Multilevel analysis of clinical parameters in chronic periodontitis after root planing/scaling, surgery, and systemic and local antibiotics: 2-year results
Open Access
- 1 January 2012
- journal article
- Published by Taylor & Francis Ltd in Journal of Oral Microbiology
- Vol. 4 (1)
- https://doi.org/10.3402/jom.v4i0.17535
Abstract
Aim: Find the periodontal treatment that best maintained clinical results over time evaluated by changes in pocket depth (PD) and clinical attachment level (CAL). Methods: 229 patients with chronic periodontitis from USA (n=134) and Sweden (n=95) were randomly assigned to eight groups receiving (1) scaling+root planing (SRP) alone or combined with (2) surgery (SURG)+systemic amoxicillin (AMOX)+systemic metronidazole (MET); (3) SURG+local tetracycline (TET); (4) SURG; (5) AMOX+MET+TET; (6) AMOX+MET; (7) TET; and (8) SURG+AMOX+MET+ TET. Antibiotics were given immediately after SRP. Plaque, gingival redness, bleeding on probing, suppuration, PD, and CAL were recorded at baseline and after 3, 6, 12, 18, and 24 months. Treatment effects were evaluated by linear multilevel regression and logistic multilevel regression models. We considered only data from sites with a baseline PD of at least 5 mm of 187 patients completing the study. Results: Surgically treated patients experienced most CAL loss. Adjunctive therapy including SURG was most effective in reducing PD. Combining SURG with AMOX, MET, and TET gave significant clinical benefits. Past and current smoking habits were significant predictors of deeper PD. Only current smoking was a significant predictor of CAL loss. Bleeding, accumulation of plaque, gingival redness, and suppuration were significant predictors of further CAL loss and deeper PD. Conclusions: Both surgical and non-surgical therapies can be used to arrest chronic periodontitis. SURG+ AMOX+MET+TET gave best maintenance of clinical results. Keywords: modeling; chronic periodontitis; periodontal therapy; antibiotics; surgery (Published: 24 April 2012) Citation: Journal of Oral Microbiology 2012, 4: 17535 - http://dx.doi.org/10.3402/jom.v4i0.17535 Access the appendices to this article – see Supplementary files under Article Tools online. *The Chief Editor Ingar Olsen, has not had any part in the review and decision process for this paper.Keywords
This publication has 38 references indexed in Scilit:
- Multilevel analysis of clinical parameters in chronic periodontitis after root planing/scaling, surgery, and systemic and local antibiotics: 2-year resultsJournal of Oral Microbiology, 2012
- A randomized‐controlled trial of low‐dose doxycycline for periodontitis in smokersJournal of Clinical Periodontology, 2007
- Adjunctive subantimicrobial dose doxycycline: effect on clinical parameters and gingival crevicular fluid transforming growth factor‐β1 levels in severe, generalized chronic periodontitisJournal of Clinical Periodontology, 2005
- Effect of Partial Recording Protocols on Estimates of Prevalence of Periodontal DiseaseThe Journal of Periodontology, 2005
- Local tetracycline is an effective adjunct in the treatment of chronic periodontitisEvidence-Based Dentistry, 2004
- Smoking affects the outcome of guided tissue regeneration with bioresorbable membranes: a retrospective analysis of intrabony defectsJournal of Clinical Periodontology, 2004
- Effects of alginate coated on PLGA microspheres for delivery tetracycline hydrochloride to periodontal pocketsJournal of Microencapsulation, 2004
- Antibiotic resistance profile of the subgingival microbiota following systemic or local tetracycline therapyJournal of Clinical Periodontology, 2004
- Subantimicrobial dose doxycycline as an adjunct to scaling and root planing: post‐treatment effectsJournal of Clinical Periodontology, 2001
- Profiles of destructive periodontal disease in different populationsJournal of Periodontal Research, 1996