One‐Stage Full‐Mouth Versus Partial‐Mouth Scaling and Root Planing During the Effective Half‐Life of Systemically Administered Azithromycin

• Published in: Journal of periodontology (1970) 2009-09, Vol.80 (9), p.1406-1413
• Main Authors: Yashima, Akihiro, Gomi, Kazuhiro, Maeda, Nobuko, Arai, Takashi
• Format: Article
• Language: English
• Subjects: Adult; Aggregatibacter actinomycetemcomitans - drug effects; Aggregatibacter actinomycetemcomitans - isolation & purification; Anti-Bacterial Agents - pharmacokinetics; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobial; Azithromycin - pharmacokinetics; Azithromycin - therapeutic use; Bacteroides - drug effects; Bacteroides - isolation & purification; Biological and medical sciences; Chronic Periodontitis - drug therapy; Chronic Periodontitis - microbiology; Chronic Periodontitis - therapy; dental scaling; Dental Scaling - instrumentation; Dental Scaling - methods; Dentistry; Double-Blind Method; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Follow-Up Studies; Gingiva - metabolism; Gingival Crevicular Fluid - chemistry; Gingival Hemorrhage - drug therapy; Gingival Hemorrhage - therapy; Half-Life; Humans; infection control; Male; Medical sciences; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Periodontal Attachment Loss - drug therapy; Periodontal Attachment Loss - therapy; Periodontal Index; Periodontal Pocket - drug therapy; Periodontal Pocket - therapy; periodontitis; Pharmacology. Drug treatments; Porphyromonas gingivalis - drug effects; Porphyromonas gingivalis - isolation & purification; Prevotella intermedia - drug effects; Prevotella intermedia - isolation & purification; root planing; Root Planing - instrumentation; Root Planing - methods; Treatment Outcome; Treponema denticola - drug effects; Treponema denticola - isolation & purification
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1902/jop.2009.090067

Background: One‐stage full‐mouth scaling and root planing (FM‐SRP) in combination with systemically administered azithromycin was shown to be clinically and bacteriologically effective in the treatment of chronic periodontitis. However, FM‐SRP requires 2 hours for completion. Azithromycin has a long half‐life. Therefore, if SRP of the full mouth is performed within 7 days while an effective concentration of azithromycin remains in the gingiva, the effects may be the same as FM‐SRP. The aim of this study was to compare the clinical and bacteriologic effects of FM‐SRP and partial‐mouth scaling and root planing (PM‐SRP) in patients with chronic periodontitis, which was performed in three sessions within 7 days, during the effective half‐life of systemically administrated azithromycin. Methods: Thirty adult subjects with chronic periodontitis were randomly divided into three groups (FM‐SRP, PM‐SRP, and control). A clinical examination was conducted to record the probing depth, clinical attachment level gain, bleeding on probing, gingival index, and volume of gingival crevicular fluid; bacterial samples were obtained before treatment and 1, 3, 6, 9, and 12 months thereafter. Quantitative and qualitative analyses were performed using the polymerase chain reaction‐Invader method. Results: All clinical parameters showed better improvement in FM‐SRP and PM‐SRP groups compared to the control group, with no significant differences between the two test groups. Periodontal bacteria were well controlled in the two test groups, but they tended to increase gradually 3 months after treatment in the control group. Conclusion: PM‐ and FM‐SRP demonstrated comparable clinical and bacteriologic results.