***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The purpose of this clinical trial is to evaluate the adjunctive clinical effects of the systemic administration of ornidazole ( ORN ) in the full-mouth scaling and root planing ( SRP ) of individuals with moderate-to-advanced chronic periodontitis . METHODS Fifty-eight individuals presenting ≥12 teeth with probing depth ( PD ) ≥4 mm were selected . All participants were instructed on strict oral hygiene measures and were advised to use 0.2 % chlorhexidine mouthwash for 1 week before being allocated to two groups . Thirty participants were r and omly assigned to full-mouth SRP + placebo ( control group ) , and 28 participants were assigned to full-mouth SRP + ORN ( test group ) . The clinical outcomes evaluated were plaque index , gingival index , clinical attachment level ( CAL ) , and PD . RESULTS Fifty participants could be evaluated by ≤6 months . At 6 months , the test group had greater mean reduction ( 2.84 mm ) in PD compared to the control group ( 0.84 mm ) ( P < 0.05 ) , and there was also a greater mean CAL reduction ( 2.92 mm ) in the test group compared to the control group ( 0.92 mm ) ( P < 0.05 ) . CONCLUSION The systemic use of ORN , when used in conjunction with initial periodontal treatment consisting of SRP in adults with periodontitis , achieves significantly better clinical results than initial periodontal treatment alone BACKGROUND AND AIM Several studies have reported adjunctive benefits to scaling and root planing ( SRP ) of systemic amoxycillin and metronidazole in the treatment of periodontal diseases . To date no comparisons have been made of these antimicrobials alone or in combination . The aim of this study was to compare the adjunctive benefits to SRP of amoxycillin and metronidazole alone and combined . METHODS 66 subjects < 46 years of age with advanced chronic periodontal disease participated in this r and omised , double blind , 4 parallel treatment group design ed study . All subjects received quadrant SRP and then were prescribed amoxycillin capsules ( 250 mg ) and metronidazole tablets ( 200 mg ) ( AM ) or lactate capsules and metronidazole ( PM ) or amoxycillin and calcium lactate tablets ( AP ) or lactate and calcium lactate ( PP ) . All medication was 3 of each per day for 7 days . Subgingival plaque sample s were obtained and probing depth ( PD ) , loss of attachment ( LOA ) , bleeding on probing ( BOP ) , suppuration ( SUPP ) and plaque ( DEP ) were recorded pre-treatment , 1 , 3 and 6 months post-treatment . RESULTS Final group sizes were : AM=15 , PM=16 , AP=16 and PP=15 . PD improved in all groups . Treatment effects were highly significantly different and always greatest in the AM and least in the PP groups . Benefits of PM and AP over PP were also noted . LOA improved in all groups and showed the same highly significant treatment differences , again favouring AM . BOP improved in all groups , particularly in AM compared to the other groups . SUPP improved in all groups and was virtually eradicated in AM with differences among treatments highly significant . DEP changed little in any group and there were no significant differences among groups . Microbiological data showed significant differences in favour of AM compared to PP and PM for total aerobes and anaerobes at 1 month . P. intermedia counts were always lower in active groups compared to PP and reached significance for AM and AP at 1 month and AM and PM at 3 months . CONCLUSION The significant differences among treatment groups and the overall trend in the data , in line with other studies , support the considerable adjunctive benefits to SRP of amoxycillin and metronidazole combined in the treatment of advanced chronic periodontal disease OBJECTIVE To evaluate the clinical and microbiological effects of systemic azithromycin as an adjunct to scaling and root planing ( SRP ) in the treatment of Porphyromonas gingivalis-associated chronic periodontitis . METHODS Twenty-nine patients harbouring P. gingivalis were r and omized into test and placebo groups . Test patients received SRP plus 500 mg of azithromycin per day ( 3 days ) , and control patients received SRP plus placebo .  Clinical [ plaque and bleeding indexes , probing pocket depth ( PPD ) , clinical attachment level ( CAL ) ] and microbiological data ( four-sites pooled sample s , processed by culture ) were collected at baseline , and 1 , 3 and 6 months , post-therapy . Clinical variables were compared by anova , and microbiological variables by chi-square , signed-rank and Wilcoxon tests . RESULTS Fifteen test and 11 placebo patients completed the study .  Mean PPD decreased 0.34 mm [ 95 % confidence interval ( CI ) 0.19 - 0.49 ] in the placebo and 0.80 mm ( CI 0.57 - 1.04 ) in the test group after 6 months . For mean CAL gain , the correspondent figures were 0.29 ( CI 0.08 - 0.49 ) and 0.76 ( CI 0.46 - 1.05 ) , respectively . The frequency of detection of P. gingivalis decreased significantly ( p0.01 ) in the test group after 1 , 3 and 6 months . CONCLUSIONS Within the limitations of this study , the adjunctive use of systemic azithromycin in the treatment of P. gingivalis periodontitis demonstrated significant clinical and microbiological benefits when compared with SRP plus placebo AIM To evaluate the effects of systemic azithromycin ( AZM ) as an adjunct to scaling and root planing ( SRP ) in the treatment of generalized chronic periodontitis ( ChP ) . METHODS Forty subjects were r and omly assigned to receive SRP alone or combined with AZM ( 500 mg/day ) for 5 days ( n=20/group ) . Clinical and microbiological examinations were performed at baseline , 6 months and 1-year post-SRP . Nine plaque sample s per subject were analysed by checkerboard DNA-DNA hybridization for 40 bacterial species . Differences between groups were assessed using the Mann-Whitney test and over time using Friedman and Dunn 's tests . RESULTS No statistically significant differences were observed between groups for any parameters evaluated at 1-year post-treatments . Both therapies equally reduced the mean probing depth ( PD ) ( SRP : 3.83 ± 1.92 , AZM : 3.45 ± 1.74 ) and improved the mean clinical attachment ( SRP : 2.35 ± 1.70 , AZM : 2.68 ± 1.76 ) in sites with initial PD7 mm ( primary outcome variable ) between baseline and 1 year . The mean counts and proportions of several periodontal pathogens were reduced , and those of host-beneficial species were increased after treatments . Nonetheless , an important recolonization with red complex species was observed in both groups over the course of the study . CONCLUSION The data of the present study suggest no adjunctive benefit of AZM in the treatment of generalized BACKGROUND This study assessed the long-term effects of adjunctive antimicrobial therapy on  periodontal disease progression and oral colonization . METHODS Patients with previously untreated chronic periodontitis and subgingival Actinobacillus actinomycetemcomitans and /or Porphyromonas gingivalis were r and omly assigned to subgingival scaling without ( control group ) or with systemic amoxicillin plus metronidazole and CHX irrigation ( test group ) . Relative attachment levels were determined and subgingival and mucosal plaque sample s were taken at baseline , at 10 days ( plaque only ) and at 3 , 6 , 9 , 12 , 18 , and 24 months following initial therapy . During maintenance therapy , patients received supragingival debridement only . RESULTS After 24 months , the 18 test group patients showed at sites with initial probing depths ( PD ) > or = 7 mm a significantly ( P < 0.05 ) higher frequency of 2 mm or more attachment gain ( 37.3 % + /- 4.6 % ) and lower frequency of attachment loss ( 7.2 % + /- 3.1 % ) compared to the 17 controls ( 8.2 % + /- 3.9 % and 19.1 % + /- 13.1 % , respectively ) . Compared to controls , the intraoral prevalence of A. actinomycetemcomitans ( up to 18 months ) and P. gingivalis ( up to 3 months ) decreased and that of Eikenella corrodens ( at 10 days ) increased in test patients ( P < 0.05 ) . In both treatment groups , the detection frequency of Tannerella forsythensis decreased transiently , while an overall increase was recorded for Treponema ssp . CONCLUSIONS Over the 24-month period , a single course of the administered adjunctive antimicrobial therapy led to a relative risk reduction of 62 % for attachment loss at deep sites . However , with the exception of A. actinomycetemcomitans , it failed to induce long-term changes in the prevalence profiles of oral colonization BACKGROUND One-stage full-mouth scaling and root planing ( FM-SRP ) in combination with systemically administered azithromycin was shown to be clinical ly and bacteriologically effective in the treatment of chronic periodontitis . However , FM-SRP requires 2 hours for completion . Azithromycin has a long half-life . Therefore , if SRP of the full mouth is performed within 7 days while an effective concentration of azithromycin remains in the gingiva , the effects may be the same as FM-SRP . The aim of this study was to compare the clinical and bacteriologic effects of FM-SRP and partial-mouth scaling and root planing ( PM-SRP ) in patients with chronic periodontitis , which was performed in three sessions within 7 days , during the effective half-life of systemically administrated azithromycin . METHODS Thirty adult subjects with chronic periodontitis were r and omly divided into three groups ( FM-SRP , PM-SRP , and control ) . A clinical examination was conducted to record the probing depth , clinical attachment level gain , bleeding on probing , gingival index , and volume of gingival crevicular fluid ; bacterial sample s were obtained before treatment and 1 , 3 , 6 , 9 , and 12 months thereafter . Quantitative and qualitative analyses were performed using the polymerase chain reaction-Invader method . RESULTS All clinical parameters showed better improvement in FM-SRP and PM-SRP groups compared to the control group , with no significant differences between the two test groups . Periodontal bacteria were well controlled in the two test groups , but they tended to increase gradually 3 months after treatment in the control group . CONCLUSION PM- and FM-SRP demonstrated comparable clinical and bacteriologic results BACKGROUND It has been suggested that scaling and root planing of all pockets within a few hours and chlorhexidine treatments ( full-mouth disinfection ) may reduce the need for supplementary therapies . The aim of this study was to evaluate the clinical benefit of amoxicillin and metronidazole administered immediately after completion of full-mouth periodontal debridement in patients with chronic periodontitis . METHODS This was a single-center , double-masked , placebo-controlled , r and omized longitudinal study of 6 months ' duration . Fifty-one patients received full-mouth periodontal debridement  , performed within 48 hours . Twenty-five subjects received metronidazole , 500 mg , and amoxicillin , 375 mg , three times a day for 7 days ; 26 subjects received a placebo . RESULTS Forty-seven patients could be followed up to month 6 . No differences in clinical parameters were noted before treatment . The overall mean probing depth decreased from 4.3 + /- 0.4 mm to 3.0 + /- 0.2 mm in the test group and from 4.4 + /- 0.4 mm to 3.1 + /- 0.3 mm in the control group ( P = 0.05 , difference between groups ) . More importantly , test subjects had a significantly lower mean number of persisting pockets > 4 mm and bleeding on probing that required further treatment ( P = 0.005 ) : 6 months after full-mouth debridement plus antibiotics , only 0.4 + /- 0.8 persisting pockets were still present , whereas 3.0 + /- 4.3 persisting pockets were still present in the control group . The protective risk of the antibiotics for having more than one pocket deeper than 4 mm and bleeding on probing per subject after 6 months was 8.85 . CONCLUSION Systemic metronidazole and amoxicillin significantly improved the 6-month clinical outcomes of full-mouth non-surgical periodontal debridement , thus significantly reducing the need for additional therapy BACKGROUND The objective of this study was to assess the adjunctive clinical effect of the administration of systemic amoxicillin and metronidazole in the non-surgical treatment of generalized aggressive periodontitis ( GAP ) . METHODS Forty-one systemically healthy subjects with GAP were included in this 6-month double-blind , placebo-controlled , r and omized clinical trial . Patients received a course of full-mouth non-surgical periodontal treatment delivered over a 24 h period using machine-driven and h and instruments . Test subjects received an adjunctive course of systemic antibiotic consisting of 500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days 
    Output:
    
Overall , there was a tendency toward improvement of the measured outcomes , CAL , PPD , and BOP in studies for which systemic antibiotics were used as adjunctive therapy with SRP .