Non-Surgical Periodontal Treatment With Antibiotics in Type 2 Diabetic Patients

Aim: To assess the adjunctive effect of systemic antibiotics combined with non-surgical treatment of chronic periodontitis in type 2 diabetic patients.

Materials and Methods: 52 type 2 diabetics were randomly assigned to the following groups: treatment (TG, n=29) received full mouth scaling and root planing within one week combined with a 7-days course of Amoxycillin and Metronidazole; control (CG, n=23) received the same periodontal treatment and a 7-days course of placebo medicine. Subjects were recalled after 6, 12, and 24 weeks post-treatment. Plaque samples were collected and periodontal indices (PPD, CAL, PI, BOP, and SI) recorded at baseline and recalls. Using Quantiative PCR, plaque samples were tested for Porphyromonas gingivalis (P.g.), Actinobacillus actinomycetemcomitans (A.a.), Treponema denticola (T.d.) and Tannerella forsythensis (T.f.).

Results: In the two groups, periodontal indices, except CAL, were significantly decreased compared to baseline and there was no significant difference between the two groups (ANOVA, p<0.05). In TG, all bacterial concentrations were significantly reduced with time compared to baseline (ANOVA, p<0.05) and was maintained low at all the recall visits. CG only had a significant reduction of T.f. and T.d. compared to baseline (ANOVA, p<0.05) and the concentration started to increase at 6 months. The prevalence of P.g., T.f. and T.d. was significantly reduced in TG (Chi square, p<0.001) and the reduction of A.a. was approaching significance (p=0.069). In CG, the reduction of P.g. and T.d. was significant (p<0.05) and the reduction in P.g. was approaching significance (p=0.087). Reduction of A.a. was not significant (p>0.05).

Conclusions: In type 2 diabetic patients systemic antibiotics did not produce significant additional benefit to non-surgical periodontal therapy as detected by clinical indices. It, however, showed a significant suppressive effect of periodontal pathogens. This anti-bacterial effect could help maintain the beneficial effect of periodontal treatment for a longer time period.