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Metronidazole: Protecting your Bone Grafts

August 20-22, 2009 I went to the International Congress of Oral Implantologist annual meeting in Vancouver, Canada to get my Fellowship, and there I listened to many hours of lectures.  One of the lectures that made a big impression on me was one given by Dr. Joseph Choukroun: Controlling Systematic Perioperative Anaerobic Contamination During Sinus-Lift Procedures by using Metronidazole: An Innovative Approach.

My son Phillip was also there as a 4th year dental student, and we both thought it would be a good idea to put metronidazole into our bone grafts.  However, when I looked into it on the internet, I could not find metronidazole in liquid form, anywhere.  So I forgot about it and only occasionally would think to look for it in dental supply catalogs of different types.  Recently, I went to a course on L-PRF and the doctor made mention of using an IV bag solution of metronidazole in his bone grafts.  I inquired where he got the product and he could not remember but thought it was from Schein Dental.  Sure enough, when I got back to the office and looked it up noting Schein didn’t indeed have IV bags of metronidazole, but only in a case of twenty-four 500ml bags!   After speaking with the poor sales girl for at least 5 minutes to convince her that dentists are not going to purchase 24 bags of something they only need a drop of, she referred me to the manufacturer who when called would not budge either.  Yet, another dead end!

Not to be detoured, I asked my wife if she could call a local compounding pharmacist to see if they could mix this up for me.  After several phone calls I was speaking with a friendly pharmacist from MyerLee Pharmacy.  I explained what I needed: 12.5mg of metronidazole in 0.25cc normal saline, and because I’m not going to use very much at one time, I only want it in 5ml vials.  He said, “Sure.  That’ll be $37.50 for 2 vials of 5ml, and it will last 60 days after opening”.  They delivered it the next day to my office!  Cool!

They also have a great tasting very strong topical anesthetic and their own whitening gel (35% with 5% potassium nitrate), too.  So, if you are looking for a place to get metronidazole for your bone grafts then give these guys a call.  They will help you secure whatever you need!

References:

1. Implant Dent. 2009 Apr;18(2):102-11. The relevance of Choukroun’s platelet-rich fibrin and metronidazole during complex maxillary rehabilitations using bone allograft. Part I: a new grafting protocol. Simonpieri ADel Corso MSammartino GDohan Ehrenfest DM. Private Practice, Monte Carlo, Monaco.

2. Implant Dent. 2009 Jun;18(3):220-9. The relevance of Choukroun’s platelet-rich fibrin and metronidazole during complex maxillary rehabilitations using bone allograft. Part II: implant surgery, prosthodontics, and survival. Simonpieri ADel Corso MSammartino GDohan Ehrenfest DM. Department of Periodontology, Turin University, Turin, Italy.

3. Implant Dent. 2008 Sep;17(3):257-70. Controlling systematic perioperative anaerobic contamination during sinus-lift procedures by using metronidazole: an innovative approach. Choukroun JSimonpieri ADel Corso MMazor ZSammartino GDohan Ehrenfest DM. Pain Clinic Center, Nice, France.

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