High sensitive- C reactive protein, periodontal parameters and periodontal microbiota after scaling-root planning plus Azithromycin as treatment of Chronic Periodontitis: A Randomized Clinical Trial
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Objective: This single blind randomized clinical trial (RCT) determined the effect of scaling and root planning plus azithromycin (SRP+Azi) in serum C reactive protein levels and other blood biomarkers, clinical periodontal parameters and subgingival microbial composition three months after periodontal therapy.
Materials and Methods: Forty-nine chronic periodontitis patients participatedin the study and were randomly assignedsession of scaling and root planning plus oral azithromycin 500 mg daily for five days (SRP+Azi) while, 27 patients in the control group received the same single session of scaling and root planning plus placebo (SRP+Pb). A group of 25 subjects presenting periodontal health-gingivitis were included as a comparison group and in them was determined clinical periodontal parameters, blood parameters and microbiota at baseline. Periodontitis groups received a full mouth periodontal examination, blood test and microbiological cultures at baseline, and three months after therapy.
Primary outcome variable was the variation in serum high sensitive C- reactive protein (hs-CRP). Secondary outcome variables were variation of triglycerides, High density Cholesterol (HDL), low density Cholesterol (LDL), fasting glucose, pocket depth and microbial composition.
Results: Therapy with SRP+Azi do not significantly reduce the plasmatic levels of hs-CRP however, a positive trend was notice (4,33 to 2,99 mg/l). This group obtained also greater reduction of pocket depth (PD), artery index and P. gingivalis and P intermedia detection frequency when compared to the SRP placebo group (p<0.05). Other blood biochemistry parameters did not changed significantly in the test group. In contrast, the control group increased the hs- CRP levels after therapy and in some cases a increase of pocket depth was detected.
Conclusions: Combined SRP+Azi therapy in chronic periodontitis did not reduced hs- CRP serum level significantly after three months. However, this group reduced significantly their probing pocket depth, reduced P. gingivalis and P intermedia frequency and increased clinical attachment gain.
Key words: Chronic periodontitis, Creactive protein, azithromycin, randomized clinical trial.
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