Clinical and microbiological evaluation of four different local drug delivery agents in the management of stage I Grade A/B Periodontitis: A Comparative Study

Abstract Background: Periodontitis is a complex multifactorial disease and results in a progressive loss of attachment and formation of periodontal pocket. There are multiple options of anti-microbials that can be locally delivered into the mucosa such as Tetracycline, Doxycycline, Silver nanoparticle Chlorhexidine, Metronidazole, Ornidazole and Quaternary ammonium compounds. Since research with drug delivery system is limited, this clinical study evaluates the comparative efficacy of four different local drug delivery agents as an adjunct to scaling and root planing in the management of Stage I Grade A/B periodontitis. Material and Methods: The study involved 140 patients randomly divided into 4 groups/sites. Group 1/Site 1 treated with Ornidazole as an adjunct to SRP, Group 2/Site 2 treated with Metronidazole as an adjunct to SRP, Group 3/Site 3 treated with Siver nanoparticle gel as an adjunct to SRP and Group 4/Site 4 treated with oxygen releasing formula blue M gel as an adjunct to SRP. Clinical parameters were assessed for investigation included PI, GI, PPD and CAL at baseline, 1 month and 3 months. Microbiological parameters were recorded following baseline and after 3 months for every subject in all the four groups post treatment. Results: All the groups showed significant improvement in PI, GI, PPD and CAL gain from baseline to 3 months of time interval when treated with Ornidazole, Metronidazole, Siver nanoparticle gel and oxygen releasing formula blue M gel. Group 4/Site 4 and Group 3/Sites 3 showed more substantial reductions in CFU counts 4.30×102±6.11 and 3.67×102±4.72 respectively after 3 months of intervention. Conclusion: It can be assumed that the adjunctive use of oxygen releasing formula (Blue M gelTM), Siver nanoparticle gel (Megaheal gelTM), Ornidazole (Ornigreat gelTM) and Metronidazole (Metrohex plus gelTM) after scaling and root planning improved the treatment outcome in subjects with Stage I Grade A/B periodontitis.