Elsevier

Dental Abstracts

Volume 62, Issue 2, March–April 2017, Page 102
Dental Abstracts

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Adding antibiotics to scaling and root planing

https://doi.org/10.1016/j.denabs.2016.09.045Get rights and content

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Background

Patients with diabetes mellitus (DM) have a higher prevalence and severity of periodontal destruction compared to persons without DM. Even after scaling and root planing (SRP), many patients with DM have a high number of residual pockets and periodontal pathogens present. As a result, clinicians are considering the use of adjunctive therapies to improve SRP outcomes in these patients. Metronidazole (MTZ) and amoxicillin (AMX) are often considered the most promising treatment for chronic and

Methods

Twenty-nine patients were randomly assigned to receive SRP only (control group) and another 29 were randomly assigned to receive SRP + MTZ (400 mg three times a day) + AMX (500 mg three times a day) for 14 days. Six subgingival plaque samples from each subject were analyzed to detect 40 bacterial species at baseline and after 3 months, 1 year, and 2 years. The microbial agents were divided into five (red, orange, and green complexes: Actinomyces species; and “others”) and three (red and orange

Results

Both treatments significantly reduced the proportion of the red complex agents after 3 months, with the SRP group dropping from 16.3% to 7.6% and the SRP + MTZ + AMX group dropping from 17.8% to 5.3%. The proportion of red complex agents was maintained for up to 2 years in the antibiotic group but increased in the control group. The difference between the two groups at 2 years was statistically significant.

Individuals considered at low risk for future progression of their disease were also

Discussion

SRP + MTZ + AMX was more effective than SRP only for altering the composition of the subgingival biofilm in patients with type 2 DM and producing a profile more compatible with good periodontal health. The effect of using these antibiotics along with SRP was sustained for up to 2 years after the intervention.

Clinical Significance

The clinical parameters we look for in patients were positively altered in this population of patients with periodontitis and DM by adding antibiotics to SRP. The

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Tamashiro NS, Duarte PM, Miranda TS, et al: Amoxicillin plus metronidazole therapy for patients with periodontitis and type 2 diabetes: A 2-year randomized controlled trial. J Dent Res 95:829-836, 2016

Reprints available from M Feres, Centro de Pós-Graduação e Pesquisa-CEPPE, Universidade Guarulhos, Praça Tereza Cristina, 229 Centro, 07023-070 Guarulhos, SP, Brazil; e-mail: [email protected]

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