The Clinical and Microbiological Effects of Systemic Ornidazole in Sites With and Without Subgingival Debridement in Early‐Onset Periodontitis Patients

Abstract

Background: The purpose of this study was to evaluate the clinical and microbiological effects of systemic ornidazole (ORN) in sites with or without subgingival debridement in early‐onset periodontitis (EOP) patients. Methods: Two pooled bacterial samples consisting of 4 sites each (scaled and non‐scaled sites) were obtained from 30 individuals exhibiting EOP. All patients received oral hygiene instruction (OHI), supragingival scaling and ORN. Subgingival scaling and root planing (SRP) was carried out only in scaled sites. Bacterial samples were taken at baseline (BL) and 1 week and 2, 6, and 12 months after systemic ornidazole administration (500 mg/bid for 7 days). One more sample was taken at scaled sites, one week after SRP. Results: One week following SRP (scaled sites) Gram‐negative facultative and anaerobic rods were significantly reduced while Gram‐positive facultative cocci were significantly increased. After ORN administration, P. gingivalis, P. denticola, P. intermedia, B. forsythus, C. rectus , and S. sputigena were no longer detectable in either scaled or non‐scaled sites. A statistically significant long‐term (2, 6, and 12 months) reduction of P. gingivalis, P. intermedia, P. loescheii, B. forsythus , and C. rectus and a pronounced increase of S. milleri, S. oralis , and S. sanguis counts in both scaled and non‐scaled sites were detected in comparison to baseline. A sustained reduction of bleeding tendency and of probing depth was also observed in both scaled and non‐scaled sites. Conclusions: ORN combined with SRP effects beneficial shifts in the bacterial population associated with substantial clinical improvement, thereby indicating that ORN is effective adjunct in the treatment of EOP deep periodontal pockets where anaerobic bacteria are predominant. J Periodontol 2000;71:1862‐1873.