Comparing the periodontal tissue response to non‐surgical scaling and root planing alone, adjunctive azithromycin, or adjunctive amoxicillin plus metronidazole in generalised chronic moderate‐to‐severe periodontitis: a preliminary randomised controlled trial

Abstract

Background

The usefulness of administrating adjunctive systemic antibiotics to expedite healing of periodontal tissues is a topic of interest given the lack of clear guidelines.

Aim

To compare clinical outcomes in patients given adjunctive azithromycin (AZ), adjunctive amoxicillin plus metronidazole (AMX+MTZ), or scaling and root planing (SRP) alone in the treatment of moderate‐to‐severe chronic periodontitis.

Methods

Thirty‐eight patients were randomly assigned into: SRP alone; 500mg AMX plus 400 mg MTZ three times per day for seven days; or 500mg AZ for three days. Antibiotics were administered after the first SRP session and clinical parameters for full‐mouth and baseline probing pocket depth (PPD) categories were reviewed two‐months post‐treatment.

Results

Thirty‐four of 38 patients completed the study. All groups experienced significant improvements in full‐mouth clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing. AZ exhibited greater reductions in PPD than SRP alone for baseline severe sites, whilst AMX+MTZ showed significant improvements in PPD and CAL than SRP alone for baseline moderate and severe sites. Of the two antibiotic therapies, AMX+MTZ demonstrated greater reductions in PPD compared with AZ in baseline moderate sites only.

Conclusions

For patients with moderate‐to‐severe periodontitis, adjunctive systemic antibiotics may result in greater clinical benefits.

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