This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There are compelling data to indicate that systemically administered metronidazole is a useful adjunct to scaling and root planing (SRP) or to periodontal surgery in the treatment of periodontitis. What is not clear is the optimum dosage and duration and the best time for its administration. Should metronidazole be given before mechanical debridement (SRP), during mechanical debridement, or after its completion? There are conceptual reasons to support each approach. The agent could be given before SRP to lower the numbers of pathogens, allowing SRP to occur in a 'field' more conducive to healing. Further, the inflamed tissues might provide better delivery to the periodontal pocket. Alternatively, the agent could be administered in conjunction with SRP, since the antibiotic might be most effective when microbial biomass is being reduced (by debridement) and the agent might have good access to subgingival sites due to the mildly lacerated tissues. Finally, one can make a case for administering the agent after SRP when the bacterial biomass has been reduced, the tissues would be in a healing phase, and the antibiotic would function as a 'mop up' to reduce or eliminate the already lowered number of periodontal pathogens remaining. The optimum sequence, in relation to mechanical debridement, for the use of any antibiotic in the treatment of periodontal disease has not been investigated. This project, then, is a randomized, placebo-controlled clinical trial comparing the effect of systemic metronidazole taken before, during, or after mechanical debridement, on clinical and microbiological parameters of periodontal disease.
Showing the most recent 10 out of 642 publications
