title: Periodontal flap surgery with 25% metronidazole gel. (1). Clinical outcomes.
abstract: OBJECTIVE
  The aim of this 12-month, randomised controlled, single-blind, parallel-arm study, was to test whether local application of a slow-release antimicrobial might exert an adjunctive effect on healing following periodontal surgery.
  
  
  METHODS
  Following non-surgical therapy, 43 patients with moderate to advanced periodontitis, had at least 1 pocket > or =6 mm with bleeding on probing (BOP). Treatment consisted of modified Widman surgery with no osseous resection. The test group (T) received gel application over the exposed root surface and the control group (C) received no gel, followed by flap closure.
  
  
  RESULTS
  38 patients completed the study: 5 patients did not attend at 12 months and could not be traced. Surgery was very successful in both groups in improving probing depths (mean baseline: T=7.4 mm, C=7.1 mm; 12 months T=3.7 mm, C=3.5 mm) and relative attachment levels (baseline: T=10.3 mm, C=10.1 mm; 12 months T=8.2 mm, C=8.8 mm). Differences between groups were not significant at 12 months, although the improvements within groups between baseline and 12 months were highly statistically significant (p<0.01). Plaque and BOP levels were low in both groups after treatment.
  
  
  CONCLUSIONS
  MWF surgery was effective in establishing the periodontal health of sites with advanced disease and this study was unable to detect an additional benefit to using a 25% metronidazole gel.
authors.affiliation: Department of Periodontology, Eastman Dental Institute for Oral Healthcare Sciences, University College London, University of London, UK. i.needleman@eastman.ucl.ac.uk
authors.forename: I G
authors.initials: IG
authors.lastname: Needleman
authors.forename: A M
authors.initials: AM
authors.lastname: Collins
authors.forename: D R
authors.initials: DR
authors.lastname: Moles
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D003692:Delayed-Action Preparations; D003774:Dental Plaque Index; D005500:Follow-Up Studies; D005782:Gels; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000601:surgery; D010510:Periodontal Diseases / Q000188:drug therapy / Q000601:surgery*; D010514:Periodontal Pocket / Q000188:drug therapy / Q000601:surgery; D010518:Periodontitis / Q000188:drug therapy / Q000601:surgery; D015203:Reproducibility of Results; D016037:Single-Blind Method; D013524:Surgical Flaps; D014092:Tooth Root / Q000187:drug effects; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000890:Anti-Infective Agents; D003692:Delayed-Action Preparations; D005782:Gels; D008795:Metronidazole