n=18) and GAgP (n=18) received SRP combined with 400 mg MTZ + 500 mg AMX (both TID/14 days. SRP was performed in 14 days and the antibiotic intake started immediately after the first session of mechanical instrumentation. The following clinical parameters were evaluated at six sites per tooth: plaque index, gingival bleeding index, probing depth (PD), clinical attachment (CA), bleeding on probing and suppuration. Subjects were clinically monitored at baseline and 3 and 6 months post-therapy.
Results: No statistically significant differences were observed between groups for any clinical parameters evaluated at 6 months post-therapy. Both groups exhibited a statistically significant reduction in mean PD (GAgP: 3.88 mm ± 1.16 mm, GChP: 4.10 mm ± 0.67 mm) and gain in mean CA (GAgP: 3.30 mm ± 0.96 mm, GChP: 3.70 mm ± 0.72 mm) in sites with initial PD ≥ 7 mm between baseline and 6 months (p<0.05, ANCOVA test). No statistically significant differences were observed between groups for the mean reduction in number of sites with PD ≥ 5 mm post-therapy (GAgP: 29.99 ± 20.60, GChP: 31.80 ± 14.79), and at 6 months both groups exhibited a low mean number of these residual sites (GChP 4.2 ± 6.2 and GAgP: 3.9 ± 7.3) (p>0.05, ANCOVA test). The frequency of adverse events did not differ between groups (p>0.05, Chi-square test).

Conclusions: Subjects with GAgP and GChP equally benefit from the adjunctive administration of systemic MTZ+AMX in the active phase of the periodontal treatment.