Evaluation of different local drug delivery systems in the management of chronic periodontitis: A comparative study

Abstract

Periodontal disease is an immune-inflammatory disease affecting the soft tissues and alveolar bone and surrounding periodontal tissues. The standard treatment involves scaling and root planing (SRP) which removes the sub gingival microbial deposits effectively and the gingival health is maintained. Sometimes the treated areas may show regrowth of the microorganisms and the non-surgical periodontal treatment alone cannot eliminate the micro-organisms in mild periodontitis cases due to the difficulty in reaching the subgingival areas which are deeper and in complex root morphologies. So now a days the non-surgical periodontal treatment combined with the use of systemic antimicrobial agents and host modulating agents has shown to use effectively in the treatment of periodontal diseases.All the patients who were diagnosed with chronic periodontitis underwent initial therapy i.e., full-mouth scaling and root planing. Then the oral hygiene instructions were given to the patients and were recalled after 1 week (baseline visit). A total of 20 patients who met the inclusion criteria and showed satisfactory condition after the initial therapy with persistent periodontal pockets were included in this study. They were randomly assigned into two groups i.e., Group-A: metronidazole gel (metrogyl) and Group B: tetracycline fibre groups with 10 patients in each group. The periodontal clinical parameters like plaque index (PI), gingival index (GI) and periodontal pocket depth (PPD) were evaluated at the baseline visit before the application of local drug delivery and 15 and 30 days after the local drug delivery application.The mean plaque scores were reduced from 1.41±0.04 at baseline to 1.04±0.14 at 30 days. Likewise in Group-B the mean PI scores reduced from 1.50±0.10 at baseline to 1.25±0.18 at 30 days. The mean gingival index scores reduced from 1.41±0.04 at baseline to 1.01±0.04 at 30 days. Likewise in Group-B mean GI Scores reduced from 1.36±0.03 at baseline to 0.99±0.06 at 30 days. The mean PPD scores were reduced from 5.65±0.12 at baseline to 3.15±0.10 at 30 days in Group-A. Likewise in Group-B mean PPD scores reduced from 5.68±0.06 at baseline to 3.26±0.10 at 30 days. This study demonstrated that although thorough SRP is an effective treatment method for elimination of chronic periodontal pockets, improved results can be obtained by adjunctive use of locally administered metronidazole gel and tetracycline fibers.