Metronidazole and Amoxicillin for the Treatment of Type 2 Diabetic Subjects With Periodontitis

Inclusion Criteria: * ≥ 35 years of age * Diagnosis of type 2 DM for ≥ 5 years * DM treatment with diet and insulin supplementation or oral hypoglycemic agents * Glycated hemoglobin (HbA1c) levels ≥ 6.5% ≤ 11% * At least 15 teeth * More than 30% of the sites with probing depth (PD) and clinical attachment level (CAL) ≥ 4 mm * Minimum of six teeth with at least one site with PD and CAL ≥ 5 mm and bleeding on probing (BoP) at baseline. Exclusion Criteria: * Pregnancy * Lactation * Current smoking * Smoking within the past 5 years * Scaling and root planing (SRP) in the previous 12 months * Antimicrobial therapies during the previous 6 months * Medical conditions requiring prophylactic antibiotic coverage * Continuous use of mouthrinses containing antimicrobials in the preceding 3 months * Systemic conditions (except DM) that could affect the progression of periodontitis (e.g. immunological disorders, osteoporosis) * Long-term administration of anti-inflammatory * Long-term administration of immunosuppressive medications * Allergy to metronidazole and/or amoxicillin * Presence of periapical pathology * Use of orthodontic appliances * Presence of extensive prosthetic rehabilitation * Major complications of DM (i.e. cardiovascular and peripheral vascular diseases \[ulcers, gangrene and amputation\], neuropathy and nephropathy)