Adjunctive benefits of systemic amoxicillin and metronidazole in non-surgical treatment of generalized aggressive periodontitis: a randomized placebo-controlled clinical trial
Adjunctive benefits of systemic amoxicillin and metronidazole in non-surgical treatment of generalized aggressive periodontitis: a randomized placebo-controlled clinical trial
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DOI：
10.1111/j.1600-051x.2005.00814.x
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发表时间：
2005-10-01
影响因子：
6.7
通讯作者：
Tonetti, MS
中科院分区：
文献类型：
--
作者：
Guerrero, A;Griffith, GS;Tonetti, MS
背景资料：本研究的目的是评估阿莫西林和甲硝唑全身给药的非手术治疗全身侵袭性牙周炎（GAP）的连续性临床效果。方法：41例全身健康的受试者与GAP包括在这个为期6个月的双盲，安慰剂对照，随机临床试验。患者接受了一个疗程的全口非手术牙周治疗提供了超过24小时的时间内使用机器驱动和手动仪器。受试者接受了连续的全身抗生素疗程，包括500 mg阿莫西林和500 mg甲硝唑，每天三次，共7天。临床参数收集在基线，并在2和6个月posttreatment.Results：在测试和安慰剂组，所有的临床参数在2个月和6个月改善。在深囊袋（>= 7 mm）中，试验治疗导致6个月时全口探测囊袋深度（PPD）额外减少1.4 mm（95%置信区间0.8，2.0 mm），寿命累积附着丧失（LCAL）增加1 mm（0.7，1.3 mm）。在中度囊袋（4 - 6 mm）中，预防性获益的幅度较小：PPD减少0.4 mm（0.1，0.7 mm），LCAL增加0.5 mm（0.2，0.8 mm）。此外，6个月的数据显示，试验组25%的部位LCAL增加>= 2 mm，而安慰剂组为16%（p = 0.028）。同样，在试验组30%的部位和安慰剂组21%的部位观察到PPD减少2 mm或以上。在试验组中，74%的基线PPD>= 5 mm的囊袋在6个月时为4 mm或更浅。而安慰剂组为54%（p = 0.008）。在6个月的疾病进展，观察在1.5%的测试和3.3%的网站在测试和安慰剂，分别（p = 0.072）。结论：这些数据表明，为期7天的全身甲硝唑和阿莫西林的连续疗程显着改善了短期的临床结果，全口非手术牙周清创术与GAP的主题。
Background: The objective of this study was to assess the adjunctive clinical effect of the administration of systemic amoxicillin and metronidazole in the non-surgical treatment of generalized aggressive periodontitis (GAP).Methods: Forty-one systemically healthy subjects with GAP were included in this 6-month double-blind, placebo-controlled, randomized clinical trial. Patients received a course of full-mouth non-surgical periodontal treatment delivered over a 24 h period using machine-driven and hand instruments. Test subjects received an adjunctive course of systemic antibiotic consisting of 500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days. Clinical parameters were collected at baseline, and at 2 and 6 months post-treatment.Results: In both the test and the placebo groups, all clinical parameters improved at 2 and 6 months. In deep pockets ( >= 7 mm), the test treatment resulted in an additional 1.4 mm (95% confidence interval 0.8, 2.0 mm) in full-mouth probing pocket depth (PPD) reduction and 1 mm (0.7, 1.3 mm) of life cumulative attachment loss (LCAL) gain at 6 months. In moderate pockets (4-6 mm), the adjunctive benefit was smaller in magnitude: PPD reduction was 0.4 mm (0.1, 0.7 mm) and LCAL gain was 0.5 mm (0.2, 0.8 mm). In addition, the 6-month data showed LCAL gains >= 2 mm at 25% of sites in test patients compared with 16% in placebo (p = 0.028). Similarly, PPD reductions of 2 mm or more were observed in 30% of sites in test and 21% of sites in placebo patients. Seventy-four percent of pockets with PPD >= 5 mm at baseline were 4 mm or shallower at 6 months in the test group. This compared with 54% in the placebo group (p = 0.008). Disease progression at 6 months was observed at 1.5% of test and 3.3% of sites in test and placebo, respectively (p = 0.072).Conclusions: These data indicate that a 7-day adjunctive course of systemic metronidazole and amoxicillin significantly improved the short-term clinical outcomes of full-mouth non-surgical periodontal debridement in subjects with GAP.