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Topical and systemic antimicrobial therapy in guided tissue regeneration
G Zucchelli1, N M Sforza, C Clauser
1Department of Periodontology, Faculty of Odontology, Bologna University, Italy. giovanzu@tin.it
Journal of Periodontology
|May 4, 1999
Summary
Topical metronidazole gel reduced bacterial contamination on membranes during guided tissue regeneration (GTR) but did not improve clinical outcomes. Systemic antibiotics were less effective against bacterial colonization but resulted in less gingival recession.
Area of Science:
- Periodontal regeneration
- Biomaterials in dentistry
- Antimicrobial strategies
Background:
- Bacterial contamination of membranes hinders healing in guided tissue regeneration (GTR).
- Connective tissue integration with barrier membranes improves clinical outcomes.
- Evaluating topical antibiotics for GTR procedures is crucial.
Purpose of the Study:
- Assess topical antibiotic effects on GTR clinical outcomes.
- Determine impact on membrane bacterial colonization.
- Evaluate flap connective tissue integration with membranes.
Main Methods:
- Fifty-six GTR defects treated with titanium-reinforced ePTFE membranes.
- Test group: weekly topical 25% metronidazole gel.
- Control group: systemic amoxicillin/clavulanic acid (1g/day for 14 days).
- Clinical outcomes assessed at 1 year; SEM used for bacterial/tissue analysis.
Main Results:
- No significant difference in clinical attachment gain or probing depth reduction between groups.
- Increased gingival recession observed in the topical metronidazole group (P=0.003).
- Topical metronidazole significantly reduced bacterial colonization (P<0.001) but showed no difference in connective tissue integration.
Conclusions:
- Local antibiotic application effectively reduces membrane contamination compared to systemic use.
- The gel vehicle may interfere with gingival tissues, negating clinical benefits.
- Neither topical nor systemic antibiotics significantly improved clinical outcomes in this study.