title: Systemic metronidazole in the treatment of periodontitis.
abstract: The present study evaluated the effect of systemic metronidazole on advanced periodontitis in 10 patients with inadequate oral hygiene. Clinical and microbiological observations were made at a total of 173 bleeding pockets of 5 mm depth or more. The clinical observations comprised plaque index scores, dichotomous measurements of gingival redness and suppuration, pocket depths and attachment levels. The microbiological variables investigated were the % spirochaetes, % black-pigmented Bacteroides species, % facultative streptococci and presence of absence of Bacteroides gingivalis. At baseline, after clinical measurements and microbiological samples had been taken, each patient received a thorough scaling and root planing. After 3 months, the clinical measurements and microbiological sampling were repeated and a 5-day course of metronidazole was administered while one side of the mouth was scaled and root planed. After a further 3 months, the final measurements and samples were taken. In comparing pre- and post-treatment data, the following significant differences were observed: for debridement alone, a reduction in mean % spirochaetes from 11.5% to 4.9% and an increase in mean % streptococci from 4.7% to 8.8%; for metronidazole alone, a 0.3 mm gain in mean attachment level, a 0.4 mm reduction in mean pocket depth and a reduction in the frequency of suppurating sites from 32% to 16%; for debridement plus metronidazole, a 0.2 mm gain in mean attachment level, a 0.5 mm reduction in mean pocket depth and a reduction in mean % spirochaetes from 5.6% to 2.5%. Thus systemic metronidazole, either alone or accompanied by debridement, produced a modest clinical improvement after debridement alone had failed.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Periodontology Unit, University of Glasgow Dental Hospital and School, UK.
authors.forename: W M
authors.initials: WM
authors.lastname: Jenkins
authors.forename: T W
authors.initials: TW
authors.lastname: MacFarlane
authors.forename: W H
authors.initials: WH
authors.lastname: Gilmour
authors.forename: I
authors.initials: I
authors.lastname: Ramsay
authors.forename: D
authors.initials: D
authors.lastname: MacKenzie
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001419:Bacteria / Q000302:isolation & purification; D001439:Bacteroides / Q000302:isolation & purification; D003773:Dental Plaque / Q000517:prevention & control; D003777:Dental Prophylaxis; D012534:Dental Scaling; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010514:Periodontal Pocket / Q000628:therapy; D010518:Periodontitis / Q000188:drug therapy* / Q000628:therapy; D013144:Spirochaetales / Q000302:isolation & purification; D014092:Tooth Root / Q000601:surgery
chemical_list: D008795:Metronidazole