Effect of systemic antibiotic and probiotic therapies as adjuvant treatments of subgingival instrumentation for periodontitis: a randomized controlled clinical study.

Abstract

Objective:This study assessed the efficacy of two adjunct therapies (antibiotic and probiotic) for periodontal treatment based on clinical and immunological parameters in patients with Stage II and III Grade B periodontitis.Methodology:45 patients were randomly allocated into three groups: control group (CG); antibiotic group (GAtb), in which 500 mg amoxicillin + 400 mg metronidazole were used; and probiotic group (GProb), for which Lactobacillus reuteri was used. Patients received medications after undergoing periodontal debridement. Clinical and immunological parameters were assessed at baseline, 30 days, and 90 days.Results:All therapies reduced bleeding on probing (BoP) in the evaluated periods, and the GAtb had a greater reduction at 90 days (p=0.03). The GProb group showed better results for plaque index (PI) and gingival recession (GR) compared to the GAtb at 90 days (p=0.0014; p=0.006). The area of inflammation (PISA Index) significantly decreased in all therapies in the evaluated periods. Therapies had no significant differences regarding moderate pockets. The GAtb had a greater reduction in probing depth (PD) for deep pockets (p=0.03) at 90 days and in the number of deep pocket sites at 30 days (p=0.04). The occurrence of adverse effects was commonly reported in the GAtb as a percentage per patient. The GAtb had a significant reduction in the concentration of interleukins IL-1β and IL-8 and an increase in IL-10 and TNF-α. The CG had a reduction in IL-6 and IL-1 β, whereas in the GProb there was no difference.Conclusion:After three months, none of the adjuvant therapies provided any additional benefit for subgingival instrumentation.