Effectiveness of Systemic Amoxicillin/Metronidazole as an Adjunctive Therapy to Full‐Mouth Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A Systematic Review and Meta‐Analysis

Sgolastra, Fabrizio; Petrucci, Ambra; Gatto, Roberto; Monaco, Annalisa

doi:10.1902/jop.2011.110432

Cited by 115 publications

(136 citation statements)

References 51 publications

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“…Although antibiotics are useful adjuncts to mechanical therapy in the treatment of aggressive periodontitis [36], concerns about overall efficacy and gastrointestinal side effects, and growing concerns about antibiotic resistance contraindicate their routine use in chronic periodontitis patients [37]. Systemic antibiotics, however, were allowed as part of rescue treatment for Treatment Group participants (Section 2.12.2).…”

Section: Methodsmentioning

confidence: 99%

Design features of the Diabetes and Periodontal Therapy Trial (DPTT): A multicenter randomized single-masked clinical trial testing the effect of nonsurgical periodontal therapy on glycosylated hemoglobin (HbA1c) levels in subjects with type 2 diabetes and chronic periodontitis

Engebretson¹,

Gelato²,

Hyman³

et al. 2013

Contemporary Clinical Trials

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Background Evidence suggests that periodontitis is associated with prevalent and incident type 2 diabetes mellitus (T2DM), raising the question of whether periodontitis treatment may improve glycemic control in patients with T2DM. Meta-analyses of mostly small clinical trials suggest that periodontitis treatment results in a modest reduction in glycosylated hemoglobin (Hb) A1c. Purpose The purpose of the Diabetes and Periodontal Therapy Trial (DPTT) was to determine if periodontal treatment reduces HbA1c in patients with T2DM and periodontitis. Methods DPTT was a phase-III, single-masked, multi-center, randomized trial with a planned enrollment of 600 participants. Participants were randomly assigned to receive periodontal treatment immediately (Treatment Group) or after 6 months (Control Group). HbA1c values and clinical periodontal measures were determined at baseline and 3 and 6 months following randomization. Medication usage and dosing were assessed at each visit. Periodontal treatment consisted of scaling and root planing for a minimum of two 90-minute sessions, plus the use of an antibacterial mouth rinse for at least 32 days afterwards. The primary outcome was change in HbA1c from baseline to 6 months and the trial was powered to detect a between-group difference of 0.6%. Secondary outcomes included changes in periodontal clinical measures, fasting plasma glucose, the Homeostasis Model Assessment (HOMA2) and the need for rescue diabetes or periodontal therapy. Conclusion Dental and medical researchers collaborated to recruit, treat and monitor participants with two chronic diseases to determine if treatment of one condition affects the status of the other.

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Section: Methodsmentioning

confidence: 99%

Design features of the Diabetes and Periodontal Therapy Trial (DPTT): A multicenter randomized single-masked clinical trial testing the effect of nonsurgical periodontal therapy on glycosylated hemoglobin (HbA1c) levels in subjects with type 2 diabetes and chronic periodontitis

Engebretson¹,

Gelato²,

Hyman³

et al. 2013

Contemporary Clinical Trials

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“…Full-text reviews of the remaining 33 articles resulted in the exclusion of 24 articles, which left nine SRs for inclusion in the study (Table 2). [19][20][21][22][23][24][25][26][27] Figure 1 illustrates the literature search results in detail.…”

Section: Resultsmentioning

confidence: 99%

An overview of systematic reviews of the use of systemic antimicrobials for the treatment of periodontitis

et al. 2014

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“…The benefits of the adjunctive use of antibiotics in the treatment of destructive periodontal diseases have been demonstrated. 17,18 However, the efficacy of classic chemotherapeutic agents has been influenced by their complex dosing schedule, low compliance, development of bacterial resistance, and other side effects. 17 In contrast, azithromycin has a convenient dosing schedule, thus potentially increasing compliance, 19 and is effective against major periodontopathogens.…”

Section: Discussionmentioning

confidence: 99%

Predictors of clinical outcomes after periodontal treatment of aggressive periodontitis: 12-month randomized trial

et al. 2016

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Little is known about the factors that may be used in clinical practice to predict the therapeutic response of aggressive periodontitis patients. The aim of this study was to determine predictors of clinical outcomes after non-surgical treatment of aggressive periodontitis. A total of 24 patients (aged 13-26 years) received oral hygiene instructions, as well as subgingival scaling and root planing. Twelve subjects received systemic azithromycin at random. Clinical variables were assessed at baseline, 3, 6, 9, and 12 months. Baseline microbiological assessment was performed by checkerboard DNA-DNA hybridization. Multivariable models used generalized estimating equations. There were significant improvements in the entire sample in regard to pocket depth, clinical attachment level and bleeding on probing. Significant predictors of a reduction in mean pocket depth were: use of azithromycin, non-molar teeth, generalized disease and baseline pocket depth. Absence of plaque predicted a 0.22 mm higher attachment gain, whereas a baseline pocket depth ≥7 mm predicted a 1.36 mm higher attachment loss. Azithromycin, plaque, and baseline pocket depth were significant predictors of bleeding on probing. The concomitant presence of all three red complex species predicted a 0.78 mm higher attachment loss. It may be concluded that dental plaque, tooth type, disease extent, baseline pocket depth, and use of azithromycin were significant predictors of the clinical response to treatment for aggressive periodontitis in young individuals. Moreover, the presence of multiple periodontal pathogens may predict challenges in achieving a favorable outcome for aggressive periodontitis.

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Effectiveness of Systemic Amoxicillin/Metronidazole as an Adjunctive Therapy to Full‐Mouth Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A Systematic Review and Meta‐Analysis

Abstract: The findings of the meta-analysis seem to support the effectiveness and the clinical safety of FMSRP + AMX/MET; however, future studies are needed to confirm these results.

Cited by 115 publications

References 51 publications

Design features of the Diabetes and Periodontal Therapy Trial (DPTT): A multicenter randomized single-masked clinical trial testing the effect of nonsurgical periodontal therapy on glycosylated hemoglobin (HbA1c) levels in subjects with type 2 diabetes and chronic periodontitis

Design features of the Diabetes and Periodontal Therapy Trial (DPTT): A multicenter randomized single-masked clinical trial testing the effect of nonsurgical periodontal therapy on glycosylated hemoglobin (HbA1c) levels in subjects with type 2 diabetes and chronic periodontitis

An overview of systematic reviews of the use of systemic antimicrobials for the treatment of periodontitis

Predictors of clinical outcomes after periodontal treatment of aggressive periodontitis: 12-month randomized trial

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