Azithromycin and Full-Mouth Scaling For the Treatment of Generalized Stage III and IV Periodontitis: A 6-Month Randomized Comparative Clinical Trial

Abstract The effectiveness of azithromycin combined with full-mouth scaling procedures was compared to quadrant-wise scaling combined with the same dosage of azithromycin when treating periodontitis patients over a 6-month period. In this randomized clinical trial study, thirty-four individuals diagnosed with generalized stage III and IV periodontitis underwent baseline, 3-month, and 6-month post-treatment examinations. The study population was randomly assigned to either full-mouth scaling (FMS) or quadrant-wise scaling and root planning (QSRP) in addition to their taking of systemic azithromycin (500 mg/day) for three consecutive days. Periodontal probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) were monitored along with the quantification of total bacterial load and red complex bacterial species (Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola) in subgingival samples by real time polymerase chain reaction. The volume of gingival crevicular fluid (GCF) was also monitored over time. The primary outcomes included improvements of PD and CAL. Data was statistically analyzed through a repeated-measures analysis of variance (ANOVA) test, multiple least significant difference (LSD) comparisons, Kruskal-Wallis, Friedman, and paired Student t-tests (p

摘要 本研究对比了6个月疗程内，阿奇霉素联合全口刮治术与分象限刮治联合同等剂量阿奇霉素治疗牙周炎患者的疗效。本随机临床试验共纳入34名确诊为广泛型III、IV期牙周炎的受试者，分别在基线、治疗后3个月及6个月开展检查。受试者被随机分配至两组：一组接受全身性阿奇霉素（每日500mg，连续服用3天）联合全口刮治（full-mouth scaling, FMS），另一组接受相同方案的全身性阿奇霉素联合分象限刮治及根面平整（quadrant-wise scaling and root planning, QSRP）。研究监测了牙周探诊深度（periodontal probing depth, PD）、临床附着水平（clinical attachment level, CAL）、牙龈指数（gingival index, GI）与菌斑指数（plaque index, PI），并通过实时聚合酶链反应定量检测龈下样本中的总细菌载量及红色复合体菌种（牙龈卟啉单胞菌Porphyromonas gingivalis、福赛斯坦纳菌Tannerella forsythia、齿垢密螺旋体Treponema denticola）。此外还动态监测了龈沟液（gingival crevicular fluid, GCF）体积。本研究的主要结局指标为PD与CAL的改善情况。数据采用重复测量方差分析（ANOVA）、最小显著差异多重比较（LSD）、克拉斯卡尔-沃利斯检验、弗里德曼检验及配对t检验进行统计学分析（p