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  • Effectiveness of systemic amoxicillin/metronidazole as adjunctive therapy to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta-analysis.

Effectiveness of systemic amoxicillin/metronidazole as adjunctive therapy to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta-analysis.

Journal of periodontology (2012-01-10)
Fabrizio Sgolastra, Roberto Gatto, Ambra Petrucci, Annalisa Monaco
ABSTRACT

The combination of Amoxicillin and metronidazole (AMX/MET) as an adjunctive treatment to scaling root planing (SRP) has been proposed for the treatment of chronic periodontitis; however, its effectiveness and clinical safety remain to be defined. The purpose of the present meta-analysis is to assess the effectiveness of SRP + AMX/MET compared to SRP alone. An electronic search of eight databases from their earliest records through October 8, 2011 and a hand search of international dental journals for the last 15 years were conducted. Gain in clinical attachment level (CAL), reduction in probing depth (PD), secondary outcomes, and adverse events were analyzed. A random-effect model was used to pool the extracted data. The weighted mean difference (WMD) with 95% confidence interval (CI) was calculated for continuous outcomes; heterogeneity was assessed with the Cochrane χ(2) and I(2) tests. The level of significance was set at P <0.05. After the selection process, four randomized clinical trials were included. Results of the meta-analysis showed significant CAL gain (WMD = 0.21; 95% CI = 0.02 to 0.4; P <0.05) and PD reduction (WMD = 0.43; 95% CI = 0.24 to 0.63; P <0.05) in favor of SRP + AMX/MET. No significant differences were found for bleeding on probing (WMD = 10.77; 95% CI = -3.43 to 24.97; P >0.05) or suppuration (WMD = 1.77; 95% CI = -1.7 to 5.24; P >0.05). The findings of this meta-analysis seem to support the effectiveness of SRP + AMX/MET; however, future studies are needed to confirm these results.

MATERIALS
Product Number
Brand
Product Description

Supelco
Metronidazole, VETRANAL®, analytical standard
Supelco
Metronidazole, analytical standard
Sigma-Aldrich
Metronidazole, BioXtra
Sigma-Aldrich
Metronidazole, SAJ first grade, ≥99.0%
Supelco
Metronidazole, Pharmaceutical Secondary Standard; Certified Reference Material
Metronidazole, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
Amoxicillin, 95.0-102.0% anhydrous basis