Comparative evaluation of locally delivered minocycline and metronidazole in the treatment of periodontitis

Abstract

Objective:The aim of this study was to evaluate and compare the efficacy of subgingivally delivered Minocycline microspheres and 25% Metronidazole gel when used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.Materials and Methods:A randomized, controlled, single center study was conducted involving 60 sites in 20 patients suffering from moderate to advanced chronic periodontitis. Each patient contributed three sites which were randomized to three treatment groups: SRP + insertion of Minocycline microspheres at day 1 (Group A), SRP + insertion of Metronidazole gel at day 1 and at day 7 (Group B), and SRP alone (Group C). Gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at day 1, 1 month, and 3 months post therapy.Results:All treatments showed significant reductions in PPD and CAL at 1 and 3 months when compared to baseline values (P < 0.001). At 3 months, sites treated with minocycline showed an additional reduction in PPD of 0.85 ± 0.03 mm, significantly greater than SRP alone. Differences in mean PPD reduction between Group B and Group C and between Group A and Group B were not significant. At 3 months, difference in CAL gain between Group A and C was 0.50 ± 0.45, which was statistically significant and between Group B and C was 0.35 ± 0.11, which was not found to be statistically significant (P = 0.20). Differences in relative CAL between Group A and Group B were also not found to be statistically significant (P = 0.53).Conclusion:The results concluded that treatment with Minocycline microspheres and Metronidazole gel improve PPD and CAL in patients with periodontitis compared to SRP alone.

Non-surgical Periodontal Therapy With Adjunctive Topical Metronidazole + Piroxicam Gel Compared With Piroxicam Gel in the Treatment of Chronic Periodontitis

“…That study determined that treatment with minocycline microspheres and metronidazole gel improved PPD and CAL in patients with periodontitis compared to SRP alone (44). Bergamaschi et al compared the effect of metronidazole (local and systemic) as adjunctive therapy to full mouth periodontal debridement in smokers with chronic periodontitis, and concluded that adjunctive use of metronidazole (gel or tablet) to periodontal debridement led to similar clinical and microbiological improvement compared to treatment with placebo + periodontal debridement in smokers with chronic periodontitis up to 6 months after treatment (45).…”

Curcumin and Metronidazole in Periodontal Therapy

“…Metronidazole follows first order kinetics i.e., gel provides increased drug concentration for 24 h after which it subsequently decreases rapidly at a rate directly proportional to their pocket concentration. 33 Whereas in curcumin group, gingival scores reduction was observed from 2.145267 to 1.4496 (p < 0.001). These results were attributed to its following anti-inflammatory and wound healing properties it reduces the inflammatory mediators generated via arachiodonic acid pathway and causes shrinkage by reducing inflammatory oedema and vascular engorgement of connective tissue.…”

Characterization and formulation of miswak film for the treatment of chronic periodontitis: An in vitro study

“…Delivering antimicrobial in the form of LDD provides 100-fold greater concentration than a systemic regimen. [ 18 ]…”