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Biological responses following one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial.

Abstract

BACKGROUND AND OBJECTIVE

Full-mouth scaling and root planing (FM-SRP) increases the systemic levels of inflammatory mediators via early inflammation but may be inhibited using an antimicrobial agent. This prospective intervention study evaluates the biological response and clinical effects of FM-SRP with and without systemically administered azithromycin (AZM).

MATERIALS AND METHODS

A multicenter parallel randomized controlled and open-label trial. A central randomization center used computer-generated tables to allocate treatments. Sixty-three patients with moderate to severe generalized periodontitis (New American Academy of Periodontology Classification: Stage3 or 4, Grade B) were randomly assigned to receive FM-SRP with AZM (test group, n = 32) or FM-SRP without AZM (control group, n = 31). Clinical parameters and body temperature were measured, and subgingival plaque, peripheral blood, and gingival crevicular fluid were collected before and after treatment. Periodontopathic bacteria and IgG titers were measured by gingival crevicular fluid and peripheral blood. High-sensitivity assays were used to analyze systemic and local inflammatory markers, such as endotoxin, high-sensitive CRP (hs-CRP), and six inflammatory cytokines. Follow-up 6 weeks.

RESULTS

The total number of bacteria and the number of Porphyromonas gingivalis and Prevotella intermedia were significantly lower in the test group after FM-SRP. IgG titers for P gingivalis significantly decreased after FM-SRP with AZM, and the body temperature increased significantly after FM-SRP without AZM. In the control group, serum hs-CRP, IFN-γ, IL-12p70, and IL-6 were significantly increased one day after treatment, but subsequently decreased below the original numerical value. In the test group, only hs-CRP showed a significant increase.

CONCLUSIONS

FM-SRP resulted in similar improvements in clinical parameters with and without the use of AZM. Inflammatory mediators showed no difference between the two groups after FM-SRP treatment. The use of AZM was effective in preventing the elevation of body temperature after FM-SRP.

Authors+Show Affiliations

Department of Periodontology, School of Dental Medicine, Tsurumi University, Yokohama, Japan.Division of Periodontology, Department of Oral Interdisciplinary Medicine, School of Dentistry, Kanagawa Dental University, Yokosuka, Japan. Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.Division of Periodontology, Department of Oral Interdisciplinary Medicine, School of Dentistry, Kanagawa Dental University, Yokosuka, Japan. Bunkyo-Dori Dental Clinic, Chiba, Japan.Bunkyo-Dori Dental Clinic, Chiba, Japan.Seikeikai Group, Seikeikai Hospital, Yokohama, Japan.Seikeikai Group, Seikeikai Hospital, Yokohama, Japan.Seikeikai Group, Seikeikai Hospital, Yokohama, Japan.Department of Periodontology, School of Dental Medicine, Tsurumi University, Yokohama, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31292965

Citation

Yashima, Akihiro, et al. "Biological Responses Following One-stage Full-mouth Scaling and Root Planing With and Without Azithromycin: Multicenter Randomized Trial." Journal of Periodontal Research, 2019.
Yashima A, Morozumi T, Yoshie H, et al. Biological responses following one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial. J Periodont Res. 2019.
Yashima, A., Morozumi, T., Yoshie, H., Hokari, T., Izumi, Y., Akizuki, T., ... Gomi, K. (2019). Biological responses following one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial. Journal of Periodontal Research, doi:10.1111/jre.12680.
Yashima A, et al. Biological Responses Following One-stage Full-mouth Scaling and Root Planing With and Without Azithromycin: Multicenter Randomized Trial. J Periodont Res. 2019 Jul 10; PubMed PMID: 31292965.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biological responses following one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial. AU - Yashima,Akihiro, AU - Morozumi,Toshiya, AU - Yoshie,Hiromasa, AU - Hokari,Takahiro, AU - Izumi,Yuichi, AU - Akizuki,Tatsuya, AU - Mizutani,Koji, AU - Takamatsu,Hideyuki, AU - Minabe,Masato, AU - Miyauchi,Satomi, AU - Yoshino,Toshiaki, AU - Tanaka,Maki, AU - Tanaka,Yoshie, AU - Gomi,Kazuhiro, Y1 - 2019/07/10/ PY - 2019/02/13/received PY - 2019/04/22/revised PY - 2019/06/09/accepted PY - 2019/7/12/entrez KW - acute-phase reaction KW - antimicrobial agents KW - full-mouth scaling and root planing KW - inflammation mediators KW - periodontitis JF - Journal of periodontal research JO - J. Periodont. Res. N2 - BACKGROUND AND OBJECTIVE: Full-mouth scaling and root planing (FM-SRP) increases the systemic levels of inflammatory mediators via early inflammation but may be inhibited using an antimicrobial agent. This prospective intervention study evaluates the biological response and clinical effects of FM-SRP with and without systemically administered azithromycin (AZM). MATERIALS AND METHODS: A multicenter parallel randomized controlled and open-label trial. A central randomization center used computer-generated tables to allocate treatments. Sixty-three patients with moderate to severe generalized periodontitis (New American Academy of Periodontology Classification: Stage3 or 4, Grade B) were randomly assigned to receive FM-SRP with AZM (test group, n = 32) or FM-SRP without AZM (control group, n = 31). Clinical parameters and body temperature were measured, and subgingival plaque, peripheral blood, and gingival crevicular fluid were collected before and after treatment. Periodontopathic bacteria and IgG titers were measured by gingival crevicular fluid and peripheral blood. High-sensitivity assays were used to analyze systemic and local inflammatory markers, such as endotoxin, high-sensitive CRP (hs-CRP), and six inflammatory cytokines. Follow-up 6 weeks. RESULTS: The total number of bacteria and the number of Porphyromonas gingivalis and Prevotella intermedia were significantly lower in the test group after FM-SRP. IgG titers for P gingivalis significantly decreased after FM-SRP with AZM, and the body temperature increased significantly after FM-SRP without AZM. In the control group, serum hs-CRP, IFN-γ, IL-12p70, and IL-6 were significantly increased one day after treatment, but subsequently decreased below the original numerical value. In the test group, only hs-CRP showed a significant increase. CONCLUSIONS: FM-SRP resulted in similar improvements in clinical parameters with and without the use of AZM. Inflammatory mediators showed no difference between the two groups after FM-SRP treatment. The use of AZM was effective in preventing the elevation of body temperature after FM-SRP. SN - 1600-0765 UR - https://www.unboundmedicine.com/medline/citation/31292965/Biological_responses_following_one-stage_full-mouth_scaling_and_root_planing_with_and_without_azithromycin:_Multicenter_randomized_trial L2 - https://doi.org/10.1111/jre.12680 DB - PRIME DP - Unbound Medicine ER -