Evaluation of clinical and microbiological effectiveness of systemic antibiotic versus topical gaseous ozone as adjunctives to initial periodontal therapy

The objective of this randomized clinical trial was to describe the clinical and microbiological results obtained by treatment with topical gaseous ozone and systemic metronidazole as adjuncts to initial periodontal therapy in chronic periodontitis (CP) patients.A total of 30 CP patients (18 female, 12 male) ages ranging between 31-56, with a probing depth (PD) ? 5 mm and sulcus bleeding index (SBI) ? 2 in at least 3 single-rooted teeth within each quadrant were selected, and divided into 3 groups randomly. Groups of patients received: 1) Topical gaseous ozone combined with scaling and root planning (SRP) (SRP+Ozon), 2) Systemic metronidazole combined with SRP (SRP+Antibiotic), 3) SRP. Subgingival plaque samples were obtained from selected teeth with PD ? 5 mm and SBI ? 2 at day 0 and day 90. Following the microbiological procedure, clinical measurements including plaque index (PI), SBI, PD, relative attachment level (RAL) were performed. For the microbiological evaluation total viable cell count (TVC) and proportions of obligate anaerobic microorganisms were determined.At the end of the experimental period, statistically significant improvements (p<0.05) in PI, SBI, PD and attachment level as well as reductions in the number of total bacteria and proportions of obligate anaerobic microorganisms within each group were observed.IVWhile no statistically significant difference was observed only in the PI value during the inter group comparisons of mean differences belonging to clinical parameters, statistically significant reductions were observed in the SBI, PD and RAL values in favor of the SRP+Antibiotic group (p<0.05).Although no statistically significant difference was noted in the inter group comparison of changes in the proportions of obligate anaerobic bacteria, the fact that the change in SRP+Antibiotic and SRP+Ozone groups were higher compared to the SRP group only, shows the necessity of long term studies where the methodology is evaluated in different patient groups using clinical, microbiological and biochemical parameters. The results of our study are promising for future studies in this field.