Periodontology Literature Review

ANTIBIOTICS: SYSTEMIC DELIVERY

Lindhe, J., Liljenberg, B., Aldielson, B., and Borjesson, I.: The effect of metronidazole therapy on human periodontal disease. J Perio Res 17:534, 1982.

Purpose:

The purpose of this study was to investigate the potential for metronidazole to work with and without scaling in long term (50 weeks) periodontal patients.

Materials and methods:

A total of 16 patients were utilized who had periodontal pockets greater than 6 mm with at least four pairs of teeth with disease. Dark field microscopy was used to assess the subgingival microbiota. The test group received 200 mg of metronidazole 5 times daily for 3 periods of 2 weeks each, with intervals of 8 weeks without the antibiotic. Subgingival scalings occurred for 4 visits during a 2 week period.

Results:

The use of a long term antibiotic was tested in this study and showed that attachment levels to be slightly better (statistically significantly better though) in the test group with metronidazole only over control groups; Coccoid cells increased markedly in all groups expect the non scaled -non drug group. Spirochetes were reduced in all groups with the same exception as before that is the negative control group. Finally it was noted that in all groups, the leukocyte infiltrate was gone with the same exception as before, the negative control group. This group showed infiltrate in the apical portion. In the test group of metronidazole, a narrow band of infiltrates existed near the junctional epithelium.

Conclusion:

Thus metronidazole did have a long term effect on the microbiota and clinical parameters but to what extent will relapse occur once the drug is discontinued has not been tested, thus is this form of therapy really an important adjunct to scaling and root planing?

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