Department of Diagnosis and Surgery, Division of Periodontology, College of Dentistry, São Paulo State University, São José dos Campos, Brazil.
Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, Campinas State University, Piracicaba, Brazil.
J Periodontol. 2017 Dec;88(12):1244-1252. doi: 10.1902/jop.2017.170165. Epub 2017 Jul 3.
The aim of the present study is to evaluate the periodontal clinical and microbiologic responses and possible adverse effects of clarithromycin (CLM) combined with periodontal mechanical therapy in the treatment of patients with generalized aggressive periodontitis.
Forty patients were selected and randomly assigned into one of two groups: 1) CLM (n = 20): one-stage full-mouth ultrasonic debridement (FMUD) associated with CLM (500 mg, every 12 hours for 3 days); and 2) placebo (n = 20): FMUD associated with placebo pills. Clinical and microbiologic parameters were evaluated at baseline and 3 and 6 months postoperatively.
Both treatments presented statistically significant clinical and microbiologic improvements. However, the CLM group presented lower means of probing depth for pockets ≥7 mm at 6 months (4.0 ± 1.7 mm) compared with the placebo group (4.7 ± 1.3 mm) (P = 0.04). In addition, the CLM group also presented greater reduction of Porphyromonas gingivalis (Pg) DNA counts at 6 months (P = 0.0001).
Results from this study suggest both treatments are effective; however, adjunct use of CLM to FMUD leads to better reduction of deep pockets and Pg at 6 months compared with FMUD alone.
本研究旨在评估克拉霉素（CLM）联合牙周机械治疗在治疗广泛性侵袭性牙周炎患者中的牙周临床和微生物学反应及可能的不良反应。
选择 40 名患者并随机分为两组：1）CLM 组（n=20）：一次性全口超声洁治术（FMUD）联合 CLM（500mg，每 12 小时 1 次，共 3 天）；2）安慰剂组（n=20）：FMUD 联合安慰剂。在基线和术后 3 个月和 6 个月时评估临床和微生物学参数。
两种治疗均显示出统计学显著的临床和微生物学改善。然而，CLM 组在 6 个月时≥7mm 的探诊深度的平均值（4.0±1.7mm）低于安慰剂组（4.7±1.3mm）（P=0.04）。此外，CLM 组在 6 个月时还表现出牙龈卟啉单胞菌（Pg）DNA 计数的更大降低（P=0.0001）。
本研究结果表明两种治疗均有效；然而，与单纯 FMUD 相比，CLM 联合 FMUD 可在 6 个月时更好地减少深袋和 Pg。
