Control of periodontal infections: a randomized controlled trial I. The primary outcome attachment gain and pocket depth reduction at treated sites.

Objective To compare the treatment outcome of scaling and root planing (SRP) in combination with systemic antibiotics, local antibiotic therapy and/or periodontal surgery. Material and Methods One hundred and eighty-seven patients were assigned to eight groups treated by SRP plus none, one, two or three adjunctive treatments and monitored for 24 similar to months in a randomized controlled clinical trial using a 2 similar to 2 similar to 2 factorial design. Systemic amoxicillin similar to metronidazole (SMA), local tetracycline delivery (LTC) and periodontal surgery (SURG) were evaluated as adjuncts. Changes in clinical attachment level (CAL) and probing pocket depth (PPD) were statistically evaluated by ancova of main effects. Results Effects of adjunctive therapy to SRP were minimal at 3 similar to months. Between 3 and 6 similar to months PPD reduction occurred particularly in patients receiving periodontal surgery. After 6 similar to months, both CAL gain and PPD reduction reached a plateau that was maintained at 24 similar to months in all groups. The 24-month CAL gain was improved by SMA (0.50 similar to mm) while PPD was reduced by SMA (0.51 similar to mm) and SURG (0.36 similar to mm). Smoking reduced CAL gain and PPD reduction. Conclusion Patients receiving adjunctive therapies generally exhibited improved CAL gain and/or PPD reduction when compared with the outcome of SRP alone. Only additive, not synergistic effects of the various adjunctive therapies were observed.