Awartani F A, Zulqarnain B J
Department of Preventive Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
Quintessence Int. 1998 Jan;29(1):41-8.
Control of subgingival plaque is of paramount importance in the treatment of periodontal diseases. The role of subgingival sustained-release antibiotic therapy needs elucidation. A single-blind clinical trial was carried out in 13 patients with adult periodontitis to compare the effects of subgingival application of metronidazole dental gel with those of subgingival scaling.
A split-mouth design was used so that each patient received all treatments simultaneously. Randomly selected quadrants were treated with application of 25% metronidazole gel, subgingival scaling, or a combination of scaling and gel application. The remaining quadrant in each patient was left untreated as a control.
All three treatments were effective in significantly reducing Plaque Index, Gingival Index, and bleeding on probing over the 14-week observation period. No statistically significant differences were found between scaling alone and combined treatment. Scaling and combined treatment were better than metronidazole. Metronidazole produced transient effects, best noted during the first 4 weeks after treatment. No additive effect of metronidazole was noted in the combined treatment. At week 14, only combined treatment sites and scaled sites showed statistically greater probing depth reduction than control sites.
For the treatment of mild-to-moderate adult periodontitis, subgingival scaling alone is as effective as the combination of scaling and antibiotic therapy.
龈下菌斑的控制在牙周疾病治疗中至关重要。龈下缓释抗生素疗法的作用有待阐明。对13例成人牙周炎患者进行了一项单盲临床试验，以比较龈下应用甲硝唑牙凝胶与龈下刮治的效果。
采用半口设计，使每位患者同时接受所有治疗。随机选择象限分别接受25%甲硝唑凝胶应用、龈下刮治或刮治与凝胶应用联合治疗。每位患者剩余的象限不做处理作为对照。
在14周的观察期内，所有三种治疗方法均能有效显著降低菌斑指数、牙龈指数和探诊出血。单独刮治与联合治疗之间未发现统计学上的显著差异。刮治和联合治疗优于甲硝唑。甲硝唑产生短暂效果，在治疗后的前4周最为明显。联合治疗中未发现甲硝唑的叠加效应。在第14周时，只有联合治疗部位和刮治部位的探诊深度降低在统计学上比对照部位更显著。
对于轻至中度成人牙周炎的治疗，单独龈下刮治与刮治和抗生素治疗联合应用效果相同。
