Clinical evaluation of subgingival application of metronidazole 25%, and adjunctive therapy

The effect of topical application of a metronidazole gel (ELYZOL DENTAL GEL), and adjunctive therapy in the treatment of adult periodontitis was assessed clinically. A single, masked examiner performed clinical assessments. Fourteen patients were involved, each one received four different treatments including control, and the four treatments were randomly applied to at least one tooth in each quadrant for each patient in a comparative split-mouth design. Clinical examinations were carried out before treatment and 90 days after treatment. All patients had at least one tooth in each quadrant with probing pocket depth of > or = 5mm. The four treatment groups were: (I) One session of one hour of scaling and root planning, (II) metronidazole 25% dental gel (ELYZOL DENTAL GEL) applied on day 0 and day 7, (III) scaling adjunctive to metronidazole 25%, and (IV) No treatment. Instruction in oral hygiene was given to all subjects at base line examination. At the end of the study (day 90), all groups had statistically significant improvement in probing pocket depth (P < 0.02), and in plaque and bleeding indices (P < 0.05) when compared to day 0. However, group III had statistically significantly greater improvement (P < 0.03) in probing pocket depth than groups I, II and IV. Both groups I and II had statistically significantly greater improvement (P < 0.05) in probing pocket depth than control group. On the other hand, both groups were not statistically significantly different from each other in probing pocket depth improvement. It is suggested that topical Elyzol treatment may improve periodontal health as well as subgingival scaling and root planning therapy, and adjunctive treatment could obtain an additional therapeutic effect.