Metronidazole and amoxicillin as adjuncts to scaling and root planing for the treatment of type 2 diabetic subjects with periodontitis: 1-year outcomes of a randomized placebo-controlled clinical trial

J Clin Periodontol. 2014 Sep;41(9):890-9. doi: 10.1111/jcpe.12282. Epub 2014 Jul 17.

Abstract

Aim: To evaluate the clinical and microbiological effects of the use of metronidazole (MTZ) + amoxicillin (AMX) as adjuncts to scaling and root planing (SRP) for the treatment of chronic periodontitis (ChP) in type 2 diabetic subjects.

Material and methods: Fifty-eight type 2 diabetic subjects (n = 29/group) with generalized ChP were randomly assigned to receive SRP alone or with MTZ [400 mg/thrice a day (TID)]+AMX (500 mg/TID) for 14 days. Subgingival biofilm samples were analyzed by qPCR for the presence of seven periodontal pathogens. Subjects were monitored at baseline, 3, 6 and 12 months post-therapies.

Results: The group receiving SRP+MTZ+AMX presented greater mean probing depth (PD) reduction and clinical attachment gain, a lower number of sites with PD ≥5 mm (primary outcome variable) and a reduced number of subjects with ≥9 of these residual pockets than the control group at 1-year post-therapy (p < 0.05). The antibiotic-treated group also presented reduced levels and greater decreases of the three red complex species, Eubacterium nodatum and Prevotella intermedia, compared to the control group at 1 year (p < 0.05).

Conclusions: The adjunctive use of MTZ+AMX significantly improved the clinical and microbiological outcomes of SRP in the treatment of type 2 diabetic subjects with ChP.

Keywords: amoxicillin; chronic periodontitis; dental scaling; diabetes mellitus; metronidazole; real-time polymerase chain reaction; root planing.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amoxicillin / administration & dosage*
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Infective Agents / administration & dosage*
  • Biofilms / drug effects
  • Chronic Periodontitis / complications
  • Chronic Periodontitis / microbiology
  • Chronic Periodontitis / therapy*
  • Combined Modality Therapy
  • Dental Plaque / microbiology
  • Dental Scaling / methods*
  • Diabetes Mellitus, Type 2 / complications*
  • Double-Blind Method
  • Drug Combinations
  • Eubacterium / drug effects
  • Eubacterium / isolation & purification
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Metronidazole / administration & dosage*
  • Middle Aged
  • Periodontal Attachment Loss / microbiology
  • Periodontal Attachment Loss / therapy
  • Periodontal Pocket / microbiology
  • Periodontal Pocket / therapy
  • Placebos
  • Prevotella intermedia / drug effects
  • Prevotella intermedia / isolation & purification
  • Prospective Studies
  • Root Planing / methods*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Drug Combinations
  • Placebos
  • Metronidazole
  • Amoxicillin