T. Lie et al., EFFECTS OF TOPICAL METRONIDAZOLE AND TETRACYCLINE IN TREATMENT OF ADULT PERIODONTITIS, Journal of periodontology, 69(7), 1998, pp. 819-827
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.