|| ISSN(online): 2589-8698 || ISSN(print): 2589-868X || International Journal of Medical and Biomedical Studies Available Online at www.ijmbs.info PubMed (National Library of Medicine ID: 101738825) Index Copernicus Value 2019: 79.34 Original Research Article Volume 5, Issue 3; March: 2021; Page No. 177-185 177 | Page TOPICAL CHEMOTHERAPEUTIC ADJUNCTS IN NON-SURGICAL PERIODONTAL THERAPY – A RANDOMISED CONTROLLED DOUBLE BLINDED TRIAL. Dr Upendra Prasad 1 , Dr Abhinav Deshpande 2 , Dr Praneeta Kamble 3 , Dr Abhishek Singh 4 , Dr Adiya Apon 5 , Dr Geetika Prabhakar 6 . 1,2,4,5,6 PG-Student, Department of Periodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India 3 Associate Professor, Department of Periodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India Article Info: Received 18 February 2021; Accepted 27 March 2021 DOI: https://doi.org/10.32553/ijmbs.v5i3.1851 Corresponding author: Dr. Praneeta Kamble Conflict of interest: No conflict of interest. Abstract Introduction: Topical chemotherapeutic agents used in treatment of chronic periodontitis are antimicrobial agents which help in plaque control. The present study evaluates the efficacy of ornidazole gel with gold standard chlorhexidine gel when used as adjunct to scaling and root planing. Material and Methods: 90 patients diagnosed as chronic periodontitis, having pocket depth ≥3 mm and in good systemic health were selected by systematic sampling method and divided in 3 groups. In all 3 groups scaling and root planing was done. In group A, Ornidazole gel application was done while in Group B Chlorhexidine gel application was done while Group C was control group. Plaque Index (PI) and Gingival Index (GI) were recorded at baseline, 1 and 3 months while Probing pocket depth (PPD) and Clinical attachment level (CAL) were recorded at baseline and 3 months. Results: PI and GI showed significant reduction in all three groups after 1 and 3 months compared to baseline. On inter group comparison, both PI and GI showed no significant difference in reduction of scores after 1 month and 3 months (p>0.05). PPD and CAL values showed statistically significant reduction after 3 months when compared to baseline values. The intergroup comparison revealed statistically significant reduction in group A and B compared to control group C (p<0.05). Conclusion: Ornidazole showed comparable efficacy as Chlorhexidine when used as adjunct to scaling and root planing for treatment of chronic periodontitis. Introduction: Periodontal disease is a major global dental problem induced by bacterial plaque. These are chronic disorders affecting most of the people. Periodontitis manifests as inflammation of the gingival and the deeper periodontal tissues which may result into loss of supporting structures of tooth and finally the tooth. The disease affects the gingiva causing gingivitis which may or may not progress into periodontitis. As Bacterial plaque is considered as the main etiological factor for initiation of disease, plaque control remains the ultimate focus for maintaining the periodontal health. Various treatment modalities have been attempted to control the plaque. Although, mechanical debridement with oral prophylaxis is till date the gold standard, still many antimicrobial agents have been used to prevent the plaque accumulation and disease progression. 1 Chemotherapeutic agents such as tetracycline, minocycline, doxycycline, ornidazole, chlorhexidine etc. are available in the form of gels, paste, films, strips, and fibers. 2-6 These can be used for mouth rinsing, irrigation, systemic administration or local applications. 7 Chlorhexidine is considered as gold standard in chemical plaque control due to it substantivity and has been used effectively in treatment of gingivitis over last 4 decades. But due to its adverse effects such as staining of teeth, desquamation, altered taste and mucosal burning, other active ingredients have also been investigated as an alternative for this agent. 8 One such agent is Nitroimidazole group of compounds. It acts by inhibiting DNA synthesis. It works on the principle that inactive form passively diffuses into cells where it is activated by chemical reduction. The nitro group gets reduced to anionic radicles which causes oxidation of DNA leading to strand breakage and cell death. Hence, it has both anti-microbial and mutagenic effect. This effect is primarily seen on obligate gram negative anaerobes like P. Gingivalis, P. Intermedia, Fusobacterium, Selenomonas sputigina, Bacteroides Forsythus and the gram-positive anaerobes like Peptostreptococcus, and C. Rectus which are implicated in periodontal disease. Ornidazole and metronidazole are two such drugs belonging to nitroimidazole group. 9 Ornidazole and chlorhexidine both have a broad-spectrum antimicrobial activity of which chlorhexidine is more active against gram positive bacteria. It is bacteriostatic at lower concentration and bactericidal at higher concentration. The actual level at which the activity is bacteriostatic or bactericidal vary between species. On the other hand, Ornidazole is bactericidal even at lower concentration and is