Analysis of clinical results of systemic antimicrobials combined with nonsurgical periodontal treatment for generalized aggressive periodontitis: a pilot study.

Objective: To assess the clinical benefit of either metronidazole and amoxicillin or doxycycline administered immediately after completion of full-mouth scaling and root planing (FRP) for treatment of generalized aggressive periodontitis.

Methods: Patients, 18 to 40 years of age, referred to the Karadeniz Technical University department of periodontology between January 2009 and September 2009 were randomly chosen for inclusion in the study if radiographic examination showed they had ≥ 20 teeth, clinical attachment loss and a probing pocket depth (PPD) ≥ 6 mm at 2 sites in ≥ 12 teeth, ≥ 3 of which were not first molars or incisors. Patients were divided into 3 groups and received FRP alone, FRP combined with metronidazole and amoxicillin, or FRP combined with doxycycline. PPD, clinical attachment level, gingival index, gingival bleeding index and plaque index values were measured at baseline and 2 months after treatment.

Results: Thirty-eight patients with untreated generalized aggressive periodontitis participated in the study. In all 3 groups, the periodontal index values 2 months after treatment were significantly lower than baseline values (p < 0.05). Values for PPD and clinical attachment level were more improved in the antibiotic groups than in the FRP group, and more improved in the metronidazole and amoxicillin group than in the doxycycline group (p < 0.05). However, no statistically significant intergroup difference was observed in the other clinical parameters (p > 0.05). Systemic use of metronidazole and amoxicillin or doxycycline was clinically superior to FRP for reducing PPDs ≥ 7 mm (p < 0.05).

Conclusion: Treatment of generalized aggressive periodontitis with FRP alone or FRP combined with systemic antibiotics provided significant clinical benefits that reduced the need for periodontal surgery. Both antibiotic treatments had additional clinical benefits over those of FRP alone.