Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
J Periodontol. 2012 Dec;83(12):1480-91. doi: 10.1902/jop.2012.110519. Epub 2012 Feb 11.
This study examines the efficacy of azithromycin in combination with non-surgical periodontal therapy on clinical and microbiologic parameters and gingival crevicular fluid (GCF) matrix metalloproteinases-8 (MMP-8) levels over 6 months in patients with severe generalized chronic periodontitis (CP).
Twenty-eight of 36 patients with severe generalized CP were included in this randomized, double-masked, placebo-controlled, parallel-arm study. They were randomly assigned to azithromycin or placebo groups (500 mg, once daily for 3 days). Probing depth (PD), clinical attachment level, dichotomous presence or absence of supragingival plaque accumulation, and bleeding on probing were recorded. GCF samples were obtained from one single-rooted tooth with PD ≥ 6 mm, whereas microbiologic samples were collected from two single-rooted teeth with PD ≥ 6 mm. Microbiologic parameters were analyzed by quantitative real-time polymerase chain reaction for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, and total bacteria. GCF MMP-8 levels were determined by immunofluorescence assay.
Azithromycin and placebo groups demonstrated similar but significant improvements in all clinical parameters (P <0.05). A. actinomycetemcomitans, P. gingivalis, T. forsythia, P. intermedia, and total bacteria significantly decreased over the 6-month period in both groups, whereas F. nucleatum was significantly reduced in all visits in the azithromycin group, with the levels also being lower compared with those of the placebo group (P <0.05). The azithromycin and placebo groups exhibited significant reduction in GCF MMP-8 levels at the post-treatment visit and at 2 weeks (P <0.05).
On the basis of the present findings, it can be concluded that adjunctive azithromycin provides no additional benefit over non-surgical periodontal treatment on parameters investigated in patients with severe generalized CP.
本研究旨在探讨阿奇霉素联合非手术牙周治疗对重度广泛性慢性牙周炎（CP）患者的临床和微生物学参数以及龈沟液（GCF）基质金属蛋白酶-8（MMP-8）水平的影响，为期 6 个月。
36 例重度广泛性 CP 患者中有 28 例被纳入本项随机、双盲、安慰剂对照、平行臂研究。他们被随机分配至阿奇霉素组或安慰剂组（500mg，每日一次，共 3 天）。记录探诊深度（PD）、临床附着水平、龈上菌斑是否存在以及探诊出血情况。从 PD≥6mm 的单个牙根获得 GCF 样本，从 PD≥6mm 的两个单个牙根获得微生物样本。采用实时定量聚合酶链反应分析 Aggregatibacter actinomycetemcomitans、Porphyromonas gingivalis、Tannerella forsythia、Fusobacterium nucleatum、Prevotella intermedia 和总细菌的微生物学参数。通过免疫荧光法测定 GCF MMP-8 水平。
阿奇霉素组和安慰剂组的所有临床参数均有相似但显著的改善（P<0.05）。两组中 A. actinomycetemcomitans、P. gingivalis、T. forsythia、P. intermedia 和总细菌在 6 个月期间均显著减少，而 F. nucleatum 在阿奇霉素组的所有访视中均显著减少，且水平也低于安慰剂组（P<0.05）。阿奇霉素组和安慰剂组在治疗后访视和 2 周时 GCF MMP-8 水平均显著降低（P<0.05）。
根据本研究结果，可得出结论，与非手术牙周治疗相比，辅助阿奇霉素对重度广泛性 CP 患者的各项研究参数无额外获益。
