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Quintessence Int 41 (2010), No. 4     1. Mar. 2010
Quintessence Int 41 (2010), No. 4  (01.03.2010)

Page 303-312, PubMed:20305865


Short-term effects of systemic antibiotics during periodontal healing
Buchmann, Rainer / Conrads, Georg / Sculean, Anton
Objectives: To investigate the short-term effects of nonsurgical therapy (scaling and root planing, SRP) on the subgingival microbiota in chronic (CP) and aggressive (AP) periodontal disease.
Method and Materials: Ninety-seven CP and AP subjects underwent fullmouth SRP on 2 consecutive days. AP patients were randomly assigned to either receive systemic metronidazole plus amoxicillin (AP+AB) or were treated mechanically alone (AP). Pathogens were identified with 16S rRNA oligodeoxynucleotide probes and dot-blot hybridization before and at days 2, 3, 4, 7, 10, and 21 of healing. CP subjects were treated by scaling and root planing along with placebo tablets.
Results: Initially, AP cell counts were 69.9- (Porphyromonas gingivalis), 10.2- (Aggregatibacter actinomycetemcomitans), 5.7- (Tannerella forsythia), and 3.3-fold (Prevotella intermedia) enhanced compared to CP cell counts. Following SRP, immediate elimination occurred in single individuals of all three treatment groups at day 2. After SRP plus antibiotic therapy (AP+AB), the prevalence scores dropped beyond the levels of AP and CP, beginning at day 7, and remained low until day 21 (P <= .05). Clinical healing statistically benefited from SRP with no differences among the three treatment groups.
Conclusion: Nonsurgical therapy resulted in both a suppression and early elimination of single taxa immediately after completion of active treatment. Systemic antibiotics significantly accelerate the suppression of the periodontal microflora, but have limited effect on the elimination of target isolates during healing.

Keywords: aggressive periodontitis, early healing, periodontal pathogens, rRNA probes, suppression, systemic antibiotics