THERAPEUTIC EFFICACY OF AMOXICILLIN COMBINED WITH METRONIDAZOLE IN TREATMENT OF PERIODONTITIS WITH TYPE II DIABETES AND TH1/TH2/TH17 STATUS

Abstract

This study evaluated the efficacy of amoxicillin and metronidazole in treating periodontitis in patients with type 2 diabetes mellitus (T2DM), focusing on Th1/Th2/Th17 immune responses. Patients (n = 219) were randomized to receive placebo, amoxicillin, metronidazole, or a combination, alongside standard antidiabetic and periodontal therapy. At 3 months, the combination therapy significantly improved periodontal indices, glycaemic control, and reduced pro-inflammatory Th1/Th17 cells and cytokines, while increasing anti-inflammatory Th2 responses (p < 0.05). Subgingival Bacteroides, Fusobacterium, and Lactobacillus were also significantly reduced. The combination group showed the highest clinical efficacy (88%) versus placebo (30%), amoxicillin (69%), and metronidazole (75%). These findings support the enhanced therapeutic effect of combined antibiotic therapy in T2DM-associated periodontitis through modulation of local immune responses.