الفهرس | Only 14 pages are availabe for public view |
Abstract Chronic adult periodontitis is a bacterially induced chronic inflammatory disease that destroys the connective tissue and bone that support teeth. P. gingivalis and P. intermedia are among the strongest markers of periodontal destruction, through their high virulence factor and overcoming cellular and humoral defense mechanisms. Because of high pathogenesis of these bacteria, the dental practitioner needs the antibiotic in addition to surgical and/ or nonsurgical therapy in treatment of severe chronic periodontitis in which P.g and P.i are involved. Moxifloxacin is a fourth-generation synthetic fluoroquinolone antibacterial agent. It is marketed worldwide (as the hydrochloride) under the brand names Avelox, Avalox, and Avelon for oral treatment. It is a broad-spectrum antibiotic that is active against both Gram-positive and Gram-negative bacteria and a good activity against periodontal pathogens. Accordingly; the aim of the present study was to assess the clinical and microbiological effects of moxifloxacin as an adjunct to scaling /root planing and to compare it to scaling/ root planing alone and scaling/ root planing combined with the established antibiotic regimen metronidazole and augmentin in patients with advanced chronic periodontitis. Thirty patients with advanced chronic periodontitis were used in the current study and divided into three groups; the 1 st group included ten patients treated with scaling and root planing (SRP) alone (control group), ten patients were treated with SRP plus Augmentin(625mg, every 8 hours for 10 days) and metronidazole (250 mg, every 8 hours for 10 days), and the last ten patients treated with SRP plus moxifloxacin (400mg, once daily for 10 days) (test group). In each subject, subgingival plaque samples were collected from The 4 deepest sites of 4 teeth, one in each quadrant at baseline before initial therapy and 3 and 6 months after the completion of therapy for evaluation of their content of two subgingival microbial species including P.i and P.g using the DNA probes. The result of quantitative PCR technique revealed, after 3 months and after 6 months, there was no statistically significant difference between Moxifloxacin and Augmentin/Metronidazole groups; both showed the statistically significant highest mean percentage reduction in log10 values of P. gingivalis as (after 3 months MXF 43.5%, Aug/MET 45.6% and after 6 months MXF 32.2%, Aug/MET 34.4%). While SRP without antibiotic showed the statistically significant lowest mean percentage reduction in log10 values of P. gingivalis as (after 3 months 30.5% and after 6 months 21.4%). Similarly after 3 months and after 6 months, there was no statistically significant difference between Moxifloxacin and Augmentin/ Metronidazole; both showed the statistically significant highest mean percentage reduction in log10 values of P. intermedia as (after 3 months MXF 42.2%, Aug/MET 50.8% and after 6 months MXF 37.9%, Aug/MET 38.7%). SRP without antibiotic showed the statistically significant lowest mean percentage reduction in log10 values of P. intermedia as (after 3 months 19.7%, after 6 months 12.8%). The results obtained suggested that moxifloxacin as an adjunct to SRP represents a viable approach to treat severe chronic periodontitis. |