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Objective: To compare the clinical and microbiological effects of three protocols for nonsurgical periodontal therapy, including full-mouth scaling and root planing plus systemic antibiotics, on the treatment of chronic periodontitis patients., Methods: Twenty-nine patients diagnosed with moderate to severe chronic periodontitis, selected according to specific criteria, were randomly assigned to one of three treatment groups: quadrant scaling, full-mouth scaling, and full-mouth scaling supplemented by systemic antibiotics. Antibiotic selection was based on the results of individual susceptibility testing. Oral hygiene instructions and reinforcement were given during the study. All patients received a clinical periodontal and microbiological examination at baseline and at reexamination, 4-6 weeks after therapy. Means and standard deviations were calculated and differences between groups were analyzed via the Kruskal-Wallis test, p < 0.05., Results: The mean age of the study sample was 49.1 + 11.6 years old, and there were 17 men and 12 women. Patients treated with antibiotics showed antimicrobial susceptibility for amoxicillin and doxycycline. All study groups showed a similar significant improvement in periodontal parameters. Plaque scores were reduced in a range of 29.0% to 42.6%. Bleeding on probing was reduced by 34.8% to 55.0%; the reduction for the full-mouth scaling group was larger. Mean reduction in pocket depth was 1.2 to 1.3 mm in all groups. Mean bacterial counts were reduced in the groups receiving full-mouth treatment, but not in the quadrant treatment group., Conclusion: The three protocols for non-surgical periodontal treatment demonstrated a similar positive effect on clinical parameters; however, only full-mouth treatment groups showed a reduction in anaerobic microbial counts at re-examination.

The occurrence of bacterial strains resistant to different antimicrobials is a growing problem in Latin American countries. The aim was to measure the antimicrobial susceptibility of Fusobacterium nucleatum, Prevotella intermedia and Prophyromona gingivalis, isolated from chronic periodontitis patients. Twenty-five patients diagnosed with generalized- moderate or advanced- chronic periodontitis were consecutively recruited from patients attending the Periodontal Specialist Program, Javeriana University, according to specific criteria, including no recent antibiotic consumption. All patients filled out a questionnaire on antibiotic intake. The deepest periodontal pocket in each quadrant was sampled. Pooled samples were mixed, diluted and plated on enriched brucella agar plates. After anaerobic incubation, identification of the target bacteria was performed, based on colony morphology, gram staining, aerotolerance and biochemical reactions (RapID Ana II, Remel, U.S.A.). Following identification, the bacteria were subjected to antimicrobial testing, using amoxicillin, tetracycline, doxycicline, azithromycin and metronidazole (E-test, AbBiodisk, Sweden). The minimal inhibitory concentrations obtained were compared with a reference standard to determine antimicrobial resistance. Amoxicillin-resistant species were tested for beta-lactamase production. Forty-four percent of the patients used antibiotics without any medical prescription, 40% used antibiotics at least once a year. The presence of eleven species was confirmed after a series of biochemical tests: four Fusobacterium nucleatum, five Prevotella intermedia and two Prophyromona gingivalis. All strains were resistant to metronidazole, five were resistant to tetracycline and azithromicin, and two strains were resistant to doxycicline and amoxicillin. The strains resistant to amoxicillin were positive for beta-lactamase production, Antimicrobial resistance, particularly against metronidazole, was a common phenomenon for the bacterial isolates analyzed in this Colombian sample.