None of the authors had any competing interests related to this study. Part of the study was funded by Helbo Photodynamic Systems GmbH & Co KG, Wels, Austria.
A.S.—examinator, collecting biological material conception and design of the study, writing the first draft, cooperating with all authors, providing funds, revising the literature. E.D.—periodontist conducting periodontal therapy, providing funds, revising the literature. M. P.—development of study protocol, revising draft, providing funds. J.K.P.—interpretation of data, manuscript writing. V.D.P.—conducting and performing laboratory analysis. H.K.—conducting and performing laboratory analysis. N.B.A.—interpretation of data, manuscript writing. R.M.—conducting statistical analysis, interpretation of the data. A.S.—development of study protocol, manuscript writing. All authors read and approved the final manuscript.
To evaluate in patients with aggressive periodontitis (AgP) the effect of nonsurgical periodontal treatment in conjunction with either additional administration of systemic antibiotics (AB) or application of photodynamic therapy (PDT) on the gingival crevicular fluid (GCF) concentration of matrix metalloproteinases 8 and 9 (MMP-8 and -9).
Thirty-six patients with AgP were included in the study. Patients were randomly assigned to treatment with either scaling and root planing (SRP) followed by systemic administration of AB (e.g. Amoxicillin + Metronidazole) or SRP + PDT. The analysis of MMP-8 and -9 GCF concentrations was performed at baseline and at 3 and 6 months after treatment. Nonparametric U-Mann-Whitney test was used for comparison between groups. Changes from baseline to 3 and 6 months were analyzed with the Friedman’s ANOVA test with Kendall’s index of consistency.
In the AB group, patients showed a statistically significant (p = 0.01) decrease of MMP-8 GCF level at both 3 and 6 months post treatment. In the PDT group, the change of MMP-8 GCF level was not statistically significant. Both groups showed at 3 and 6 months a decrease in MMP-9 levels. However, this change did not reach statistical significance.
Within the limits of the present study, it may be suggested that in patients with AgP, nonsurgical periodontal therapy in conjunction with adjunctive systemic administration of amoxicilin and metronidazole is more effective in reducing GCF MMP-8 levels compared to the adjunctive use of PDT.
Keestra JA, Grosjean I, Coucke W, Quirynen M, Teughels W. Non-surgical periodontal therapy with systemic antibiotics in patients with untreated aggressive periodontitis: a systematic review and meta-analysis. J Periodontal Res. 2014; doi:10.1111/jre.
Guerrero A, Nibali L, Lambertenghi R, Ready D, Suvan J, Griffiths GS, et al. Impact of baseline microbiological status on clinical outcomes in generalized aggressive periodontitis patients treated with or without adjunctive amoxicillin and metronidazole: an exploratory analysis from a randomized controlled clinical trial. J Clin Periodontol. 2014;41:1080–9. CrossRefPubMed
Oberoi SS, Dhingra C, Sharma G, Sardana D. Antibiotics in dental practice: how justified are we. Int Dent J. 2014; doi:10.1111/idj.12146.
Arweiler NB, Pietruska M, Skurska A, Dolińska E, Pietruski JK, Bläs M, et al. Nonsurgical treatment of aggressive periodontitis with photodynamic therapy or systemic antibiotics. Three-month results of a randomized, prospective, controlled clinical study. Schweiz Monatsschr Zahnmed. 2013;123:532–44. PubMed
- Effect of nonsurgical periodontal treatment in conjunction with either systemic administration of amoxicillin and metronidazole or additional photodynamic therapy on the concentration of matrix metalloproteinases 8 and 9 in gingival crevicular fluid in patients with aggressive periodontitis
Jan K. Pietruski
Nicole B. Arweiler
- BioMed Central
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