Liaw, A., Miller, C., and Nimmo, A. (2019) Comparing the periodontal tissue response to non‐surgical scaling and root planing alone, adjunctive azithromycin, or adjunctive amoxicillin plus metronidazole in generalized chronic moderate‐to‐severe periodontitis: a preliminary randomized controlled trial. Australian Dental Journal, 64 (2). pp. 145-152.

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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; 500 mg AMX plus 400 mg MTZ three times per day for 7 days; or 500 mg AZ for 3 days. Antibiotics were administered after the first SRP session and clinical parameters for full‐mouth and baseline probing pocket depth (PPD) categories were reviewed 2‐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 showed greater reductions in PPD compared with AZ in baseline moderate sites only.

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

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