Peter Eickholz1, Katrin Nickles2, Raphael Koch3, Inga Harks4, Thomas Hoffmann5, Ti-Sun Kim6, Thomas Kocher7, Jörg Meyle8, Doğan Kaner9,10, Ulrich Schlagenhauf11, Stephan Doering12, Martina Gravemeier4, Benjamin Ehmke4. 1. Department of Periodontology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany. eickholz@med.uni-frankfurt.de. 2. Department of Periodontology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany. 3. Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany. 4. Department of Periodontology, University Hospital Münster, Münster, Germany. 5. Department of Periodontology, TU Dresden, Dresden, Germany. 6. Section of Periodontology, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany. 7. Unit of Periodontology, University Medicine Greifswald, Greifswald, Germany. 8. Department of Periodontology, University of Giessen, Giessen, Germany. 9. Department of Periodontology, Witten/Herdecke University, Witten, Germany. 10. Department of Periodontology and Synoptic Dentistry, Charité Centrum 3, Charité-Universitäsmedizin Berlin, Berlin, Germany. 11. Department of Periodontology, University Hospital Würzburg, Würzburg, Germany. 12. Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Abstract
OBJECTIVES: Evaluation of the clinical effect of systemic amoxicillin and metronidazole adjunctively to mechanical debridement at furcation sites. MATERIAL AND METHODS: This is an exploratory per-protocol collective subanalysis from a prospective, randomized, double-blind, multi-centre trial (ClinicalTrials.gov NCT00707369) on the effect of adjunctive systemic amoxicillin 500 mg plus metronidazole 400 mg (3×/day, 7 days) use on furcation involvement in moderate to severe periodontitis. Outcome was the change in frequency of classes of furcation involvement after 27.5 months. Therapy comprised mechanical debridement in conjunction with antibiotic or placebo administration, and maintenance therapy at three months intervals. RESULTS:Three hundred and forty-five patients (175 placebo, 170 antibiotics) with 6576 furcation sites (class 0 2956; class I 2370; class II 886; class III 364) were examined (3472 placebo, 3104 antibiotics). Pocket reduction/attachment gain at the furcation sites was noticeably better after antibiotics (1.2/0.6 mm) than after placebo (0.7/0.2 mm) 27.5 months after therapy. However, most furcation degrees were unchanged (placebo 61.5%/antibiotics 62.2%), more sites improved than deteriorated (20.3%/18.2%, 22.1%/15.7% respectively) and no differences in the change of furcation degrees between treatments could be detected. CONCLUSION: Compared to placebo, prescription of adjunctive systemic antibiotics failed to show clinically relevant benefit with regard to furcation class involvement.
RCT Entities:
OBJECTIVES: Evaluation of the clinical effect of systemic amoxicillin and metronidazole adjunctively to mechanical debridement at furcation sites. MATERIAL AND METHODS: This is an exploratory per-protocol collective subanalysis from a prospective, randomized, double-blind, multi-centre trial (ClinicalTrials.gov NCT00707369) on the effect of adjunctive systemic amoxicillin 500 mg plus metronidazole 400 mg (3×/day, 7 days) use on furcation involvement in moderate to severe periodontitis. Outcome was the change in frequency of classes of furcation involvement after 27.5 months. Therapy comprised mechanical debridement in conjunction with antibiotic or placebo administration, and maintenance therapy at three months intervals. RESULTS: Three hundred and forty-five patients (175 placebo, 170 antibiotics) with 6576 furcation sites (class 0 2956; class I 2370; class II 886; class III 364) were examined (3472 placebo, 3104 antibiotics). Pocket reduction/attachment gain at the furcation sites was noticeably better after antibiotics (1.2/0.6 mm) than after placebo (0.7/0.2 mm) 27.5 months after therapy. However, most furcation degrees were unchanged (placebo 61.5%/antibiotics 62.2%), more sites improved than deteriorated (20.3%/18.2%, 22.1%/15.7% respectively) and no differences in the change of furcation degrees between treatments could be detected. CONCLUSION: Compared to placebo, prescription of adjunctive systemic antibiotics failed to show clinically relevant benefit with regard to furcation class involvement.
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Authors: Daniel Hagenfeld; Raphael Koch; Sebastian Jünemann; Karola Prior; Inga Harks; Peter Eickholz; Thomas Hoffmann; Ti-Sun Kim; Thomas Kocher; Jörg Meyle; Doğan Kaner; Ulrich Schlagenhauf; Benjamin Ehmke; Dag Harmsen Journal: PLoS One Date: 2018-04-18 Impact factor: 3.240
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