Generalized Aggressive Periodontitis: Systemic Amoxicillin/Metronidazole versus Controlled-Delivery-Chlorhexidine

Adjunctive systemic administration of amoxicillin/metronidazole (AM) in generalized aggressive periodontitis (gAP) therapy results in periodontal long-term stability. However, the use of antibiotics should be limited due to possible side effects and increasing bacterial resistances. Chlorhexidindigluconate in a controlled-delivery-device (PerioChip^Ž, , ) (PC) improves the outcome of scaling/root planing (SRP), when adjunctively used in chronic periodontitis therapy. Its effect in the treatment of gAP has not been evaluated.

Objectives:

The effect of adjunctive use of PC in the treatment of gAP was investigated. Efficacy of PC was compared to the standard treatment with AM.

Methods:

36 Patients (18/group, 35ą4 years) with untreated gAP were treated by SRP and randomly assigned to either systemic AM (500mg/250mg 3x/d for 10d) or local application of PC at every site with PD≥5mm. Clinical parameters PD, CAL, BoP and Pus were recorded at 6 sites/tooth with a pressure-sensitive periodontal probe (Florida Probe, USA) at baseline, 3 and 6 months after therapy by the blinded investigator. During supportive periodontal care at month 3, application of PC was repeated at sites with remaining PD≥5mm.

Results:

At month 3, initial mean PD/patient was decreased from 4.1ą0.8mm to 2.4ą0.4mm for AM and from 3.8ą0.8mm to 2.5ą0.4mm for PC. Mean CAL/patient changed from 4.9ą1.2mm to 4.0ą1.2mm for AM and from 4.6ą1.1mm to 4.0ą1.0mm for PC. Changes within groups were significant (p<0.001), while no differences between groups could be found. At month 6, for AM no significant change could be observed with PD 2.3ą0.4mm and CAL 4.0ą1.1mm. For PC, PD worsened significantly to 2.6ą0.5mm (p=0.013) between months 3 and 6. After 6 months, AM showed significant (p<0.006) more PD reduction and gain (1.8ą0.6mm/0.9ą0.4mm) compared to PC (1.2ą0.5mm/0.5ą0.4mm).

Conclusion:

AM showed higher efficacy in terms of PD reduction, gain and long-term stability than PC.

Supported by German Research Foundation (DFG) GRK325

*0217 Generalized Aggressive Periodontitis: Systemic Amoxicillin/Metronidazole versus Controlled-Delivery-Chlorhexidine - Patient-Based Analysis*
A. FRIEDMANN, D. KANER, and J.-P. BERNIMOULIN, Humboldt-Universitat, Berlin, Germany Adjunctive systemic administration of amoxicillin/metronidazole (AM) in generalized aggressive periodontitis (gAP) therapy results in periodontal long-term stability. However, the use of antibiotics should be limited due to possible side effects and increasing bacterial resistances. Chlorhexidindigluconate in a controlled-delivery-device (PerioChip^Ž, , ) (PC) improves the outcome of scaling/root planing (SRP), when adjunctively used in chronic periodontitis therapy. Its effect in the treatment of gAP has not been evaluated. Objectives: The effect of adjunctive use of PC in the treatment of gAP was investigated. Efficacy of PC was compared to the standard treatment with AM. Methods: 36 Patients (18/group, 35ą4 years) with untreated gAP were treated by SRP and randomly assigned to either systemic AM (500mg/250mg 3x/d for 10d) or local application of PC at every site with PD≥5mm. Clinical parameters PD, CAL, BoP and Pus were recorded at 6 sites/tooth with a pressure-sensitive periodontal probe (Florida Probe, USA) at baseline, 3 and 6 months after therapy by the blinded investigator. During supportive periodontal care at month 3, application of PC was repeated at sites with remaining PD≥5mm. Results: At month 3, initial mean PD/patient was decreased from 4.1ą0.8mm to 2.4ą0.4mm for AM and from 3.8ą0.8mm to 2.5ą0.4mm for PC. Mean CAL/patient changed from 4.9ą1.2mm to 4.0ą1.2mm for AM and from 4.6ą1.1mm to 4.0ą1.0mm for PC. Changes within groups were significant (p<0.001), while no differences between groups could be found. At month 6, for AM no significant change could be observed with PD 2.3ą0.4mm and CAL 4.0ą1.1mm. For PC, PD worsened significantly to 2.6ą0.5mm (p=0.013) between months 3 and 6. After 6 months, AM showed significant (p<0.006) more PD reduction and gain (1.8ą0.6mm/0.9ą0.4mm) compared to PC (1.2ą0.5mm/0.5ą0.4mm). Conclusion: AM showed higher efficacy in terms of PD reduction, gain and long-term stability than PC. Supported by German Research Foundation (DFG) GRK325
Seq #21 - Periodontal Research 11:00 AM-1:00 PM, Friday, 27 August 2004 Crowne Plaza Hotel SEDEF I
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