Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil.
Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA.
J Periodontol. 2021 Apr;92(4):479-487. doi: 10.1002/JPER.20-0196. Epub 2020 Oct 6.
The aim of this study was to perform a 5-year follow-up analysis of a previously-published randomized trial (RCT) evaluating the 2-years effects of metronidazole (MTZ) plus amoxicillin (AMX) as adjuncts to scaling and root planing (SRP) in the treatment of periodontitis in type 2 diabetic patients.
Volunteers who received periodontal treatment in the aforementioned RCT were selected for clinical and microbiological evaluation. Patients did not receive regular supportive periodontal therapy (SPT) from 2 to 5 years post-treatment.
Of the patients enrolled in the RCT, 43% entered this study (n = 10/control and 15/test group). Most of clinical parameter values, including the number of sites with probing depth ≥ 5 mm (primary outcome variable), were reduced at 5 years post-therapy when compared with baseline in the antibiotic-treated group (P < 0.05), but presented higher values than those at 2 years (P < 0.05). The mean proportions of microbial complexes did not differ between MTZ+AMX+SRP and SRP-only groups at 5 years post-treatment (P > 0.05).
Diabetic patients treated with adjunctive MTZ+AMX were better maintained over a period of 5 years than those treated with SRP only. However, the clinical and microbiological benefits obtained up to 2 years post-treatment were not fully sustained in these patients who did not receive SPT between 2 and 5 years post-treatment.
本研究旨在对先前发表的一项随机试验（RCT）进行 5 年随访分析，该试验评估了甲硝唑（MTZ）加阿莫西林（AMX）作为辅助治疗 2 型糖尿病患者牙周炎的 2 年疗效。
选择先前 RCT 中接受牙周治疗的志愿者进行临床和微生物学评估。患者在治疗后 2 至 5 年内未接受常规支持性牙周治疗（SPT）。
在 RCT 中，43%的患者进入本研究（n=10/对照组和 15/试验组）。与基线相比，治疗组在治疗后 5 年时大多数临床参数值（包括探诊深度≥5mm 的位点数，主要观察变量）均降低（P<0.05），但与 2 年时相比仍升高（P<0.05）。在治疗后 5 年时，MTZ+AMX+SRP 和仅 SRP 组之间微生物复合体的平均比例没有差异（P>0.05）。
在未接受 2 至 5 年 SPT 的情况下，与仅接受 SRP 治疗的患者相比，接受辅助 MTZ+AMX 治疗的糖尿病患者在 5 年内得到了更好的维持。然而，在这些患者中，2 年治疗后获得的临床和微生物学益处并未完全维持。
