Periodontology Literature Review

ANTIBIOTICS: SYSTEMIC DELIVERY

Loesche, W. et al: Treatment of Perio Infection due to Anaerobic Bacteria with Short-Term Treatment with Metronidazole. J Clin Perio, 8:29, 1981.

Purpose:

The purpose of this study was to investigate the use of systemic metronidazole in periodontal patients.

Materials and methods:

A total of 5 patients were selected. 3 patients received 250 mg metronidazole three times a day (tid) for 7 days. 2 patients received the same metronidazole schedule plus they received scaling and root planing (SRP) on one half of their dentition at the beginning of systemic therapy and the other half at the end of systemic therapy. No oral hygiene instructions (OHI) were given.

Bacterial Procedures:

Plaque was removed and studied in each quadrant of each patient thus totaling 4 samples per 5 patients. The total count and B. asaccharolyticus were obtained. A second plaque sample obtained from the same sampling day was viewed by dark field microscopy for the presence of spirochetes.

Clinical Procedures: The following were recorded; papillary Bleeding Score (PBS) using a stim-u-dent, probing depth, and loss of attachment.

Results:

Case reports for each patient are presented. However, in general, the patients presented with clinical disease coincident with elevated proportions of B. asaccharolyticus (41%) and spirochetes (29%). The authors state that these values are consistent with disease activity.

The 1 week treatment with metronidazole caused an improvement on the periodontal health of the most diseased sites in each of the patients despite the absence of OHI and a minimal amount of mechanical debridement. The two patients that were mechanically debrided exhibited the best response of all the patients. Also as expected, the greatest improvement occurred in the deepest pockets. At 6 months the degree of improvement was beyond that of reported results with tetracycline.

Conclusion:

The authors suggest that the use of metronidazole can enhance and or prolong the time needed between recall appointments.

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