Effect of metronidazole on chronic periodontal disease in subjects using a topically applied chlorhexidine gel

Publisher Website
Google Scholar
Abstract
A double blind test between subjects comparing the effect of metronidazole and placebo tablets was completed over 22 wk in 45 subjects with chronic periodontal disease ranging in severity from moderate (PI [plaque index] = 2.0-3.9) to high (PI = [4.0-6.0). All subjects used a topically applied chlorhexidine gel for the first 10 wk. Throughout the trial plaque, bleeding and calculus were assessed on the buccal, lingual, mesial and distal surfaces of teeth 16, 21, 24, 36, 41 and 44 and their supporting tissues. The pocket depths on the same 4 aspects of all teeth present were measured. The regime employed consisted of oral hygiene instruction (OHI) at the initial visit followed by scaling and further OHI at visits 1 and 2 wk later. After the 3rd visit 16 .times. 200 mg metronidazole or placebo tablets were issued with instructions to take 1 that evening and 3/day at 5-h intervals for the next 5 days. Four weeks later, scaling and OHI were carried out and the course of test or placebo tablets was repeated. The subjects returned for further scaling and OHI 4 wk later and the chlorhexidine gel was withdrawn. Final assessments were made 12 wk later. Metronidazole had no effect on plaque levels and gingival bleeding beyond the effect of OHI, scaling and chlorhexidine gel. On the other hand, significantly greater reductions in pocket depths were achieved with the use of metronidazole. A surprise and interesting finding was that these reductions were apparent only in the subjects with severe periodontal disease (PI = 4.0-6.0).