Crevicular Fluid Variables after Topical Metronidazole Application or Scaling and Root Planing

Objectives: Topical metronidazole application is common in periodontal treatment. The aim of this study was to compare the influence on crevicular fluid variables between topical metronidazole application and scaling and root planing. Methods: In 39 volunteers (mean age 43.7±8.9 years) with chronic periodontitis the pockets ³5mm and positive at bleeding on probing (BOP) were treated with two topical metronidazole gel applications (25%, Colgate, Hamburg, Germany) or by scaling and root planing in a split-mouth study. BOP, probing pocket depth (PPD) and clinical attachment loss (CAL) were recorded and crevicular fluid samples were analyzed for aspartate aminotransferase (AST) and total/transformed a2-macroglobulin (TOMG/TRMG) at baseline immediately before treatment (0) as well as after three and six months. Results: The results for topical metronidazole application were as follows: BOP 0-0.51, 3-0.33, 6-0.27 (p<0.001), PPD (mm) 0-4.53, 3-3.89, 6-3.81 (p<0.001), CAL (mm) 0-5.15, 3-4.67, 6-4.64 (p<0.001), AST (U/mL) 0-31.51, 3-35.77, 6-45.20 (n.s.), TOMG (mg/100mL) 0-83.02, 3-34.47, 6-29.27 (p<0.001), TRMG (mg/100mL) 0-37.69, 3-24.85, 6-15.78 (p<0.001). The results for scaling and root planing were as follows: BOP 0-0.60, 3-0.31, 6-0.29 (p<0.001), PPD 0-4.59, 3-3.68, 6-3.56 (p<0.001), CAL 0-5.25, 3-4.50, 6-4.71 (p<0.001), AST 0-32.36, 3-35.45, 6-36.52 (n.s.), TOMG 0-63.33, 3-32.32, 6-21.49 (p<0.001), TRMG 0-38.62, 3-18.56, 6-15.45 (p<0.001). No significant differences were found between both groups at any variable. Conclusion: The study suggests that (i) the total and transformed a2-macroglobulin reflects clinical changes and (ii) topical metronidazole gel application and scaling and root planing have the same influence on clinical and crevicular fluid variables.