Metronidazole and amoxicillin as adjuncts to scaling and root planing for the treatment of type 2 diabetic subjects with periodontitis: 1‐year outcomes of a randomized placebo‐controlled clinical trial

Miranda, Tamires Szeremeske; Feres, Magda; Pérez-Chaparro, Paula Juliana; Faveri, Marcelo; Figueiredo, Luciene Cristina; Tamashiro, N.; Bastos, Marta Ferreira; Duarte, Poliana Mendes

doi:10.1111/jcpe.12282

Cited by 72 publications

(137 citation statements)

References 39 publications

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“…The study investigators reported on 6 major groups of antimicrobials: amoxicillin and metronidazole combination therapy, 18,44,45,47,50,55,60 metronidazole, 39,52,61 erythromycin analogues (azithromycin 39,46,49,51,[56][57][58][59] and clarithromycin 53 ), moxifloxacin 48 (a fourth-generation fluoroquinolone antibacterial agent), and others (for example, tetracycline 20,43,54 and doxycycline 22,48,62 as the antimicrobial dose of doxycycline, not to be confused with SDD, which is covered in a separate section). The variety of dosing regimens used for each systemic antimicrobial drug is described elsewhere.…”

Section: Moderatementioning

confidence: 99%

See 1 more Smart Citation

Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts

Smiley¹,

Tracy²,

Abt³

et al. 2015

The Journal of the American Dental Association

231

199

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Section: Moderatementioning

confidence: 99%

“…Compared with SRP alone, SRP plus systemic antimicrobials resulted in a 0.35-mm mean gain in CAL (95% CI, 0.20-0.51) ( Figure 5). 18,20,22,39,[43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] We judged the overall level of certainty in the evidence to be moderate on the basis of the evidence profile in Table 3.…”

Section: Moderatementioning

confidence: 99%

Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts

Smiley¹,

Tracy²,

Abt³

et al. 2015

The Journal of the American Dental Association

231

199

View full text Add to dashboard Cite

“…The patients treated with antibiotics had greater reduction in three high-risk pathogens: Tf , Td , Pg . Again, this is a very small study, and results need to be interpreted with caution 35. Issues with management extend beyond simply the initial therapy of high-risk pathogens.…”

Section: Discussionmentioning

confidence: 87%

“…Again, this is a very small study, and results need to be interpreted with caution. 35 Issues with management extend beyond simply the initial therapy of high-risk pathogens. What is the most effective manner in which to maintain periodontal health?…”

Section: Discussionmentioning

confidence: 99%

High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis

Bale

Doneen

Vigerust

2016

Postgraduate Medical Journal

100

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Periodontal disease (PD) is generated by microorganisms. These microbes can enter the general circulation causing a bacteraemia. The result can be adverse systemic effects, which could promote conditions such as cardiovascular disease. Level A evidence supports that PD is independently associated with arterial disease. PD is a common chronic condition affecting the majority of Americans 30 years of age and older. Atherosclerosis remains the largest cause of death and disability. Studies indicate that the adverse cardiovascular effects from PD are due to a few putative or high-risk bacteria: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola or Fusobacterium nucleatum. There are three accepted essential elements in the pathogenesis of atherosclerosis: lipoprotein serum concentration, endothelial permeability and binding of lipoproteins in the arterial intima. There is scientific evidence that PD caused by the high-risk pathogens can influence the pathogenesis triad in an adverse manner. With this appreciation, it is reasonable to state PD, due to high-risk pathogens, is a contributory cause of atherosclerosis. Distinguishing this type of PD as causal provides a significant opportunity to reduce arterial disease.

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“…Few studies reported the effects of AMX and MTZ on response of inflammatory biomarker (Almaghlouth, Cionca, Cancela, Decaillet, Courvoisier, Giannopoulou, & Mombelli, 2014, Giannopoulou et al, 2016). Furthermore, the effect of the combination of AMX and MTZ on diabetes has also been reported (Miranda et al, 2014). However, most of these studies focused on the effects of one or two antibiotics, and these have not compared the effectiveness with other antibiotics.…”

Section: Introductionmentioning

confidence: 91%

Antibiotic effects against periodontal bacteria in organ cultured tissue

Takeshita

Haraguchi

Miura

et al. 2016

Clinical & Exp Dental Res

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Mechanical reduction of infectious bacteria by using physical instruments is considered the principal therapeutic strategy for periodontal disease; addition of antibiotics is adjunctive. However, local antibiotic treatment, combined with conventional mechanical debridement, has recently been shown to be more effective in periodontitis subjects with type 2 diabetes. This suggests that some bacteria may invade the inflamed inner gingival epithelium, and mechanical debridement alone will be unable to reduce these bacteria completely. Therefore, we tried to establish infected organ culture models that mimic the inner gingival epithelium and aimed to see the effects of antibiotics in these established models. Mouse dorsal skin epithelia were isolated, and periodontal bacteria were injected into the epithelia. Infected epithelia were incubated with test antibiotics, and colony‐forming ability was evaluated. Results indicated that effective antibiotics differed according to injected bacteria and the bacterial combinations tested. Overall, in organ culture model, the combination of amoxicillin or cefdinir and metronidazole compensate for the effects of less effective bacterial combinations on each other. This in vitro study would suggest effective periodontal treatment regimens, especially for severe periodontitis.

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Metronidazole and amoxicillin as adjuncts to scaling and root planing for the treatment of type 2 diabetic subjects with periodontitis: 1‐year outcomes of a randomized placebo‐controlled clinical trial

Abstract: The adjunctive use of MTZ+AMX significantly improved the clinical and microbiological outcomes of SRP in the treatment of type 2 diabetic subjects with ChP.

Cited by 72 publications

References 39 publications

Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts

Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts

High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis

Antibiotic effects against periodontal bacteria in organ cultured tissue

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