Local Metronidazole as an Adjunct to Surgical Molar Furcation Debridement

Objectives: Aim
The aim of this randomized, controlled, double-blind, clinical trial (RCT) was to evaluate if a locally -applied metronidazole-containing gel may improve healing results following surgical debridement of molar furcation sites, as assessed by clinical means.
Methods: Materials and methods
Periodontal patients (n=20) having one pair of contralateral molars with a similar furcation involvement, class II in one furcation were included in the study.
One month after cause-related periodontal therapy, baseline measurements were performed on the selected teeth, including: plaque index (PlI), gingivitis index (GI), pocket probing depth (PPD), probing attachment level (PAL), horizontal attachment level (HAL), bleeding on probing (BoP) and finally bleeding on horizontal probing (HBoP) at the furcation.
Periodontal flap surgery (modified Widman flap) was performed at all the sites involved: both test (T) and control (C). A 25% metronidazole gel was applied under the flap before closure at one randomly selected tooth (T) for each subject.
At four weeks the PlI and GI measurements were repeated.
At six months all the clinical measurements made at baseline were repeated.
Results: Results
15 patients and 30 teeth were available for final examination.
Statistical analysis in this study used p < 0.05.
No statistically significant difference was seen between T and C for neither PlI or GI at baseline, 4- weeks nor at the 6-months final examination.
Statistically significant differences were seen between T and C for PPD and BoP at baseline and for PAL at final examination (T=4.3 mm; C=5.2 mm). No other statistically significant difference between the groups was observed.
Conclusions: Conclusion
The findings of this study demonstrate that the benefit of using 25% metronidazole gel as an adjunct to surgical treatment of molar class II furcation defects is limited and hardly of clinical importance.