Non‐surgical periodontal treatment in conjunction with 3 or 7 days systemic administration of amoxicillin and metronidazole in severe chronic periodontitis patients. A placebo‐controlled randomized clinical study

Cosgarea, Raluca; Juncar, Raluca Iulia; Heumann, Christian; Tristiu, Roxana; Lascu, Liana; Arweiler, Nicole Birgit; Stavropoulos, Andreas; Sculean, Anton

doi:10.1111/jcpe.12559

Cited by 35 publications

(70 citation statements)

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“…This study was designed as a randomized, placebo controlled, double-masked clinical trial testing the hypothesis that “the systemic use of AMX and MET administered for 3 or 7 days as adjunct to SD leads to superior clinical results compared with SD alone” [11]. …”

Section: Methodsmentioning

confidence: 99%

“…The clinical protocol was presented in detail previously [11]. Briefly, 102 subjects seeking dental treatment at the Dental University Clinic (University “Iuliu Hatieganu”, Cluj-Napoca) were included and treated as follows: patient recruitment lasted between 10.01.2012–01.03.2014, subgingival debridement was performed between 20.01.2012–30.06.2014 and the follow-up period was between 03.02.2012 (2 weeks post debridement)– 05.06.2015.…”

Section: Methodsmentioning

confidence: 99%

“…For 14 days, subjects rinsed with a 0.2% chlorhexidine digluconate solution (Corsodyl ® , GlaxoSmithKline, Brentford, London, UK, twice daily for 2 minutes) and brushed their teeth with 0.2% chlorhexidine digluconate tooth paste (Elugel ® , Pierre Fabre, Paris, France). At the end of the SD sessions, patients were allocated by another clinician (RT) to one of the three treatment groups, received their medications and intake instructions (for detailed description about the bottle pills see [11]). Two weeks following SD, patients were asked about compliance with study medication and possible adverse effects after pills intake.…”

Section: Methodsmentioning

confidence: 99%

“…actinomycetemcomitans and other periodontopathogenic bacteria from periodontally compromised sites [14–18]. Statistically and clinically significantly better clinical outcomes in terms of probing pocket depth (PD) reduction and clinical attachment level (CAL) gain were observed when the combination of AMX + MET was administered adjunctively to SRP compared to treatment with SRP alone [10, 11, 19–29]. Additionally, this adjunctive antibiotic treatment regimen yielded a statistically significant reduction of periodopathogenic bacteria and of inflammatory cytokines compared to SRP alone [19–31].…”

Section: Introductionmentioning

confidence: 99%

“…use for at least 7 days) are absent. We recently evaluated the clinical outcomes of a 3-day regimen of AMX and MET adjunctive to SRP in severe chronic periodontitis at 6 months showing that both 3 and 7 days adjunctive administration of these antibiotics led to statistically significant better clinical improvements compared to SRP alone at 6 months [11]. However, at present, it is unknown to what extent the results obtained with the short-term administration of AMX and MET remain stable over a longer period of time (e.g.…”

Section: Introductionmentioning

confidence: 99%

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One year results of a randomized controlled clinical study evaluating the effects of non-surgical periodontal therapy of chronic periodontitis in conjunction with three or seven days systemic administration of amoxicillin/metronidazole

et al. 2017

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BackgroundTo evaluate the clinical outcomes 12 months after systemic administration of amoxicillin (AMX) and metronidazole (MET) adjunctive to subgingival debridement (SD) in patients with severe chronic periodontitis (sChP).Material and methods102 patients with sChP were treated randomly as follows: SD within 2 consecutive days and placebo for 7 days (group A), SD+AMX+MET (both 500mg x3 times daily TID) for 3 days (group B), SD+AMX+MET (both 500mg x 3 TID) for 7 days (group C). At baseline, at 3-, 6-, and 12-months post-treatment probing pocket depth (PD), clinical attachment level (CAL), furcation involvement, bleeding on probing (BOP), full-mouth plaque score (FMPS) were determined. The reduction in the number of sites with PD≥6mm was defined as main outcome variable.Results75 patients completed the study. At 12 months, all three treatment groups showed statistically significant improvements (p<0.001) of mean PD, CAL, BOP and number of sites with PD≥6mm compared to baseline. Mean residual PD were statistically significantly lower and CAL gain statistically significantly greater in the two antibiotic groups as compared to placebo. While PD reductions (p = 0.012) and CAL gain (p = 0.017) were statistically significantly higher in group C compared to group A, only the 3-day AB group showed statistically significantly fewer sites with PD≥6mm at 12 m (p = 0.003). The reduction in the number of sites with PD≥6 mm (primary outcome) showed no statistical significant differences between the 3 treatment groups. However, in both antibiotic groups significantly more patients compared to the placebo group reached a low risk for disease progression at 12 months (≤4 sites with PD≥5mm).ConclusionAt 12 months, both adjunctive antibiotic protocols resulted in statistically significantly greater clinical improvements compared to placebo.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

One year results of a randomized controlled clinical study evaluating the effects of non-surgical periodontal therapy of chronic periodontitis in conjunction with three or seven days systemic administration of amoxicillin/metronidazole

et al. 2017

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Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis

Khattri

Nagraj

Arora

et al. 2020

Cochrane Database of Systematic Reviews

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Influence of psychological stress on non‐surgical periodontal treatment outcomes in patients with severe chronic periodontitis

Petit

Anadon-Rosinach

Rettig

et al. 2020

Journal of Periodontology

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Background The aim of this study was to evaluate the influence of psychological stress on non‐surgical periodontal treatment (SRP) outcomes in patients with severe chronic periodontitis (stage 3/4 generalized periodontitis) at 6 months in the French population. Methods Patients diagnosed with severe generalized chronic periodontitis (periodontitis stage 3/4) were included in this study. At baseline, psychological status was evaluated by self‐administered questionnaire (Depression Anxiety Stress Scale 42 [DASS‐42] and Toulouse coping scale [TCS]). Plasma levels of cortisol and chromogranin‐A were determined. Patients were then managed by oral hygiene instructions, scaling and root planing of sites with PD >3 mm and followed at 3 and 6 months. Quantitative and qualitative variables were described and interactions were determined by linear and logistic regressions. Results Seventy‐one patients were included in this study and 54 were followed up to 6 months. An average probing depth (PD) reduction of 0.73 ± 0.11 mm and decrease of diseased sites (PD >3 mm) were measured at 6 months illustrating SRP efficacy. Multivariable analysis showed that increased DASS‐stress score was associated to worsened SRP outcomes in terms of bleeding on probing (BOP) (OR = 1.02, P <0.05) and mean PD (P <0.05) reduction. An increase of DASS‐depression score negatively influenced PD >5 mm (OR = 1.06, P <0.05), PD >7 mm (OR = 1.17, P <0.01), CAL >5 mm (OR = 1.03, P <0.05), and CAL >7 mm (OR = 1.07, P <0.05) reduction. Negative coping strategies were also associated with worsened SRP outcomes. Conclusions Patients with increased stress, anxiety, and depression scores as well as those exhibiting negative coping strategies demonstrate worsened SRP outcomes. DASS‐42 and TCS were useful to determine psychological status and their use could be incorporated to assess treatment prognosis.

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Non‐surgical periodontal treatment in conjunction with 3 or 7 days systemic administration of amoxicillin and metronidazole in severe chronic periodontitis patients. A placebo‐controlled randomized clinical study

Abstract: The present findings indicate that in patients with severe chronic periodontitis, non-surgical periodontal therapy in conjunction with a 3 or 7 days systemic administration of AMX + MET may lead to significantly greater clinical improvements compared to non-surgical therapy alone.

Cited by 35 publications

References 80 publications

One year results of a randomized controlled clinical study evaluating the effects of non-surgical periodontal therapy of chronic periodontitis in conjunction with three or seven days systemic administration of amoxicillin/metronidazole

One year results of a randomized controlled clinical study evaluating the effects of non-surgical periodontal therapy of chronic periodontitis in conjunction with three or seven days systemic administration of amoxicillin/metronidazole

Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis

Influence of psychological stress on non‐surgical periodontal treatment outcomes in patients with severe chronic periodontitis

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