Abstract
The aim of the present parallel, double-blind investigation was to evaluate the effect of using systemic metronidazole alone or associated to scaling and root planing on adult chronic periodontal disease, monitored at baseline, 30, 60 and 90 days. Twelve subjects were divided into three groups: the first group (Group I - 22 sites) was submitted to scaling and root planing (SRP) alone; the second group (Group II - 30 sites) received SRP and 250 mg of metronidazole (3 times a day for 10 days), and the third group (Group III - 31 sites) was treated with metronidazole alone. The clinical parameters evaluated were probing depth (PD), clinical attachment level (CAL), plaque index (PlI), gingival index (GI) and bleeding upon probing (BP). Microbiological (BANA test) and enzymatic (Pocket Watch) tests were also performed. All three proposed treatments produced significant improvements in clinical conditions of subjects, from baseline, 30, 60 and 90-day period, except for clinical attachment level. The results obtained by microbiological and enzymatic tests did not show statistical differences among the groups for the 90-day period (r = 0.7924 and r = 0.7757, respectively). In relation to clinical parameters, statistical differences among groups were observed only for the gingival index (p = 0.0261) between Groups I and II, and probing depth (p = 0.0124) between Group I and the others. We conclude that the use of systemic metronidazole did not produce additional effects on the microbiological conditions of these patients with chronic periodontal disease.
Highlights
The treatment of periodontal diseases has been carried out by means of mechanical elimination of supra- and subgingival biofilm
All participants were informed about the nature of the study and gave their consent by signing an informed consent form, whose written content had been previously approved by the Ethics Committee of the School of Dentistry of Araraquara, São Paulo State University
All treatments resulted in a significant decrease of positive results from the enzymatic and BANA tests (Table 1), but Pearson’s complementary test was unable to detect any statistically significant difference among the types of treatment adopted
Summary
The treatment of periodontal diseases has been carried out by means of mechanical elimination of supra- and subgingival biofilm. This procedure alters the biofilm composition, reduces. Systemic use of metronidazole in the treatment of chronic periodontitis: a pilot study using clinical, microbiological, and enzymatic evaluation. Mechanical debridement may fail to remove pathogenic organisms because of their location in sub-epithelial gingival tissue, crevicular epithelial cells, collagenous substrata, altered cementum and radicular dentinal tubuli, subgingival hard deposits or furcations or other anatomic features that complicate adequate instrumentation. Periodontal pathogens frequently colonize oral mucosa, tongue dorsum, tonsils and other oral domains and may translocate from nonperiodontal sites to periodontal crevices[15]
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