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Periodontal flap surgery with 25% metronidazole gel. (1). Clinical outcomes
I G Needleman1, A M Collins, D R Moles
1Department of Periodontology, Eastman Dental Institute for Oral Healthcare Sciences, University College London, University of London, UK. i.needleman@eastman.ucl.ac.uk
Objectives:
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.
Materials And 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.
Conclusion:
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.