Adjunctive systemic administration of amoxicillin/metronidazole (AM) in generalized aggressive periodontitis (gAP) therapy improves clinical treatment outcome, which also is reflected in changed levels of biomarkers measured in gingival crevicular fluid (GCF). The impact of adjunctive chlorhexidindigluconate in a controlled-delivery-device (PerioChip®, PerioProducts Israel) (PC) on clinical parameters in relation to biomarkers in GCF has not been evaluated in gAP therapy.
Objectives:
Clinical treatment outcome and GCF-levels of the inflammation marker calprotectin were analyzed at deep reference sites after adjunctive therapy with either AM or PC.
Methods:
36 Patients (18/group, 35±4 years) with untreated gAP received SRP and were 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, Pus and crevicular fluid flow rate (CFFR) were recorded at baseline, 3 and 6 months after therapy by the blinded investigator at patient’s initially two deepest sites. GCF-levels for calprotectin were measured by ELISA (BMA, Switzerland.
Results:
For AM, PD decreased from 7.9±1.1mm at baseline to 4.0±1.1mm after 3 months and further to 3.7±1.1mm after 6 months (p<0.001). For PC, PD decreased from 7.8±1.1mm at baseline to 4.3±1.4mm at month 3 (p<0.001) and stagnated at 4.6±1.3mm (p=0.115). PD reduction differed not significantly at month 3 between groups, reached however significant level after 6 months (p=0.007). For AM, calprotectin concentration decreased from 59.5±83.8µg/µl at baseline to 23.0±20.8µg/µl after 3 months (p=0.001) and remained constant with 19.9±17.4µg/µl after 6 months (p=0.943). For PC, calprotectin concentration decreased from 84.0±153.6µg/µl at baseline to 42.8±60.2µg/µl at month 3 (p=0.004) and stabilized at 40.5±63.2µg/µl (p=0.824). No significant differences were found between groups.
Conclusion:
AM showed higher efficacy in terms of clinical treatment outcome. Due to high standard deviations, calprotectin failed to reflect clinical differences.
Supported by German Research Foundation (DFG) GRK 325