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- Title
Clinical benefits of systemic amoxicillin/metronidazole may depend on periodontitis stage and grade: An exploratory sub‐analysis of the ABPARO trial.
- Authors
Eickholz, Peter; Koch, Raphael; Göde, Moritz; Nickles, Katrin; Kocher, Thomas; Lorenz, Katrin; Kim, Ti‐Sun; Meyle, Jörg; Kaner, Doğan; Schlagenhauf, Ulrich; Harks, Inga; Ehmke, Benjamin
- Abstract
Aim: Assessment of treatment response after systemic amoxicillin/metronidazole adjunctive to subgingival instrumentation (SI) according to stages and grades of the 2018 classification of periodontal diseases. Materials and Methods: We carried out exploratory re‐analysis of the placebo‐controlled, multi‐centre ABPARO trial (52; 45/60 years of age; 205 males, 114 active smokers). Patients were randomized to SI with systemic amoxicillin 500 mg/metronidazole 400 mg (three times a day for 7 days, n = 205; ANTI) or placebo (n = 200; PLAC) and maintenance therapy every 3 months. Patients were reclassified according to the 2018 classification (stage/extent/grade). Treatment effect was the percentage of sites per patient with new attachment loss ≥1.3 mm (PSAL ≥ 1.3 mm) at 27.5 months post‐baseline/randomization. Results: All patients were assigned according to the stage (n = 49 localized stage III, n = 206 generalized stage III, n = 150 stage IV). Because of missing radiographs, only 222 patients were assigned to grades (n = 73 B, n = 149 C). Treatment (PLAC/ANTI) resulted in PSAL ≥ 1.3 mm (median; lower/upper quartile) in localized stage III (PLAC: 5.7; 3.3/8.4% vs. ANTI: 4.9; 3.0/8.3%; p =.749), generalized stage III (8.0; 4.5/14.3% vs. 4.7; 2.4/9.0%; p <.001), stage IV (8.5; 5.1/14.4% vs. 5.7; 3.3/10.6%; p =.008), grade B (4.4; 2.4/6.7% vs. 3.6; 1.9/4.7%; p =.151) and grade C (9.4; 5.3/14.3% vs. 4.8; 2.5/9.4%; p <.001). Conclusions: In generalized periodontitis stage III/grade C, a clinically relevant lower percentage of disease progression after adjunctive systemic amoxicillin/metronidazole was observed compared to placebo (PLAC: 9.7; 5.8/14.3% vs. ANTI: 4.7; 2.4/9.0%; p <.001).
- Subjects
RESEARCH; DISEASE progression; PERIODONTITIS; METRONIDAZOLE; TREATMENT effectiveness; RANDOMIZED controlled trials; PLACEBOS; COMPARATIVE studies; DESCRIPTIVE statistics; RESEARCH funding; STATISTICAL sampling; SMOKING; AMOXICILLIN
- Publication
Journal of Clinical Periodontology, 2023, Vol 50, Issue 9, p1239
- ISSN
0303-6979
- Publication type
Article
- DOI
10.1111/jcpe.13838