Abstract
Objective To test whether treatment of periodontal disease with scaling and root planing plus metronidazole, compared with scaling and root planing alone, increases clinical attachment.
Design A randomised single blind controlled trial
Intervention Ninety subjects stratified for periodontitis disease severity and smoking status divided into three groups: 1. Subgingival scaling using ultrasonic scalers and LA; 2. As group 1 plus 7 days of systemic metronidazole (200 mg tds); 3 as group 1 plus two applications of 25% metronidazole gel 1 week apart in all sites with probing depths more than 4mm.
Outcome measures Mean attachment level gain and the decrease in mean percentages of sites with pocket depth greater than 4.6 mm 6 months after therapy.
Results Use of local or systemic metronidazole resulted in no significant additional benefit over scaling and root planing alone. Mean attachment level gain (mm) ranged from 0.47 (for metronidazole gel) to 0.51 for scaling and root planing to 0.67 (for systemic metronidazole), and did not differ significantly from one another.
Conclusions The use of adjunctive metronidazole with scaling and root planing does not increase clinical attachment when compared with scaling and root planing alone.
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Palmer RM, Matthews JP, Wilson RF. Adjunctive systemic and locally delivered metronidazole in the treatment of periodontitis: a controlled clinical trial. Br Dent J 1998; 184:548–552
Address for reprints R.M. Palmer, Department of Periodontology and Preventive Dentistry, United Medical and Dental Schools of Guy's and St Thomas' Hospitals, London SE1 9RT England.
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Niederman, R. Local or systemic metronidazole with scaling and root planing does not increase clinical attachment level. Evid Based Dent 2, 9 (2000). https://doi.org/10.1038/sj.ebd.6400005
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DOI: https://doi.org/10.1038/sj.ebd.6400005