BACKGROUND: The aim of this study was to evaluate the clinical outcome in patients with recurrent periodontal disease following treatment with 25% metronidazole gel. METHODS: Twenty subjects in a maintenance care program but with recurrent periodontal disease participated. Three months after scaling and root planing, a total of 40 sites, 2 in each patient, with probing depth > or = 5 mm were selected. One site randomly selected was treated with metronidazole gel (test) and the other site with a placebo gel (control). Baseline and follow-up measurements included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). RESULTS: There were no statistically significant differences in PI, GI, BOP, PD, or CAL between test and control sites. CONCLUSION: This study showed that local treatment with 25% metronidazole gel did not seem to influence the clinical healing in this group of subjects with recurrent periodontal disease.

The aim of this study was to evaluate the microbial outcome in patients with recurrent periodontal disease following treatment with 25% metronidazole gel using the polymerase chain reaction (PCR). Twenty subjects in a maintenance care program but with recurrent periodontal disease participated. Three months after scaling and root planing a total of 40 sites, 2 in each patient, with pocket probing depth of > or = 5 mm were selected. One site randomly selected was treated with 25% metronidazole gel (test) and the other site with a placebo gel (control). A bacterial sample was collected on paperpoint from each test and control site at baseline and 12 weeks after treatment. The following pathogens were analysed and detected with PCR:Actinobacillus actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.) and Prevotella nigrescens (P.n.). At baseline, A.a., P.g. and P.n. were detected in 30, 60 and 70% of all test sites and in 32, 58 and 21% of all control sites. There was a statistically significant difference between the test and control sites for P.n. at baseline. The major difference after treatment with 25% metronidazole gel was the increase of positive control sites for P.g. and P.n. However, there were no statistically significant differences in the occurrence rate of A.a., P.g. and P.n. at test and control sites after treatment. This study has shown that 25% metronidazole gel treatment did not seem to influence the microbial outcome, when PCR was used to analyse the presence/absence of A.a., P.g. and P.n. in this group of subjects with recurrent periodontal disease.

The aim of this study was to analyse whether the interleukin-1 (IL-1) and IL-6 gene polymorphisms were associated with the susceptibility of chronic periodontitis. Genomic DNA was obtained from 20 patients with chronic periodontitis and 31 periodontally healthy subjects. All subjects were of North European heritage. The test subjects were kept in a maintenance program after periodontal treatment but yet showing signs of recurrent disease. Genotyping of the IL-1alpha [+4845C>T], IL-1beta [-3954C>T] and IL-6 [-174G>C] polymorphisms was carried out using an allelic discrimination Assay-by-Design method on ABI PRISM 7900 Sequence Detection System. All genotypes were analyzed using the GeneMapper 2.0 software. A similar distribution of Single Nucleotide Polymorphism (SNP) was seen in both groups. Analysis by logistic regression including gender, IL-1alpha [+4845C>T], IL-1beta [-3954C>T], IL-6 [-174G>C] genotypes, the composite IL-1 genotype, the combination of the composite IL-1 genotype and the IL-6 -174G>C genotype and adjusting for smoking did not result in any statistically significant difference. SNPs in IL-1alpha [+4845C>T], IL-1beta [-3954C>T] and IL-6 [-174G>C] do not seem to increase the susceptibility to chronic periodontitis in this group of subjects.

BACKGROUND: Several studies have found correlations between diabetes and an increased prevalence of periodontitis. OBJECTIVE: To analyse, in a group of subjects with type 2 diabetes (T2D), (i) the association between medical characteristics and severe periodontal disease and (ii) dental care habits and knowledge of oral health. METHODS: One hundred and ninety-one subjects with T2D were examined. Based on assessment of marginal bone height in panoramic radiographs, two periodontal subgroups were identified: one periodontally diseased (PD+) and one periodontally healthy (PD-) group. All subjects completed a questionnaire about their medical and oral health. RESULTS: Twenty per cent of the subjects were classified as PD+. This was verified by clinical parameters. PD+ individuals had higher haemoglobin A1c (HbA1c) levels (p=0.033) and higher prevalences of cardiovascular complications (p=0.012). They were also less likely to be of Scandinavian origin (p=0.028) and more likely to smoke (p<0.001) than the PD- group. The PD+ group rated their oral health as poor (p<0.0001) and believed that T2D had an influence on their oral status (p<0.0001). CONCLUSION: The best predictor for severe periodontal disease in subjects with T2D is smoking followed by HbA1c levels. T2D subjects should be informed about the increased risk for periodontal disease when suffering from T2D.