Efficacy of Periodontal Surgery With Adjunctive Systemic Antimicrobials in Patients Harbouring Porphyromonas gingivalis: A 48-Month Randomised Clinical Trial.

AIM: To compare the clinical and microbiological outcomes after the use of systemic antimicrobials as adjuncts to periodontal surgery in patients with periodontitis stage III and IV positive for Porphyromonas gingivalis.

MATERIAL AND

METHODS

Patients positive for P. gingivalis at the re-evaluation 6 weeks after subgingival instrumentation and with probing depths (PD) ≥ 6 mm in more than two teeth per quadrant were randomly allocated to periodontal surgery with adjunctive systemic azithromycin (AZI) or metronidazole (MET). Clinical and microbiological outcomes were evaluated at 6, 12 and 48 months after surgery.

RESULTS

Forty-three subjects were included, with 40 and 36 completing follow-ups at 12 and 48 months, respectively. Clinical outcomes improved and remained stable over time in both groups. No statistically significant differences were observed between groups for PD reductions at 12 or 48 months. At 48 months, P. gingivalis was detected in 80% (AZI) and 70.6% (MET). At the final visit, no differences in clinical endpoints were observed between patients harbouring P. gingivalis and those who were not.

CONCLUSIONS

Slight differences were observed between the groups, with clinical outcomes improving and remaining stable over time following surgical treatment. Neither protocol suppressed P. gingivalis beyond detection limit 48 months after treatment.