Stelzel M, Florès-de-Jacoby L
Department of Periodontology, Philipps University Marburg, Germany.
J Clin Periodontol. 1996 Jan;23(1):24-9. doi: 10.1111/j.1600-051x.1996.tb00500.x.
The aim of this study was to compare the topical application of a metronidazole 25% dental gel with subgingival scaling. 30 patients from the recall program participated in this open randomised study with split-mouth design. Pocket probing depths (PPD) and bleeding on probing (BOP) were measured before and 2, 12 and 24 weeks after the end of the treatment period. In addition, subgingival plaque samples were taken from all mesial sites and analysed with dark-field microscopy. All patients had at least 1 tooth in each quadrant with a PPD of 5 mm or more that should bleeding on probing, when entering the study. The treatment consisted of 2 applications of the dental gel in 2 randomly selected quadrants (on days 0 and 7) as well as simultaneous subgingival scaling of the remaining quadrants. Oral hygiene instruction was given on day 21. The average PPD and the average frequency of BOP were calculated for all sites with an initial PPD of 5 mm or more and continued at each examination, using the same sites. The statistical analyses showed that both treatments were effective in reducing PPD and BOP over the 6-month period. At the end of the follow-up period, the mean reduction in PPD was 1.3 mm after gel treatment and 1.5 mm after subgingival scaling. BOP was reduced by 35% and 42%, respectively. No significant differences between the 2 treatments were detected. Dark-field microscopy showed a shift toward a more healthy microflora for both treatment modalities; this persisted throughout the 6-month period. Application of a 25% metronidazole dental gel on recall patients seems to be as effective on the investigated clinical and microbiological parameters as subgingival scaling.
本研究的目的是比较25%甲硝唑牙科凝胶局部应用与龈下刮治术的效果。30名来自复诊项目的患者参与了这项采用分口设计的开放性随机研究。在治疗期结束前以及结束后2周、12周和24周测量牙周袋探诊深度（PPD）和探诊出血（BOP）。此外，从所有近中位点采集龈下菌斑样本，并用暗视野显微镜进行分析。所有患者在进入研究时，每个象限至少有1颗牙齿的PPD为5mm或更深，且探诊时出血。治疗包括在2个随机选择的象限（第0天和第7天）应用2次牙科凝胶，以及对其余象限同时进行龈下刮治。在第21天给予口腔卫生指导。对所有初始PPD为5mm或更深的位点计算平均PPD和BOP平均频率，并在每次检查时使用相同的位点持续进行。统计分析表明，两种治疗方法在6个月期间均能有效降低PPD和BOP。在随访期结束时，凝胶治疗后PPD的平均降低值为1.3mm，龈下刮治后为1.5mm。BOP分别降低了35%和42%。未检测到两种治疗方法之间的显著差异。暗视野显微镜显示，两种治疗方式均使微生物群落向更健康的方向转变；这种转变在整个6个月期间持续存在。对复诊患者应用25%甲硝唑牙科凝胶在研究的临床和微生物学参数方面似乎与龈下刮治术同样有效。
