Efficacy of Intra-Pocket Application of Two Antimicrobial Agents as an Adjunct to Mechanotherapy of Chronic Periodontitis (a Comparative Study)

Numerous studies have been performed to evaluate the effectiveness of the use of locally delivered antimicrobials as an adjunct to mechanotherapy in treatment of chronic periodontitis. Some studies were resulted in improved clinical outcomes and others were not. The aim of this study is evaluation of the efficacy and safety of subgingival application of a (10 mg metronidazole gel), (1% chlorhexidine collagen gel) and (CHLOSITE® GHIMAS, Italy) gel which is a combination of two chlorhexidine formulations: 0.5% chlorhexidine digluconate and 1.0% chlorhexidine dihydrochloride), as an adjunct to mechanical treatment (scaling and root planing) (SRP) of chronic periodontitis. A total of 120 sites from 15 patients with age range of (24-55 years), who had periodontal pockets measuring 5-9 mm and had been diagnosed as chronic periodontitis cases, were selected for the study. The 4-quadrant split-mouth design was used in this study. The pocket sites in each patient were randomly assigned to 4 groups (30 sites for each):(Group A) GA=(SRP) only.(Group B) GB=(SRP) + 10 mg metronidazole gel.(Group C) GC=(SRP) + 1% chlorhexidine collagen gel. (Group D) GD=(SRP) + CHLOSITE®Clinical parameters including (plaque index PI), (gingival index GI), (gingival bleeding index) GBI, (probing pocket depth PPD) & (clinical attachment level CAL) were measured and recorded at baseline before any treatment at (day 0) then the treatment was performed at the same day, The clinical parameters were also recorded at (day 30) & (day 90), in the selected sites of the four groups. The results of this study obviously showed a statistically significant reduction of all clinical parameters in all groups at (day 30 & day 90) from the base line (day 0). GD=(SRP) + CHLOSITE® revealed a reduction of the clinical parameters than groups (A, B and C) and the differences were highly statistically significant.