Avaliação clínica e microbiológica do uso sistêmico de metronidazol e amoxicilina como coadjuvantes à raspagem e alisamento radicular em individuos fumantes com periodontite crônica.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The aim of the present study was to evaluate and compare the clinical and microbiological effects of scaling and root planing (SRP) alone or in combination with systemic metronidazole or metronidazole and amoxicillin in the treatment of smokers with chronic periodontits 90 days post-therapy. Forty-two subjects were randomly assigned to 3 groups, control (C, n=15) that received SRP and placebo, test 1 (T1, n=13) that received SRP and systemic metronidazole (400 mg) 3 x a day for 14 days, and test 2 (T2, n=14) that received SRP, systemic metronidazole (400mg) and amoxicillin (500 mg) 3 x a day for 14 days. The clinical parameters evaluated at 6 sites per tooth at baseline and at 90 days post-therapy were: probing depth (PD, mm), clinical attachment level (CAL, mm), visible plaque (0,1), gingival bleeding (0,1), bleeding on probing and suppuration (0,1). Nine biofilm samples were collected per subject, 3 samples in each of the following initial PD categories: shallow (PS ≤ 3mm), moderate (PS 4-6 mm), and deep (PS ≥ 7mm). The samples were evaluated for the presence and levels of 40 bacterial subgingival species using ckeckerboard DNA-DNA hybridization. The smokers who received the antibiotic therapies showed the greatest reductions in PD and CAL for all PD categories, mainly group T2 . All therapies employed led to a reduction in the mean counts, proportions and prevalence of red complex species, but only group T2 showed a significant reduction of these 3 species. All therapies reduced some orange complex species in the different PD categories, but Eubacterium nodatum was significantly reduced only in group T2. The mean proportions of the beneficial species increased mainly in the initially deep pockets, in groups T1 and T2. The proportions of the red complex species changed from 33.28%, 25.51% and 32% at baseline to 8.67%, 4.41% and 2.01% at 90 days post-therapy in groups C, T1 and T2, respectively. The proportions of the orange complex were not effectively affected by any therapy. The association of metronidazole or metronidazole and amoxicillin to SRP led to a clinical and microbiological benefit in the treatment of smokers with chronic periodontits at 90 days post-terapy.

ASSUNTO(S)

amoxicillin metronidazole metronidazol smoking fumantes periodontite crônica chronic periodontits odontologia amoxicilina

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