In vivo evaluation of a metronidazole-containing gel for the adjuvant treatment of chronic periodontitis: preliminary results

• Published in: European journal of clinical microbiology & infectious diseases Vol. 31; no. 7; pp. 1611 - 1618
• Main Authors: Miani, P. K., do Nascimento, C., Sato, S., Filho, A. V., da Fonseca, M. J. V., Pedrazzi, V.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.07.2012; Springer; Springer Nature B.V
• Subjects: Administration, Topical; Adult; Aged; Anti-Infective Agents, Local - administration & dosage; Anti-Infective Agents, Local - pharmacokinetics; Anti-Infective Agents, Local - pharmacology; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antimicrobial agents; Bacteria - classification; Bacteria - isolation & purification; Bacterial Load; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Chemotherapy, Adjuvant - methods; Chromatography, High Pressure Liquid; Chronic Periodontitis - drug therapy; Connective tissue; Debridement; Dentistry; Drug delivery systems; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Gels - administration & dosage; Gum disease; Humans; Hygiene; Infectious diseases; Internal Medicine; Liquid chromatography; Male; Medical Microbiology; Medical sciences; Metronidazole - administration & dosage; Metronidazole - pharmacokinetics; Metronidazole - pharmacology; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pathogens; Pharmaceutical sciences; Pharmacology. Drug treatments; Teeth; Treatment Outcome; Brazil; United States > US; Gingival Crevicular Fluid; Periodontal Pocket; Metronidazole; Chronic Periodontitis; Poloxamer; Nitro compound; Imidazole derivatives; Microbiology; Stomatology; Adjuvant treatment; Infection; Antiprotozoal agent; In vivo; Periodontal disease; Antifungal agent; Chronic; Periodontitis; Parasiticide
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-011-1484-7

The present study developed an experimental metronidazole-based gel and evaluated its efficacy for the adjuvant treatment of chronic periodontitis. Sixteen patients were randomly allocated into two groups of eight subjects according to the following proposed treatments: (1) scaling and root planing (active control) or (2) scaling and root planing and direct periodontal intrapocket application of 15% metronidazole-based gel in two sites (≥5 mm in depth) (experimental group). Potential changes in the subgingival microbiota were assessed using a DNA Checkerboard method at three proposed times: baseline and following 7 or 30 days of drug administration. High-performance liquid chromatography (HPLC) monitored metronidazole concentrations in the crevicular fluid during treatment. The metronidazole experimental group presented lower bacterial counts than the control group at the three evaluated times ( p  < 0.01 for baseline, p  < 0.001 for 7 or 30 days) when the target species were analyzed as a pool of bacteria. Samples revealed significantly lower counts 7 days after drug administration compared with baseline or after 30 days ( p  < 0.05). HPLC analysis detected gel 1 h after application. The metronidazole-based gel significantly decreased the total bacterial count at the three evaluated times. Periodontopathogenic species were not different after gel administration.