Does Topical Metronidazole-Chlorhexidine Combination Gel Improve Healing of Intraoral Incisions ? A Split-Mouth Comparative Study

J Maxillofac Oral Surg. 2023 Mar;22(1):159-164. doi: 10.1007/s12663-022-01706-5. Epub 2022 Mar 28.

Abstract

Background: The oral cavity is a unique environment where wound healing needs to occur in the presence of heavily contaminated oral fluid often leading to infections at the suture site. Topical antimicrobial agents have proven to be effective in controlling intraoral infections. One such antimicrobial combination is Metronidazole-Chlorhexidine which has commonly been used to treat oral ulcers and gingival inflammation; however, there are no studies of its use in the healing of oral incisions.

Methodology: This split-mouth study comprised of 15 participants who received 30 intraoral incisions. Incisions were placed either simultaneously (Group 1) or at spaced intervals (Group 2) for various minor and major surgical procedures. Metronidazole -Chlorhexidine gel was applied to the study sites while the control sites were allowed to heal naturally. Pain, inflammation, and healing were assessed using visual analogue scale and healing index by Landry et al.

Results: The study sites showed better wound healing and decreased postoperative inflammation. There was a statistically significant decrease in post-operative pain in the study site in Group 1 but not in Group 2.

Conclusion: Metronidazole-Chlorhexidine combination gel is a cost-effective, readily available, and safe medicament to improve healing of intraoral incisions and reduce post-operative inflammation and pain.

Keywords: Healing; Inflammation; Intraoral incisions; Metronidazole-Chlorhexidine gel; Pain; Topical antibiotics.