Drug Database
ME

metronidazole (Elyzol / Pernyzol / Elyzol Dental Gel)

✓ Approved

Pfizer, Inc. · Small Molecule · Small Molecule

What is metronidazole?

metronidazole is a small molecule developed by Pfizer, Inc.. It is approved for therapeutic indications via topical.

Drug Profile

Brand NamesElyzol, Pernyzol, Elyzol Dental Gel
CompanyPfizer, Inc.
Drug ClassSmall Molecule
RouteTopical
StatusApproved
Sources: ClinicalTrials.gov, Pfizer, Inc.

Therapeutic Indications

metronidazole is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Infections and infestationsPeriodontitis✓ Approved

Related Research Articles

PubMedHealthcare (Basel, Switzerland)2026-10-16

Antibiotic Prescribing Patterns and Antimicrobial Stewardship Among Indian Periodontists: A Cross-Sectional Survey.

Chhabrani Ankita A, D'Albis Giuseppe G, Shivamallu Avinash Bettahalli AB, Capodiferro Saverio S

Background: Antimicrobial resistance is a growing concern, and inappropriate prescribing may contribute to its rise. Variability among periodontists highlights the need to understand prescribing patterns and factors influencing antibiotic selection. We aim to assess antibiotic prescribing patterns and perceptions of resistance among Indian periodontists and evaluate factors associated with prescribing practices and selection of the antibiotic regimen perceived by respondents as most effective. Methods: A cross-sectional questionnaire survey was conducted among Indian periodontists (January-April 2024), distributed via institutional email and LinkedIn. Descriptive statistics summarized responses; chi-square/Fisher's tests assessed associations with experience. Logistic regression was performed to identify factors associated with respondents' selection of the antibiotic regimen perceived as most effective for periodontal therapy. Results: Of 500 invited, 328 responded (65.6%). Respondents were mostly female (67.7%), with a mean age of 32.25 ± 6.05 years; 50.3% had <5 years' experience and 98.6% held an MDS in Periodontology. Amoxicillin plus metronidazole was the regimen most frequently perceived as effective by respondents (37.8%), followed by amoxicillin-clavulanic acid (35.4%) and amoxicillin alone (15.9%). Oral administration was preferred (89.0%). Prophylactic antibiotics were prescribed for infective endocarditis/CABG indications by 89.6%, while 48.2% did not prescribe after laser-assisted surgery. Experience was significantly associated with prescribing frequency and post-laser prescribing (p < 0.05); associations with crown lengthening and flap surgery lost significance after Bonferroni correction. Academic practice was associated with regimen selection univariably (OR = 0.56, 95% CI 0.34-0.93) but not after multivariable adjustment (aOR = 0.65, 95% CI 0.37-1.13). Most respondents (98.5%) viewed resistance as a growing concern. Conclusions: Prescribing practices varied with experience and practice setting. Amoxicillin plus metronidazole was most frequently considered effective, though no factor independently predicted selection. High awareness of resistance underscores the need for stronger antimicrobial stewardship in periodontal care.

PMID 42881671
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PubMedJournal of clinical medicine2026-10-16

Oral Piercing in the Aspect of Periodontal and Dental Health-A Narrative Review.

Cichońska Dominika D, Hopke Jakub J, Bieniek Szymon S, Balcerzak Magda M et al.

Oral piercing is an increasingly popular form of body modification, particularly among adolescents and young adults. Despite its aesthetic and cultural appeal, growing evidence indicates that oral piercings have been associated with a range of oral and periodontal complications. This literature review examines the effects of oral piercing on periodontal tissues and summarizes the associated risk factors and preventive measures. The available evidence demonstrates that tongue and lower lip piercings are most associated with periodontal damage due to chronic mechanical trauma and bacterial plaque accumulation around oral jewelry. The principal periodontal complications include gingival recession, gingival inflammation, clinical attachment loss, periodontal pocket formation, and localized alveolar bone loss. In addition, oral piercings have been linked to tooth fractures, enamel wear, mucosal lesions, infections, hypersensitivity reactions, and, in rare cases, systemic complications such as infective endocarditis. The severity of these complications is influenced by factors including the duration of jewelry wear, jewelry design and material, oral hygiene, smoking, and individual periodontal characteristics. Current evidence suggests that many of these adverse outcomes can be minimized through appropriate patient education, the use of biocompatible and well-fitted jewelry, meticulous oral hygiene, and regular dental examinations. Although the existing literature consistently reports an association between oral piercing and periodontal complications, further longitudinal studies are needed to better define long-term outcomes and strengthen evidence-based clinical recommendations.

PMID 42882045
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PubMedJournal of clinical medicine2026-10-16

Gingival Crevicular Fluid Levels of Parathyroid Hormone-Related Protein, RANK Ligand, and Osteoprotegerin in Periodontal Health, Gingivitis, and Periodontitis: A Cross-Sectional Study.

Meracı Yıldıran Bilge B, Ercan Nuray N, Ateş Yıldırım Esra E, Akgül Zeynep Z et al.

Background/Objectives: Parathyroid hormone-related protein (PTHrP) modulates the receptor activator of nuclear factor kappa B ligand (RANKL)/osteoprotegerin (OPG) system in periodontal cells in vitro but has not been measured in gingival crevicular fluid (GCF). This study compared GCF PTHrP, RANKL, and OPG across periodontal health, gingivitis, and periodontitis. Methods: This cross-sectional study included 81 participants with periodontal health, gingivitis, or stage III grade B periodontitis (n = 27 each). GCF was collected from two interproximal sites per participant. PTHrP, RANKL, and OPG were quantified by ELISA and expressed as total amount per site and concentration. Group comparisons were repeated with adjustment for age and sex. Results: PTHrP total amount differed between all three groups, with values of 4.26 ± 2.96, 12.45 ± 5.77, and 19.67 ± 4.59 pg/site in periodontal health, gingivitis, and periodontitis, respectively (p < 0.001). RANKL total amount did not differ among groups (median: 51.40, 51.40, and 51.78 pg/site; p = 0.977). OPG total amount was lower (median: 53.36, 46.70, and 46.70 pg/site; p < 0.001) and the RANKL/OPG ratio higher (median: 0.98, 1.10, and 1.14; p < 0.001) in both disease groups than in periodontal health. After adjustment, PTHrP and OPG differences persisted, whereas no pairwise difference in the RANKL/OPG ratio remained significant. PTHrP correlated negatively with OPG (r = -0.530) and positively with the RANKL/OPG ratio (r = 0.481; both adjusted p < 0.001). Conclusions: GCF PTHrP total amount differed between periodontal health, gingivitis, and periodontitis, with the highest values in periodontitis. These cross-sectional findings identify an association between GCF PTHrP and periodontal status but do not establish a causal role for PTHrP in periodontal tissue breakdown.

PMID 42882213
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PubMedJournal of clinical medicine2026-10-16

Association Between Periodontal Status and Undiagnosed Diabetes in Adults Without Diagnosed Chronic Diseases: The Korea National Health and Nutrition Examination Survey 2013-2015.

Lyu Young Sang YS, Kim So Yeong SY, Jeong Sang Hee SH, Yoon Youngmin Y et al.

Background/Objectives: Periodontitis and diabetes are closely linked; however, whether periodontal findings are associated with previously unrecognized dysglycemia in adults without known chronic diseases remains unclear. We examined the association between periodontal status and undiagnosed prediabetes and diabetes in this population. Methods: We analyzed data from 7635 adults (3218 men and 4417 women) aged ≥19 years without self-reported physician-diagnosed chronic diseases who participated in the Korea National Health and Nutrition Examination Survey 2013-2015. Glycemic status was classified as normal, undiagnosed prediabetes, or undiagnosed diabetes based on a single measurement of fasting plasma glucose and glycated hemoglobin. Periodontal status was determined with the Community Periodontal Index (CPI) and grouped as CPI 0-2, CPI 3, or CPI 4. Survey-weighted multivariable logistic regression analyses were performed in men and women separately, and effect modification by sex was formally tested. Results: Undiagnosed prediabetes and diabetes were present in 42.0% and 5.0% of men and in 31.7% and 2.9% of women (weighted estimates). After multivariable adjustment, CPI 3 (odds ratio [OR] 3.594, 95% confidence interval [CI] 1.553-8.316) and CPI 4 (OR 5.837, 95% CI 2.341-14.555) were associated with higher odds of undiagnosed diabetes in men, whereas no significant association was observed in women (p for sex interaction = 0.004). Periodontal status was not associated with undiagnosed prediabetes in either sex. Conclusions: In this cross-sectional analysis, CPI-defined periodontitis was associated with higher odds of undiagnosed diabetes in men. These findings do not establish causality or the diagnostic performance of periodontal examination as a screening test; rather, periodontal findings may help identify individuals in whom standard diabetes risk assessment or medical referral could be considered.

PMID 42882206
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PubMedMolecules (Basel, Switzerland)2026-10-16

USAG-1/SOSTDC1 as a Candidate Target for Periodontal Regeneration: Biological Rationale, Knowledge Gaps, and Future Directions.

Hashim Nada Tawfig NT, Gismalla Bakri Gobara BG, Ahmed Ayman A, Rahman Muhammed Mustahsen MM et al.

Uterine Sensitization-Associated Gene-1 (USAG-1), also known as SOSTDC1, is a bifunctional antagonist of bone morphogenetic protein (BMP) and Wnt signalling-two pathways that are central not only to tooth development but to the entire repertoire of periodontal tissue biology. Current periodontal regenerative therapy relies on exogenous BMP delivery and barrier membranes, approaches with significant limitations in predictability and tissue specificity. The recent entry of anti-USAG-1 antibody therapy into early-phase human clinical trials, with congenital tooth agenesis as the lead indication, raises the question of whether targeted USAG-1 inhibition could be repurposed for periodontal regeneration. This perspective examines the biological rationale for USAG-1 as a target in periodontal regeneration, maps the plausible mechanisms through which its inhibition could restore cementum, periodontal ligament (PDL), and alveolar bone, and outlines the conditions and research agenda under which such an approach could be clinically developed. USAG-1 transcripts have been reported in adult gingival tissues, and USAG-1 antagonises BMP and Wnt signals that are implicated in cementogenesis, PDL fibre formation, and alveolar bone homeostasis. Its inhibition is proposed as a biologically plausible, hypothesis-generating strategy for amplifying endogenous regenerative signalling in the periodontium, which might differ from, and could potentially complement, existing regenerative protocols; neither possibility has yet been tested. Realising this potential will require localised delivery strategies, validated biomarker endpoints, and controlled trials embedded in the framework of the EFP S3 stepwise treatment algorithm. Direct experimental evidence that USAG-1 inhibition promotes periodontal regeneration is currently lacking; the case advanced here is inferential and hypothesis-generating, not a demonstrated therapeutic effect.

PMID 42883157
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PubMedJournal of clinical medicine2026-10-16

Generative Artificial Intelligence in Periodontology: Application of OpenAI Models for the Classification of Periodontitis and Risk Assessment in Patients Undergoing Supportive Periodontal Care.

Camlet Albert A, Kusiak Aida A, Świetlik Dariusz D

Background/Objectives: Periodontitis is a chronic, inflammatory disease of teeth-supporting tissues and is highly prevalent worldwide. The current classification of periodontal diseases was introduced by the 2017 AAP/EFP World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The classification is primarily based on the staging and grading of periodontitis. Periodontal Risk Assessment (PRA), introduced by Lang and Tonetti, is an established tool for estimating the risk of periodontitis progression in patients undergoing supportive periodontal care. Large language models (LLMs) developed by OpenAI are widely investigated for potential clinical applications in medicine and dentistry. The aim of this study was to assess the agreement in PRA and stage and grade classification between clinicians and the following OpenAI models: GPT-5.2, OpenAI-o3, and OpenAI-o4-mini. Methods: The analysis was based on 87 medical records divided into study and control groups (57 and 30 cases, respectively). Records were reviewed for eligibility and diagnostic accuracy by two experienced clinicians. Reference diagnoses were established by consensus. A standardized prompt was used as the instruction for the OpenAI Models. The reference diagnoses were compared with the LLMs' outputs. Results: LLMs differentiated periodontitis from non-periodontal cases, with sensitivity ranging from 91.2% to 94.7% and a specificity of 100%. Among correctly identified cases of periodontitis, GPT-5.2, OpenAI-o3 and OpenAI-o4-mini achieved high agreement with clinicians in stage and grade assessment (weighted κ values for stage were 0.918, 0.900, and 0.803, respectively; weighted κ values for grade were 0.857, 0.975, and 0.802, respectively), while moderate to substantial agreement was observed for PRA (weighted κ values were 0.622; 0.570; and 0.659, respectively). The analysis including all cases revealed high overall agreement between LLMs and clinicians for stage, grade and PRA, except for GPT-5.2 and OpenAI-o4-mini for grade, which presented substantial and moderate agreement, respectively. Disagreement patterns between LLMs and clinicians indicated that discrepancies occurred mostly between adjacent categories. The global comparison of three LLMs revealed statistically significant differences in agreement with clinicians' consensus for PRA (χ2 = 24.01; p < 0.001). The paired comparison revealed statistically significant differences between OpenAI-o3 vs. OpenAI-o4-mini for staging (p = 0.006); GPT-5.2 vs. OpenAI-o4-mini for PRA (p = 0.002); and OpenAI-o3 vs. OpenAI-o4-mini for PRA (p < 0.001). Conclusions: OpenAI Models present mostly high agreement with reference diagnoses in periodontitis detection and classification and may potentially support clinical practice. However, their performance in PRA appears to be limited.

PMID 42881848
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