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Title Comparison of Anti-inflammatory Effects Produced in Gingiva by Metronidazole and Azithromycin
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Publication Date
Degree MS
Discipline/Department Dentistry
Degree Level masters
University/Publisher The Ohio State University
Abstract Objective: Previous studies suggest that azithromycin (AZM) inhibits subclinical gingi-val inflammation in individuals with minimal plaque and clinically healthy gingiva. While it is unclear whether other antibiotics produce similar effects in gingiva, metroni-dazole (MET) has been shown to decrease pro-inflammatory cytokine production by cul-tured periodontal ligament cells. This randomized, blinded, crossover study compared anti-inflammatory effects produced by AZM and MET.Methods: Twelve healthy adult subjects with good oral hygiene and clinically healthy gingiva were randomly allocated to receive a blinded regimen of either AZM (500mg ini-tial dose, then 250mg at 24 and 48 hrs) or MET (375mg every 12 hr for 48 hr). At base-line (immediately before starting the regimens) and 2, 4, 7 and 14 days later, gingival crevicular fluid (GCF) samples were collected from twelve maxillary interproximal sites, measured with a calibrated Periotron, pooled, and stored frozen. After a 21 day washout period, each subject received the alternative regimen. A second set of GCF samples were collected at the same time points. GCF samples were assayed for pro- and anti-inflammatory cytokine signatures by multiplex immunoassay.Results: Both agents induced significant transient decreases in the rate of GCF flow on days 2, 4 and 7. No significant differences in their effects were observed. With both an-tibiotics, the GCF flow rate increased to approximately 86% of baseline between days 7 and 14. In parallel with their effects on GCF volume, AZM and MET induced transient reductions in the GCF content of several pro-inflammatory cytokines (IL-1ß, IL-12, IL-17, G-CSF) as well as IL-8, RANTES, VEGF, and IL-4. The effects of AZM and MET were similar in magnitude and the most significant decreases below baseline levels were apparent on days 4 and 7. MET induced a larger decrease in GCF IL-8 content than AZM. Neither agent produced significant changes in the amounts of the anti-inflammatory cytokines IL-10 and IL-1 receptor antagonist in GCF. Conclusions: In addition to their known antimicrobial effects, AZM and MET both ap-pear to inhibit production of a similar range of pro-inflammatory cytokines and chemoki-nes in gingiva. This could potentially enhance the efficacy of these agents in the treat-ment of inflammatory periodontitis.
Subjects/Keywords Dentistry; Periodontics; Antibiotics; Azithromycin; Metronidazole; GCF; Periodontitis; healthy gingiva
Contributors Walters, John (Advisor)
Language en
Rights unrestricted ; This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
Country of Publication us
Format application/pdf
Record ID oai:etd.ohiolink.edu:osu1402670626
Repository ohiolink
Date Indexed 2021-01-29
Grantor The Ohio State University

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