Subgingival application of 25% metronidazole gel, 1% chlorhexidine gel as adjunctive therapy to scaling and root planing in treatment of chronic periodontitis

Abstract

Objectives: The aim of this study was to compare the clinical effect of subgingival application of 25% metronidazole gel or 1% chlorhexidine gel as an adjunctive to scaling and root planing over a root planing alone.
 Materials and Methods: Ten adults (6 females and 4 males) with an age range of (30-60) years, each with at least three non-adjacent periodontally involved teeth with a probing pocket depth of ≥ 5mm and bleeding on probing participated in this randomized, split mouth, clinical study. A total of (394) sites were included in the study, the selected sites in each patient were divided into: Group 1 (root planing plus 25% metronidazole gel), Group 2 (root planing plus 1% chlorhexidine gel) and Group 3 (root planing alone).Clinical evaluation included: plaque index PLI (Silness and Loe, 1964), gingival index GI (Loe and Silness, 1963), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL).
 Results: All groups showed a fluctuated mean PLI scores between visits and a gradual reduction of GI, BOP, PPD and CAL scores for all groups during subsequent visits. Intergroup comparisons for PLI, BOP, PPD and CAL parameters showed no significance difference between the 3 groups, whereas GI showed a significant difference between groups except at week 2 only; this significance observed when group 1 compared with group 3.
 Conclusions: The 3 treatment modalities similarly showed improvement in almost all clinical parameters applied in this study. Also, there was no significance difference between the application of metronidazole gel and chlorhexidine gel on improvement of clinical periodontal parameters.