Local disinfection with sodium hypochlorite as adjunct to basic periodontal therapy: a randomized controlled trial

AimTo investigate the clinical and microbiological effects of local disinfection with 0.5% sodium hypochlorite (NaOCl) with or without systemic antimicrobials (amoxicillin and metronidazole, AM) during basic periodontal therapy (BPT). Material and MethodsIn a randomized clinical trial (four groups), 110 chronic periodontitis patients received BPT plus local irrigation with saline (BPT+S), local disinfection with NaOCl (BPT+DIS), BPT+DIS+AM or BPT+S+AM. The outcome was analysed at baseline, 3, 6 and 12months. ResultsThere was no difference in clinical attachment level gain at 12months between the four groups. BPT+DIS showed no additional improvement compared to BPT+S; BPT+DIS+AM showed fewer sites with probing pocket depth (PPD) 7mm versus BPT+S only up to 6months (p=0.037). In factorial analyses, additional clinical reduction for PPD (p=0.023) and number of sites with PPD 5 (p=0.007), 6 (p=0.002) and 7mm (p<0.001) were found when AM was added to BPT, but not when DIS was applied. In all groups, a comparable decrease in targeted bacteria was found. AM caused adverse events in 22% of the patients. ConclusionLocal disinfection with NaOCl, also in combination with AM, showed, after 1-year follow-up, no additional clinical and microbiological effects compared to BPT alone.