Comparative Evaluation of Two Commercially Available Topical Gels As Adjuncts to Scaling and Root Planing for...

Gingivitis is a common plaque-induced inflammatory periodontal disease that may progress to periodontitis if left untreated. Adjunctive topical antimicrobial agents may improve the effectiveness of conventional periodontal therapy.

This randomized controlled clinical trial included 120 participants with gingivitis or Stage I, Grade A periodontitis. Participants were randomly allocated to three groups: Group A received scaling and root planing (SRP) with placebo gel; Group B received SRP with 1% chlorhexidine gluconate (CHX) gel (CHX group); and Group C received SRP with a combination gel containing 0.5% CHX and 1.5% metronidazole (MTZ) (CHX+MTZ group). Plaque Index (PI), Gingival Index (GI), and probing pocket depth (PPD) were assessed at baseline and at 3, 6, and 12 weeks. Intergroup comparisons were performed using one-way analysis of variance and Tukey's post hoc test.

All 120 participants completed the study. Baseline intergroup differences were observed for PI (p = 0.010) and GI (p < 0.001), whereas PPD was comparable (p = 0.929). At 12 weeks, both test groups had lower PI and GI scores than the placebo group. Mean PI values were 1.273 ± 0.119 in Group A, 1.229 ± 0.051 in Group B, and 1.213 ± 0.048 in Group C (p = 0.013). Mean GI values were 1.256 ± 0.097, 1.209 ± 0.053, and 1.193 ± 0.053, respectively (p = 0.003). PI and GI did not differ significantly between Groups B and C at 12 weeks. PPD also remained comparable among groups (p = 0.241).

Both CHX gel and the CHX-MTZ combination gel were associated with improvements in plaque control and gingival inflammation when used as adjuncts to SRP. No statistically significant difference was detected between the CHX and CHX+MTZ groups at 12 weeks. Therefore, the present findings do not establish an additional clinical advantage of adding MTZ to CHX under the conditions evaluated.