Metronidazole and amoxicillin for patients with periodontitis and diabetes mellitus: 5 years secondary analysis of a randomized controlled trial

Abstract

Background

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.

Methods

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.

Results

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 PD≥5mm (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).

Conclusion

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.

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https://aap.onlinelibrary.wiley.com/doi/abs/10.1002/JPER.20-0196?af=R