Amoxicillin and Metronidazole as an Adjunct to Full-Mouth Scaling and Root Planing of Chronic Periodontitis
Amoxicillin and Metronidazole as an Adjunct to Full-Mouth Scaling and Root Planing of Chronic Periodontitis
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DOI：
10.1902/jop.2009.080540
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发表时间：
2009-03-01
影响因子：
4.3
通讯作者：
Mombelli, Andrea
中科院分区：
文献类型：
--
作者：
Cionca, Norbert;Giannopoulou, Catherine;Mombelli, Andrea
工作背景：有人建议，在几个小时内对所有牙周袋进行刮治和根面平整，并进行洗必泰治疗（全口消毒），可以减少对补充治疗的需求。本研究的目的是评估阿莫西林和甲硝唑管理完成后立即全口牙周清创术在慢性牙周炎patients with chronic periodontitis.Methods：这是一个单中心，双盲，安慰剂对照，随机纵向研究6个月的持续时间的临床效益。51例患者在48小时内接受了全口牙周清创术。25名受试者接受甲硝唑，500毫克，阿莫西林，375毫克，每天三次，7 days; 26名受试者接受安慰剂。治疗前未观察到临床参数差异。试验组的总体平均探测深度从4.3 +/- 0.4 mm降至3.0 +/- 0.2 mm，对照组从4.4 +/- 0.4 mm降至3.1 +/- 0.3 mm（P=0.05，组间差异）。更重要的是，受试者的持续性囊袋>4 mm和需要进一步治疗的探诊出血的平均数量显著较低（P=0.005）：全口清创术加抗生素后6个月，仅存在0.4 +/- 0.8个持续性囊袋，而对照组中仍存在3.0 - 4.3个持续性囊袋。6个月后，每例患者有一个以上牙周袋深度超过4 mm且探诊出血的抗生素保护风险为8.85。结论：全身应用甲硝唑和阿莫西林可显著改善全口非手术牙周清创术的6个月临床疗效，从而显著减少额外治疗的需要。牙周病学杂志2009;80：364-371。
Background: It has been suggested that scaling and root planing of all pockets within a few hours and chlorhexidine treatments (full-mouth disinfection) may reduce the need for supplementary therapies. The aim of this study was to evaluate the clinical benefit of amoxicillin and metronidazole administered immediately after completion of full-mouth periodontal debridement in patients with chronic periodontitis.Methods: This was a single-center, double-masked, placebo-controlled, randomized longitudinal study of 6 months' duration. Fifty-one patients received full-mouth periodontal debridement, performed within 48 hours. Twenty-five subjects received metronidazole, 500 mg, and amoxicillin, 375 mg, three times a day for 7 days; 26 subjects received a placebo.Results: Forty-seven patients could be followed up to month 6. No differences in clinical parameters were noted before treatment. The overall mean probing depth decreased from 4.3 +/- 0.4 mm to 3.0 +/- 0.2 mm in the test group and from 4.4 +/- 0.4 mm to 3.1 +/- 0.3 mm in the control group (P=0.05, difference between groups). More importantly, test subjects had a significantly lower mean number of persisting pockets >4 mm and bleeding on probing that required further treatment (P=0.005): 6 months after full-mouth debridement plus antibiotics, only 0.4 +/- 0.8 persisting pockets were still present, whereas 3.0 4.3 persisting pockets were still present in the control group. The protective risk of the antibiotics for having more than one pocket deeper than 4 mm and bleeding on probing per subject after 6 months was 8.85.Conclusion: Systemic metronidazole and amoxicillin significantly improved the 6-month clinical outcomes of full-mouth non-surgical periodontal debridement, thus significantly reducing the need for additional therapy. J Periodontol 2009;80:364-371.