Efficacy of Chlorhexidine, Metronidazole and Combination Gel in the Treatment of Gingivitis--a Randomized Clinical Trial

Objective: Effective plaque control is essential for prevention of gingivitis and periodontitis. The aim of this 24-week follow-up parallel study was to evaluate the efficacy of three topical gels in the treatment of gingivitis as compared to placebo gel.

Methods: One hundred twenty subjects diagnosed with chronic generalized gingivitis were selected and randomly divided into four groups: Group 1--placebo gel, Group 2--chlorhexidine (CHX) gel, Group 3--metronidazole (MTZ) gel and Group 4--chlorhexidine-metronidazole (CHX-MTZ) gel. Clinical evaluation was undertaken using the gingival index (GI) of Löe and Silness and the plaque index (PI) at baseline, 6 weeks, 12 weeks and 24 weeks. Microbiological analysis was also done at the same time intervals. A subjective evaluation was also undertaken by questionnaire.

Results: Groups treated with all three gels (CHX, MTZ and CHX-MTZ) showed significant clinical and microbiological improvement as compared to the group treated with a placebo gel. The reduction in PI, GI and microbiological count in the group treated with the CHX-MTZ combination gel was significant when compared to those treated with CHX and MTZ gels.

Conclusion: Topical application of CHX or MTZ alone or in combination may have a role in the management of gingivitis.