Title Systemic Metronidazole Is An Effective Adjunct To S&RP In Generalized Aggressive Periodontitis Patients
Clinical Question Will scaling & root planning plus systemic antibiotic (metronidazole + amoxycillin) be more effective than scaling & root planning alone in aggressive periodontitis patients?
Clinical Bottom Line Systemic administration of metronidazole or metronidazole plus amoxycillin in addition to scaling and root planing results in the most pocket depth reduction when compared to scaling and root planing alone as seen in randomized clinical trial. (See Comments on the CAT below)
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
16553634Xajigeorgiou/200643 patients with generalized aggressive periodontitis randomized into 4 groups: 1. SRP + metronidazole & amoxicillinRCT
Key resultsAll treatments result in improvement of probing depth, attachment level, bleeding on probing. Administration of metronidazole plus amoxycillin or metronidazole alone resulted in greater reduction of sites >6mm.
Evidence Search Pubmed: scaling and root planing aggressive periodontitis antibiotic, Limits: RCT, English
Comments on
The Evidence
All forms of treatment provided some improvement in clinical parameters; however, significant improvement was seen when metronidazole was used as well.
Applicability Target population (generalized aggressive periodontitis) will benefit from significant improvement in pocket depths.
Specialty (Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery) (Periodontics) (Dental Hygiene)
Keywords Aggressive Periodontitis, Scaling and Root Planing, Systemic Antibiotics
ID# 266
Date of submission 11/11/2009
E-mail CookDC@uthscsa.edu
Author Deana Cook, DDS, MS
Co-author(s) e-mail wilmingtonperio@aol.com
Faculty mentor Richard Finlayson, DDS
Faculty mentor e-mail finlaysonr@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
by Courtney Deane (San Antonio, Texas) on 04/02/2012
Upon conducting a PubMed search on this subject in April 2012, I discovered a more recent publication: PMID 21303403. This 6 month RCT of 31 subjects found that systemic antibiotics in combination with mechanical debridement lowered the amount of periodontal pathogens present in patients at the final 6 month recall examination. The evidence in the CAT is supported by this more recent evidence.