Clinical and microbiological effects of subgingival administration of two active gels on persistent pockets of chronic periodontitis patients.
OBJECTIVE
The present controlled, single-blind study was performed to assess and compare the clinical healing and the microbiological findings following repeated intrasulcular applications of 1% metronidazole or 1% chlorhexidine gels in persistent periodontal pockets previously treated by scaling and root planing (SRP).


METHODS
Sixty-three systemically healthy subjects, 25 males and 38 females (mean age 48.4+/-7.2 years), diagnosed for chronic periodontitis were enrolled in this study. They underwent SRP and received oral hygiene instructions (OHI). Three months later, at baseline, a single persistent pocket with a probing depth (PD) of 5-9 mm was chosen as the experimental site in each patient; the subjects were stratified into three matched experimental groups on the basis of the treatment to be performed, which consisted of the subgingival administration of 1% metronidazole gel (MG, n=19), 1% chlorhexidine gel (CG, n=20) or placebo gel (PG, n=24). The treatments consisted of four repeated administrations of subgingival gels, each separated by 7 days, starting at the baseline. Clinical assessment was performed at the baseline and at the 180-day follow-up, after the end of treatment. For microbiological evaluations, subgingival plaque was sampled from the experimental sites at baseline, prior to the first subgingival gel administration, and at 7, 15, 30 and 90 days after the end of the treatment (days 28, 36, 51 and 111 from baseline).


RESULTS
Plaque accumulation did not change significantly in all three groups. Bleeding on probing and clinical attachment levels reduced in the MGs and CGs only. PD was significantly reduced by the same amount in all experimental groups. In the MGs and CGs a remarkable reduction in the frequencies of detection of several periodontopathic micoorganisms was recorded after the treatment. The same was not seen for the PGs.


CONCLUSIONS
Subgingival administration of MG or CG, both at 1%, may have a role in the management of persistent pockets during chronic periodontitis.
Perinetti
Giuseppe
G
Department of Cell Biology and Oncology, Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Chieti, Italy. giuseppe.perinetti@tin.it
Paolantonio
Michele
M
Cordella
Chiara
C
D'Ercole
Simonetta
S
Serra
Emanuela
E
Piccolomini
Raffaele
R
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D016022:Case-Control Studies; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use; D002908:Chronic Disease; D015169:Colony Count, Microbial; D003773:Dental Plaque / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D005884:Gingival Hemorrhage / Q000188:drug therapy; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010514:Periodontal Pocket / Q000188:drug therapy* / Q000382:microbiology; D010518:Periodontitis / Q000188:drug therapy* / Q000382:microbiology; D010919:Placebos; D016037:Single-Blind Method; D014945:Wound Healing
D000891:Anti-Infective Agents, Local; D005782:Gels; D010919:Placebos; D008795:Metronidazole; D002710:Chlorhexidine