Literature Review | Chemotherapeutics
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ANTIMICROBIALS: TOPICAL

Klinge, B., Attstrom, R., Karring, T., Kisch, J., Lewin, B., Stoltze, K.,: 3 regimens of topical metronidazole compared with subgingival scaling on periodontal pathology in adults. J Clin Perio, 19 (9 p2):708-714, 1992.

Purpose:

To test the effect of metronidazole 25% gel on probing depth (PD) and bleeding on probing (BOP), comparing it with 2 other metronidazole treatments; 15% gel 2X a week for 2 weeks, and 15% gel 1X a week for 2 weeks.

Materials and methods:

61 patients with adult periodontitis (34 were smokers) were included in this study. Four treatments were compared in split mouth design; metronidazole 25% 1X a week for 2 weeks (A), metronidazole 15% 1X a week for 2 weeks (B), metronidazole 15% 2X a week for 2 weeks (C), scaling and root planing (SRP), one tooth in each quadrant was selected (> 5 mm). The examination consisted of; probing depth (PD) at 4 sites, and bleeding on probing (BOP). Measurements were made on pre-treatment and days 24, 38, 52, 94 after the last application. The gels were applied with a Paroject syringe 1g/1.8 ml; to all teeth on quadrant.

Results:

The estimated amount of metronidazole used per tooth was 34 mg (A), 14 mg (B) and 25 mg (C). The overall mean PD was 5.8 mm. Reductions in PD from baseline were static significant in all for groups. The groups were significantly different only at 2 weeks. Treatment B was inferior to treatment A and SRP. The treatments were not different at 12 weeks. The decrease in BOP from baseline was statistically significant, but treatments were not significantly different from each other. There was a decrease in BOP from 66-73% to 40-49%. The following adverse reaction were recorded; bitter taste, 40 of 61 patients, vomiting in 2 patients, and tenderness of gingiva 18 of 61 patients.

Conclusion:

All 3 topical metronidazole regimens yielded comparable results to those seen after conventional treatment. 
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