Taking this limited number of comparative studies together, it appears that the adjunctive use of metronidazole plus amoxicillin, metronidazole alone or clindamycin in patients with generalized aggressive periodontitis results in more pronounced clinical improvements when compared with the use of doxycycline for a similar amount of time or with scaling and root planing alone.Recently, the effectiveness of azithromycin in the treatment of aggressive periodontitis was also tested.Compared with other antibiotics, azithromycin has the advantage of having a long half-life. As azithromycin only needs to be administered once a day for 3 days, one could assume that patient compliance would be better compared with other antibiotic regimens. Compliance to an adjunctive antibiotic regimen seems to be an important aspect for the clinicaloutcome in aggressive periodontitis. In a retrospective analysis, Guerrero et al. (33) demonstrated thatincomplete adherence to a metronidazole plus amoxicillin regimen resulted in signifi cantly less probing pocket-depth reduction and less gain in clinical attachment. Therefore, Haas et al. (36) compared the clinical effect of the adjunctive use of azithromycin with scaling and root planing in aggressive periodontitis. One year after treatment, a signifi cant additional1 mm reduction in probing pocket depth and 0.7 mm gain in attachment was evident, which shows the potential of azithromycin in the treatment of aggressive periodontitis. In this study, localized and generalized periodontitis patients were pooled.Local antimicrobials Although there is a clear rationale for the use of local
antimicrobials, which is based on the emerging antibiotic resistance, the possibility to achieve maximum antibacterial concentrations and the reduction of systemic side effects, the effectiveness of local antimicrobials in aggressive periodontitis has barely been investigated. However, especially for localized aggressive periodontitis, the localized character and limited number of diseased sites would in theory favor their use. Surprisingly, hardly any study has investigated, in a controlled manner, the possible adjunctive effect of local antimicrobials in localized aggressive
đang được dịch, vui lòng đợi..
