Multilevel Analysis of Clinical Parameters in Chronic Periodontitis After Root Planing/scaling, Surgery, and Systemic and Local Antibiotics: 2-year Results

Overview

Journal J Oral Microbiol

Specialty Dentistry

Date 2012 May 1

PMID 22545190

Citations 6

Authors

Ibrahimu Mdala

Anne D Haffajee

Sigmund S Socransky

Birgitte Freiesleben De Blasio

Magne Thoresen

Ingar Olsen

J Max Goodson

Affiliations

Soon will be listed here.

Abstract

Aim: Find the periodontal treatment that best maintained clinical results over time evaluated by changes in pocket depth (PD) and clinical attachment level (CAL).

Methods: 229 patients with chronic periodontitis from USA (n=134) and Sweden (n=95) were randomly assigned to eight groups receiving (1) scaling+root planing (SRP) alone or combined with (2) surgery (SURG)+systemic amoxicillin (AMOX)+systemic metronidazole (MET); (3) SURG+local tetracycline (TET); (4) SURG; (5) AMOX+MET+TET; (6) AMOX+MET; (7) TET; and (8) SURG+AMOX+MET+TET. Antibiotics were given immediately after SRP. Plaque, gingival redness, bleeding on probing, suppuration, PD, and CAL were recorded at baseline and after 3, 6, 12, 18, and 24 months. Treatment effects were evaluated by linear multilevel regression and logistic multilevel regression models. We considered only data from sites with a baseline PD of at least 5 mm of 187 patients completing the study.

Results: Surgically treated patients experienced most CAL loss. Adjunctive therapy including SURG was most effective in reducing PD. Combining SURG with AMOX, MET, and TET gave significant clinical benefits. Past and current smoking habits were significant predictors of deeper PD. Only current smoking was a significant predictor of CAL loss. Bleeding, accumulation of plaque, gingival redness, and suppuration were significant predictors of further CAL loss and deeper PD.

Conclusions: Both surgical and non-surgical therapies can be used to arrest chronic periodontitis. SURG+AMOX+MET+TET gave best maintenance of clinical results.

Citing Articles

Prognostic factors affecting probing depth reduction following non‑surgical periodontal therapy in patients with periodontitis: A linear mixed‑effects model analysis.

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A multilevel analysis of a randomized clinical trial comparing adjunctive moxifloxacin versus amoxicillin/metronidazole for the treatment of aggressive periodontitis.

Ardila C, Bedoya-Garcia J Dent Res J (Isfahan). 2021; 18:44.

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Application of Multilevel Models in Dentistry.

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Clinical Factors Influencing the Efficacy of Systemic Moxifloxacin in the Therapy of Patients With Generalized Aggressive Periodontitis: A Multilevel Analysis From a Clinical Trial.

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An estimate of pocket closure and avoided needs of surgery after scaling and root planing with systemic antibiotics: a systematic review.

Kolakovic M, Held U, Schmidlin P, Sahrmann P BMC Oral Health. 2014; 14:159.

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