Amoxicillin and metronidazole are the ideal antibiotic combination to use in addition to scaling and root planing for the treatment of aggressive periodontitis, according to international expert doctors Magda Feres, Panos Papapanou and Joerg Meyle, who were present at the scientific sessions in the last Meeting of the SEPA (Spanish Society of Periodontology and Osseointegration) in Girona.

What treatment protocol do you apply to patients with generalised aggressive periodontitis?

Dr. Panos Papapanou

“Even when addressing specific forms of periodontitis, it is essential to stress the importance of conventional treatment in controlling plaque, scaling and root planing and even periodontal surgery. Only when optimum cooperation exists and when desired results are not achieved can we consider an indication for systemic antibiotics or even host response modification.

Most patients have a bacterial profile that allows for efficient clinical results from combining amoxicillin and metronidazole, and in general, microbiological analysis is not needed.”

Dr. Magda Feres

“Patients with generalised aggressive periodontitis are treated with mechanical scaling of the root surfaces along with simultaneous 1-week administration of amoxicillin and metronidazole. Patients are treated in a series of sessions for just one week, during which they undergo treatment with the antibiotic combination. These patients also rinse with Chlorhexidine in order to improve supragingival plaque control. Our studies indicate that this therapy approach yields very favourable clinical results, reducing the need for complex surgical treatments. In all cases, pre- and post-operative microbiological analyses are performed to assess microbiological changes.”

Dr. Joerg Meyle

“Normally we use a combination of amoxicillin and metronidazole for 7 days and we try to perform mechanical treatment during the same week. It is important that mechanical biofilm removal be carried out simultaneously with the antimicrobial agent. This antibiotic is given based on microbiological testing which identifies the presence of the main periodontal pathogens, and antibiograms are even performed to confirm whether or not the bacterial strains present are susceptible to the antibiotics. We do not verify the need for additional surgical treatment until 6 months have gone by after the active treatment.”

With the collaboration of SEPA :