Adjunctive
systemic administration of amoxicillin/metronidazole (AM) in generalized
aggressive periodontitis (gAP) therapy results in periodontal long-term
stability. However, the use of antibiotics should be limited due to possible
side effects and increasing bacterial resistances. Chlorhexidindigluconate in a
controlled-delivery-device (PerioChip®, Objectives:
The
effect of adjunctive use of PC in the treatment of gAP was investigated.
Efficacy of PC was compared to the standard treatment with AM.
Methods:
36
Patients (18/group, 35±4 years) with untreated gAP were treated by SRP and randomly
assigned to either systemic AM (500mg/250mg 3x/d for 10d) or local application
of PC at every site with PD≥5mm. Clinical parameters PD, CAL, BoP and Pus
were recorded at 6 sites/tooth with a pressure-sensitive periodontal probe
(Florida Probe, USA) at baseline, 3 and 6 months after therapy by the blinded
investigator. During supportive periodontal care at month 3, application of PC
was repeated at sites with remaining PD≥5mm.
Results:
At
month 3, initial mean PD/patient was decreased from 4.1±0.8mm to 2.4±0.4mm for
AM and from 3.8±0.8mm to 2.5±0.4mm for PC. Mean CAL/patient changed from 4.9±1.2mm
to 4.0±1.2mm for AM and from 4.6±1.1mm to 4.0±1.0mm for PC. Changes within
groups were significant (p<0.001), while no differences between groups could
be found. At month 6, for AM no significant change could be observed with PD 2.3±0.4mm
and CAL 4.0±1.1mm. For PC, PD worsened significantly to 2.6±0.5mm (p=0.013)
between months 3 and 6. After 6 months, AM showed significant (p<0.006) more
PD reduction and Conclusion:
AM
showed higher efficacy in terms of PD reduction,
Supported
by German Research Foundation (DFG) GRK325