Abstract

Objectives:The purpose of the present study was to compare the topical application of chlorohexidine (CHX) and Metronidazole (MTZ) gels, individually and in combination in patients with gingivitis for up to 12 weeks follow-up.Methods:The clinical trial was conducted at Liaquat University of Medical Health Sciences (LUMHS) Jamshoro and Hyderabad, Institute of Dentistry from 1st March 2019 to 1st March 2020. Patients were selected based on inclusion criteria. Out of 125 screened patients, ninety-nine patients agreed to participate in the study. At the beginning of study all patients were assessed for gingival inflammation by using gingival index (GI) (Loe and silness, 1963). Scaling root planning (SRP) was performed in all patients. Subjects were randomly selected in three groups (n=33 each). In Group-A CHX gel was applied, Group-B Metronidazole gel was applied and the combination of two was applied to patients of Group-C. Patient follow up was done and gingival parameters were assessed at baseline, fourth week and twelve weeks. Apart from the clinical evaluation, a subjective evaluation was also undertaken. Significance level of 0.05 and a desired study power of at least 80% was estimated. Analysis of Variance (ANOVA) test for comparison was used within groups.Results:A significant improvement in gingival scores was noted in all groups from baseline. At 4 weeks CHX (1.25±0.21) MTZ (1.81±0.38) CHX+MTZ (1.29±0.34) compared to baseline CHX (2.77±0.24) MTZ (2.84±0.54) CHX+MTZ (2.74±0.31) demonstrated substantial improvement (p<0.001). However, gingival scores showed inclination at 12 weeks CHX (1.18±0.41) MTZ (1.21±0.48) CHX+MTZ (1.11±0.14) with no significant difference to week 4 (p>0.001).Conclusion:Local MTZ gel and MTZ+CHX gel showed effectiveness similar to CHX gel application adjunct to scaling and root planning in the treatment of gingivitis.

Highlights

  • Gingivitis is characterized by inflammation of the gums, or gingiva

  • Gingivitis is a non-destructive type of periodontal disease, but untreated gingivitis can progress to periodontitis

  • Gingival Parameters: A significant improvement in gingival scores was noted in all groups from baseline

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Summary

Introduction

It commonly occurs due to film of plaque, bacteria accumulating on the tooth surface.[1] Gingivitis is a non-destructive type of periodontal disease, but untreated gingivitis can progress to periodontitis. Epidemiological studies have estimated that the prevalence of adult gingivitis varies from approximately 50100% in dentate patients.[2] Existence of destructive types of microbes at sub gingival area results in. Pak J Med Sci September - October 2021 Vol 37 No 5 www.pjms.org.pk 1425 development of periodontal disease.[3] Anatomic factors of tooth and invasive nature of pathogens, resists mechanical instrumentation promoting bacterial colonization. Scaling and root planning (SRP) is the most commonly performed procedure for the treatment of periodontitis. Apart from conventional method use of different medicated agents can slow the progression of disease process.[4]

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