Abstract
Metronidazole and Chlorhexidine are commonly employed antimicrobial agents in the antinfective stage of periodontal therapy, used with the aim to achieve complete eradication of the pathogenic flora from the subgingival niches, in conjunction with professional debridement. This study was aimed to determine the adjunctive effect of a novel combination of metronidazole (1%) and chlorhexidine (0.25%) in a gel form for management of moderate to severe chronic periodontitis. Twenty subjects were included for a split mouth prospective study. Gingival index, Plaque Index, Bleeding scores and Probing depth were noted at baseline, 2 weeks and 1 month after scaling and root planing with or without an additional subgingival delivery of the antimicrobial gel. An improvement of periodontal health was seen after therapy, and the difference between the test and control sites was significant for sites with an initial probing depth of 6-8mm. However, for deeper pockets (>8mm) the difference was statistically non-significant. The reduction in bleeding score was sustained at the test sites throughout the study period. It was concluded that the adjunctive use of metronidazole (1%) and chlorhexidine (0.25%) gel could provide clinical benefit for the management of deep pockets uptil 8mm of initial probing depth.
Highlights
Chronic periodontitis--an infectious disease caused by bacteria harboured in dental biofilms, is a global health burden
A significant improvement in the gingival health of the subjects was noted following therapy, with better results for the sites treated with the antimicrobial gel
Significant difference was observed for gingival index and probing depth, between the control and treated sites in pockets deeper than 6-8mm at baseline (Fig. 1&2)
Summary
Chronic periodontitis--an infectious disease caused by bacteria harboured in dental biofilms, is a global health burden. It affects all populations in the world, with a 20-50% worldwide prevalence (1), and is a leading cause of tooth loss and morbidity. The use of these modalities is disadvantaged by the limited potential for pocket penetration, or the concern for antimicrobial resistance and systemic adverse effects. These limitations are potentially overcome with local drug delivery into the periodontal pocket, which enables achievement of higher concentrations of drug in the affected area, without the concerns of systemic side effects. The local route of drug delivery can achieve 100 fold 6|P a g e
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