Literature DB >> 35122549

Adjunctive efficacy of systemic metronidazole in the surgical treatment of periodontitis: a double-blind parallel randomized clinical trial.

James Rudolph Collins1, Gabriel Ogando2, Rolando González2, Elena Figuero3, María José Marín3, Mariano Sanz3, David Herrera3.   

Abstract

OBJECTIVES: The purpose of this study was to evaluate the clinical and microbiological impact of adjunctive metronidazole to periodontal surgery.
MATERIALS AND METHODS: Systemically healthy patients, with stages III-IV, grades B-C periodontitis, were randomly assigned to receive metronidazole or placebo adjunctive to periodontal surgery, after subgingival instrumentation. Clinical variables were recorded at the initial visit, 6 weeks after subgingival instrumentation, and 3, 6, and 12 months after surgery. Microbiological samples were taken at initial and final visits and analyzed by quantitative polymerase chain reaction.
RESULTS: Our results showed no statistically significant differences in the reduction of probing depth between the initial and final (1 year) visits in the two treatment groups. Additionally, no statistically significant differences were observed between study groups when comparing the post-subgingival instrumentation and final visits. However, 3 months after surgery, probing depth (mean difference, MD = 0.31 mm, 95% confidence interval, CI [0.13; 0.49]; p = 0.001) and clinical attachment level (MD = 0.64 mm, 95% CI [0.02; 1.27]; p = 0.044) were significantly lower in the test group.
CONCLUSIONS: The adjunctive use of systemic metronidazole to periodontal surgery has a limited clinical and microbiological impact in the present study, and therefore, its use is not recommended. CLINICAL RELEVANCE: There are no studies that have evaluated the clinical and microbiological impact of the adjunctive use of systemic metronidazole to periodontal surgery (step 3 of periodontal therapy). The results of the present study do not support the adjunctive use of systemic metronidazole to periodontal surgery.
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Entities:  

Keywords:  Antibiotics; Metronidazole; Periodontal diseases/therapy; Periodontitis; qPCR

Mesh:

Substances:

Year:  2022        PMID: 35122549     DOI: 10.1007/s00784-022-04392-2

Source DB:  PubMed          Journal:  Clin Oral Investig        ISSN: 1432-6981            Impact factor:   3.573


  32 in total

Review 1.  Antimicrobial therapy in periodontitis: the use of systemic antimicrobials against the subgingival biofilm.

Authors:  David Herrera; Bettina Alonso; Rubén León; Silvia Roldán; Mariano Sanz
Journal:  J Clin Periodontol       Date:  2008-09       Impact factor: 8.728

2.  Adjunctive effect of systemic antimicrobials in periodontitis therapy: A systematic review and meta-analysis.

Authors:  Wim Teughels; Magda Feres; Valerie Oud; Conchita Martín; Paula Matesanz; David Herrera
Journal:  J Clin Periodontol       Date:  2020-07       Impact factor: 8.728

3.  Efficacy of access flap procedures compared to subgingival debridement in the treatment of periodontitis. A systematic review and meta-analysis.

Authors:  Ignacio Sanz-Sánchez; Eduardo Montero; Filippo Citterio; Federica Romano; Ana Molina; Mario Aimetti
Journal:  J Clin Periodontol       Date:  2020-07       Impact factor: 8.728

4.  Amoxicillin plus metronidazole in the treatment of adult periodontitis patients. A double-blind placebo-controlled study.

Authors:  E G Winkel; A J Van Winkelhoff; M F Timmerman; U Van der Velden; G A Van der Weijden
Journal:  J Clin Periodontol       Date:  2001-04       Impact factor: 8.728

Review 5.  Systemic anti-infective periodontal therapy. A systematic review.

Authors:  Anne D Haffajee; Sigmund S Socransky; John C Gunsolley
Journal:  Ann Periodontol       Date:  2003-12

Review 6.  A systematic review on the effect of systemic antimicrobials as an adjunct to scaling and root planing in periodontitis patients.

Authors:  David Herrera; Mariano Sanz; Soren Jepsen; Ian Needleman; Silvia Roldán
Journal:  J Clin Periodontol       Date:  2002       Impact factor: 8.728

7.  Differential clinical treatment outcome after systemic metronidazole and amoxicillin in patients harboring Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis.

Authors:  T F Flemmig; E Milián; H Karch; B Klaiber
Journal:  J Clin Periodontol       Date:  1998-05       Impact factor: 8.728

8.  Microbiological and clinical results of metronidazole plus amoxicillin therapy in Actinobacillus actinomycetemcomitans-associated periodontitis.

Authors:  A J van Winkelhoff; C J Tijhof; J de Graaff
Journal:  J Periodontol       Date:  1992-01       Impact factor: 6.993

9.  Factors influencing the outcome of non-surgical periodontal treatment: a multilevel approach.

Authors:  Cristiano Tomasi; Alastair H Leyland; Jan L Wennström
Journal:  J Clin Periodontol       Date:  2007-08       Impact factor: 8.728

10.  Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline.

Authors:  Mariano Sanz; David Herrera; Moritz Kebschull; Iain Chapple; Søren Jepsen; Tord Beglundh; Anton Sculean; Maurizio S Tonetti
Journal:  J Clin Periodontol       Date:  2020-07       Impact factor: 8.728

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