The effects of adjunctive metronidazole plus amoxicillin in the treatment of generalized aggressive periodontitis: a 1-year double-blinded, placebo-controlled, randomized clinical trial.

AIM: To evaluate the clinical effects of the adjunctive use of metronidazole (MTZ) and amoxicillin (AMX) in the treatment of generalized aggressive periodontitis (GAgP). METHODS: Thirty subjects were randomly assigned to receive scaling and root planing (SRP) alone or combined with MTZ (400 mg/TID) and AMX (500 mg/TID) for 14 days. Subjects were clinically monitored at baseline, 6 months and 1 year post-therapies. RESULTS: Both therapies led to a statistically significant improvement in all clinical parameters at 1 year post-therapy (p < 0.05). Subjects receiving MTZ plus AMX exhibited the deepest reductions in mean probing depth (PD) and gain in clinical attachment between baseline and 1 year post-therapy in the full-mouth analysis and in initially intermediate (PD 4-6 mm) and deep (PD ≥ 7 mm) sites (p < 0.01). In addition, the antibiotic group presented lower mean number of residual sites with PD ≥ 5 or 6 mm as well as fewer subjects still presenting nine or more sites with PD ≥ 5 mm or three or more sites with PD ≥ 6 mm at the end of the study period. CONCLUSION: The non-surgical treatment of GAgP is markedly improved by the adjunctive use of MTZ+AMX, up to 1 year post-treatment.

Effect of anesthetics containing lidocaine and epinephrine on cardiovascular changes during dental implant surgery.

The purpose of this study was to evaluate cardiovascular changes during dental implant surgery using 2% lidocaine with 1:80 000 epinephrine. Eleven normotensive subjects, ranging from 18 to 56 years, were selected to undergo dental implant surgery in the jaw. They were monitored in the pre-, intra-, and postsurgical periods by continuous noninvasive automatic arterial pressure and cardiac frequency measurements taken every 2 minutes. Parameter scores were obtained for the following phases: P1, 15 minutes during preparation of the patient (control period); P2, before anesthesia; P3, immediately after anesthesia; P4, 2 minutes into anesthesia; P5, during incision and detachment; P6, during perforation; P7, during implant placement; P8, during suturing; P9, on completion; and P10, 10 minutes after termination. Individualized statistical analysis for each group during the pre-, intra-, and postoperative periods were performed by analysis of variance. The greatest variations in systolic pressure were increases of 2.29% during phase P2 and 2.59% in phase P5. Diastolic pressure decreased during phase P6 (-2.58%) and increased in P10 (3.27%). The greatest changes in heart rate occurred in phase P10 (-3.24%). There were no statistically significant changes among the evaluated phases (P > .05). In conclusion, there were no changes in the analyzed cardiocirculatory parameters during dental implant surgery (systolic, diastolic, and mean arterial blood pressures and heart rate) in normotensive subjects anesthetized with 2% lidocaine with epinephrine 1:80000.