EVALUATION OF THE EFFICACY OF A REDOX AGENT IN THE TREATMENT OF CHRONIC PERIODONTITIS

A redox dye, methylene blue, was compared with subgingival root surfac e debridement and sterile water in the treatment of adult periodontiti s. Plaque and gingival indices, bleeding on probing, and microbiologic al samples were obtained at baseline, and at 1, 4, 8 and 12 weeks foll owing treatment. All subjects had matched pockets in each of the 4 qua drants, of 5 mm or more. One treatment consisted of 0.1% methylene blu e gel irrigated professionally at 0, 1 and 4 weeks, and by subjects at days in between up to 4 weeks, at chosen sites within a randomly sele cted quadrant (split-mouth design). A 2nd treatment was sterile water irrigation as above. A 3rd quadrant received subgingival debridement, and sites in the 4th received methylene blue incorporated into a slow- release device of a biodegradable collagen alginate vicryl composite. All sites showed improvements in clinical and microbiological paramete rs. However, no statistically significant differences between treatmen t types were found for clinical measurements. Although plaque index te nded to increase after week 1, gingival index was reduced, as was the papilla bleeding index. Probing depth reductions were approximately 1. 2 mm for all treatments. Microbiological variables showed an increase in cocci and a decrease in motile organisms for all groups, the latter reaching statistical significance for subgingival debridement. The re ductions in spirochaetes were significant for subgingival debridement and methylene blue by slow-release. Culture demonstrated an increase i n the aerobe:anaerobe ratio for all groups, which was statistically si gnificant initially (weeks 1 and 4) for subgingival debridement. Methy lene blue was also effective statistically in improving this ratio, bo th by irrigation and slow-release (week 4). Methylene blue also signif icantly reduced the numbers of black-pigmented anaerobes during the tr ial period, both by irrigation and slow-release, which sterile water a nd subgingival debridement failed to do. No serious adverse experience s were seen, however, significantly greater morbidity was associated w ith subgingival debridement. These results clearly demonstrate that in altering the microflora to one that is more compatible with periodont al health, methylene blue treatment is comparable, or even better, tha n the currently standard treatment of subgingival debridement, and is better tolerated.