Comparison of Topical Metronidazole, Ciprofloxacin, Cimetidine, and Meloxicam Treatment in Plaque- Induced Gingivitis

Abstract

Objectives: The aim of the present study was to evaluate and compare the clinical effectiveness of newly prepared topical dosage forms as an adjunct to scaling and polishing (S & P) in plaque-induced gingivitis.
 Materials and Methods: The study was conducted on 75 patients (35 males and 40 females) with a moderate to severe gingivitis randomly divided into five groups, each including 15 patients. In each group, the patients received (S & P) plus one of the oral gels (1% metronidazole, 1% ciprofloxacin, 1% cimetidine, 0.5% meloxicam) twice daily for seven days, except group 0 which were treated by (S & P) alone without any drug application. All the patients were evaluated before treatment and 7 days after treatment for plaque index [PLI], gingival index [GI], and bleeding on probing [BOP] and biochemical parameters (salivary enzymes) like aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), and lactate dehydrogenase (LDH).
 Results: There was a significant improvement following all treatments type when compared to pretreatment records with minor differences in the effects of treatment modalities on the clinical parameters (PLI, GI, and BOP). Combination therapy of (S & P) plus ciprofloxacin gel resulted in the best improvement of PLI and BOP whereas the highest significant improvement in GI was with the combination therapy of (S & P) plus cimetidine gel. Similarly, AST, ALT, CK, and LDH significantly reduced in all five groups, with the most observed reduction of both AST and CK was found in the combination therapy of metronidazole gel along with (S & P). The highest decrease in ALT and LDH was observed with the combination therapy of cimetidine gel along with (S & P).
 Conclusion: The above studies revealed that adjunctive use of topical gels particularly ciprofloxacin and cimetidine along with (S & P) results in significant benefits in the treatment of plaque-associated gingivitis.