EFFECTS OF TOPICAL METRONIDAZOLE AND TETRACYCLINE IN TREATMENT OF ADULT PERIODONTITIS

THE PRESENT STUDY WAS PERFORMED to assess and compare the clinical hea ling and the microbiological findings following local application of m etronidazole or tetracycline to augment subgingival scaling in previou sly untreated adult periodontitis sites. Eighteen patients with modera te to severe adult periodontitis at single-rooted teeth were selected. In each patient, 3 interproximal sites having comparable root anatomy , probing depth greater than or equal to 5 mm and bleeding on probing were randomly assigned to 1 of 3 treatment groups: 1) two sessions of subgingival scaling and root planing; 2) similar to 1, with each treat ment supplemented with a 25% metronidazole sustained release gel; 3) s imilar to 1 with each treatment supplemented with a 3% tetracycline oi ntment. The treatments were performed by 1 operator and the clinical v ariables probing depth, attachment level, and bleeding on probing were evaluated at baseline, 3 months and 6 months by a second blinded exam iner. The microbiological findings were evaluated using a commercial t est kit. The average probing depth reduction for the 3 groups at 6 mon ths was 1.5 mm and the average gain of clinical attachment was 0.8 mm. There were no significant differences between the effects following t opical application of the metronidazole gel or the tetracycline ointme nt. Scaling and root planing alone appeared as effective as the drug a ugmented regimens, although there was a weak but non-significant tende ncy for better results in sites treated with the antibiotic drugs. Act inobacillus actinomycetemcomitans was generally not detected; Prevotel la intermedia was not significantly reduced, while Porphyromonas gingi valis was significantly reduced in all treatment groups. It was conclu ded that the augmentative effect of the metronidazole gel and the tetr acycline ointment was comparable but small compared to scaling and roo t planing alone. The clinical importance of such small augmentation ef fects should be further evaluated.