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Kim MH, Choi YY, Lee HJ, Lee H, Park JC, Yang WM. Topical application of herbal formula for the treatment of ligature-induced periodontitis. J Periodontal Implant Sci 2015; 45:145-51. [PMID: 26339524 PMCID: PMC4556800 DOI: 10.5051/jpis.2015.45.4.145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/16/2015] [Indexed: 12/31/2022] Open
Affiliation(s)
- Mi Hye Kim
- Department of Convergence Korean Medical Science, Kyung Hee University College of Korean Medicine, Seoul, Korea
| | - You Yeon Choi
- Department of Convergence Korean Medical Science, Kyung Hee University College of Korean Medicine, Seoul, Korea
| | - Hye Ji Lee
- Department of Convergence Korean Medical Science, Kyung Hee University College of Korean Medicine, Seoul, Korea
| | - Haesu Lee
- Department of Convergence Korean Medical Science, Kyung Hee University College of Korean Medicine, Seoul, Korea
| | - Jung-Chul Park
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea
| | - Woong Mo Yang
- Department of Convergence Korean Medical Science, Kyung Hee University College of Korean Medicine, Seoul, Korea
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Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N. Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2015; 146:525-35. [DOI: 10.1016/j.adaj.2015.01.026] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 10/23/2022]
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53
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Backlund CJ, Worley BV, Sergesketter AR, Schoenfisch MH. Kinetic-dependent Killing of Oral Pathogens with Nitric Oxide. J Dent Res 2015; 94:1092-8. [PMID: 26078424 DOI: 10.1177/0022034515589314] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Nitric oxide (NO)-releasing silica nanoparticles were synthesized via the co-condensation of tetramethyl orthosilicate with aminosilanes and subsequent conversion of secondary amines to N-diazeniumdiolate NO donors. A series of ~150 nm NO-releasing particles with different NO totals and release kinetics (i.e., half-lives) were achieved by altering both the identity and mol% composition of the aminosilane precursors. Independent of identical 2 h NO-release totals, enhanced antibacterial action was observed against the periodontopathogens Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis with extended NO-release kinetics at pH 7.4. Negligible bactericidal effect was observed against cariogenic Streptococcus mutans at pH 7.4, even when using NO-releasing silica particles with greater NO-release totals. However, antibacterial activity was observed against S. mutans at lower pH (6.4). This result was attributed to more rapid proton-initiated decomposition of the N-diazeniumdiolate NO donors and greater NO-release payloads. The data suggest a differential sensitivity to NO between cariogenic and periodontopathogenic bacteria with implications for the future development of NO-releasing oral care therapeutics.
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Affiliation(s)
- C J Backlund
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - B V Worley
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A R Sergesketter
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M H Schoenfisch
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Kotsakis GA, Javed F, Hinrichs JE, Karoussis IK, Romanos GE. Impact of Cigarette Smoking on Clinical Outcomes of Periodontal Flap Surgical Procedures: A Systematic Review and Meta-Analysis. J Periodontol 2015; 86:254-63. [DOI: 10.1902/jop.2014.140452] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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55
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Zhang Z, Wang Z, Nong J, Nix CA, Ji HF, Zhong Y. Metal ion-assisted self-assembly of complexes for controlled and sustained release of minocycline for biomedical applications. Biofabrication 2015; 7:015006. [PMID: 25599696 DOI: 10.1088/1758-5090/7/1/015006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study reports the development of novel drug delivery complexes self-assembled by divalent metal ion-assisted coacervation for controlled and sustained release of a hydrophilic small drug molecule minocycline hydrochloride (MH). MH is a multifaceted agent that has demonstrated therapeutic effects in infection, inflammation, tumor, as well as cardiovascular, renal, and neurological disorders due to its anti-microbial, anti-inflammatory, and cytoprotective properties. However, the inability to translate the high doses used in experimental animals to tolerable doses in human patients limits its clinical application. Localized delivery can potentially expose the diseased tissue to high concentrations of MH that systemic delivery cannot achieve, while minimizing the side effects from systemic exposure. The strong metal ion binding-assisted interaction enabled high drug entrapment and loading efficiency, and stable long term release for more than 71 d. Released MH demonstrated potent anti-biofilm, anti-inflammatory, and neuroprotective activities. Furthermore, MH release from the complexes is pH-sensitive as the chelation between minocycline and metal ions decreases with pH, allowing 'smart' drug release in response to the severity of pathology-induced tissue acidosis. This novel metal ion binding-mediated drug delivery mechanism can potentially be applied to other drugs that have high binding affinity for metal ions and may lead to the development of new delivery systems for a variety of drugs.
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Affiliation(s)
- Zhiling Zhang
- School of Biomedical Engineering, Science and Health Systems, Drexel University, 3141 Chestnut Street, Philadelphia, PA 19104, USA
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56
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Jhinger N, Kapoor D, Jain R. Comparison of Periochip (chlorhexidine gluconate 2.5 mg) and Arestin (Minocycline hydrochloride 1 mg) in the management of chronic periodontitis. Indian J Dent 2015; 6:20-6. [PMID: 25767356 PMCID: PMC4357074 DOI: 10.4103/0975-962x.151697] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The aim of the study was to compare the efficacy of chlorhexidine gluconate 2.5 mg (Periochip) and Minocycline hydrochloride 1 mg (Arestin) as local drug delivery agents in the management of chronic periodontitis. MATERIALS AND METHODS Twenty patients in the age group of 30-50 years suffering from chronic periodontitis (12 males and 8 females), with almost identical probing depth bilaterally (5-8 mm), and exhibiting bleeding on probing were selected and divided into two groups: Group I consisted of periodontal pockets on the left side and received Periochip and group II consisted of periodontal pockets on the right side and received Arestin. Patients were recalled after 6 weeks and 3 months intervals from the baseline visit to record plaque index, gingival index, and probing depth. RESULTS There was reduction in all the parameters in both the groups at 6 weeks and 3 months as compared to baseline. CONCLUSION From the results of the present study, it was concluded that both the drugs were equally effective in reduction of plaque scores as well as gingival scores. It was further observed that Arestin resulted in better results at 6 weeks while Periochip showed better results at 3 months with respect to probing depth reduction.
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Affiliation(s)
- Navjot Jhinger
- Department of Dentistry, Chintpurni Medical College and Hospital, Bungal, Pathankot, India
| | - Daljit Kapoor
- Department of Periodontology, Gian Sagar Dental College and Hospital, Patiala, India
| | - Rachna Jain
- Department of Periodontology, Gian Sagar Dental College and Hospital, Patiala, India
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Eastham JE, Seymour RA. Local drug delivery in the management of periodontal diseases part 2: specific agents. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/denu.2014.41.9.796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Jane E Eastham
- Research Assistant, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK
| | - Robin A Seymour
- Emeritus Professor of Restorative Dentistry, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK
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Backlund CJ, Sergesketter AR, Offenbacher S, Schoenfisch MH. Antibacterial efficacy of exogenous nitric oxide on periodontal pathogens. J Dent Res 2014; 93:1089-94. [PMID: 25139363 DOI: 10.1177/0022034514529974] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Current treatments for periodontitis (e.g., scaling/root planing and chlorhexidine) have limited efficacy since they fail to suppress microbial biofilms satisfactorily over time, and the use of adjunctive antimicrobials can promote the emergence of antibiotic-resistant organisms. Herein, we report the novel application of nitric oxide (NO)-releasing scaffolds (i.e., dendrimers and silica particles) as anti-periodontopathogenic agents. The effectiveness of macromolecular NO release was demonstrated by a 3-log reduction in periodontopathogenic Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis viability. In contrast, Streptococcus mutans and Streptococcus sanguinis, caries-associated organisms, were substantially less sensitive to NO treatment. Both dendrimer- and silica-based NO release exhibited substantially less toxicity to human gingival fibroblasts at concentrations necessary to eradicate periodontopathogens than did clinical concentrations of chlorhexidine. These results suggest the potential utility of macromolecular NO-release scaffolds as a novel platform for the development of periodontal disease therapeutics.
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Affiliation(s)
| | | | - S Offenbacher
- Department of Periodontology at the UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Bharti P, Katagiri S, Nitta H, Nagasawa T, Kobayashi H, Takeuchi Y, Izumiyama H, Uchimura I, Inoue S, Izumi Y. Periodontal treatment with topical antibiotics improves glycemic control in association with elevated serum adiponectin in patients with type 2 diabetes mellitus. Obes Res Clin Pract 2014; 7:e129-e138. [PMID: 24331774 DOI: 10.1016/j.orcp.2011.11.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 11/19/2011] [Accepted: 11/22/2011] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Chronic inflammation of periodontitis aggravates glycemic control in type 2 diabetic patients through aggravation of insulin resistance. Increased or decreased release of various inflammatory mediators, such as high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6 and adipokines, such as adiponectin, leptin, and resistin, are presumed to be responsible for developing and progressing insulin resistance. The purpose of this study was to examine the effects of periodontal treatment on glycemic control, serum inflammatory mediators and adipokines in type 2 diabetes patients with periodontitis. METHODS Twenty-one type 2 diabetic patients with periodontitis received periodontal treatment with topical antibiotics (intervention group) and 8 patients did not receive periodontal treatment (control group). Periodontal examination, including probing pocket depth (PPD) and bleeding on probing (BOP), and blood sampling were performed at baseline, 2 and 6 months after periodontal treatments. Glycated hemoglobin (HbA1c), hs-CRP, TNF-α, IL-6, adiponectin, leptin, and resistin were analyzed. RESULTS In the intervention group, improvements of PPD and BOP, decrease in HbA1c and elevation of serum adiponectin were observed, while in the control group, all parameters were not changed. Generalized linear model revealed that changes of serum adiponectin and TNF-α and change of BOP correlated significantly with the reduction of HbA1c at 6 months after periodontal treatments. CONCLUSION The results demonstrated that periodontal treatment improves periodontal status and glycemic control with elevation of serum adiponectin in type 2 diabetic patients. The results suggest that HbA1c is reduced by amelioration of insulin resistance due to elevated serum adiponectin after periodontal treatments.
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Affiliation(s)
- Pariksha Bharti
- Global Center of Excellence Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Sayaka Katagiri
- Section of Periodontology, Department of Hard Tissue Engineering, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
| | - Hiroshi Nitta
- Section of Behavioral Dentistry, Department of Comprehensive Oral Health Care, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Toshiyuki Nagasawa
- Section of Periodontology and Endodontology, Health Sciences University of Hokkaido, Sapporo, Japan
| | - Hiroaki Kobayashi
- Section of Periodontology, Department of Hard Tissue Engineering, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Yasuo Takeuchi
- Section of Periodontology, Department of Hard Tissue Engineering, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Hajime Izumiyama
- Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Isao Uchimura
- Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Shuji Inoue
- Department of Clinical Nutrition, Faculty of Health Care, Kiryu University, Gunma, Japan
| | - Yuichi Izumi
- Global Center of Excellence Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
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Preus HR, Sandvik L, Gjermo P, Baelum V. Baseline adjustment and change revisited: effect of smoking on change in periodontal status following periodontal therapy. Eur J Oral Sci 2014; 122:89-99. [DOI: 10.1111/eos.12111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Hans R. Preus
- Department of Periodontology; Institute of Clinical Odontology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Leiv Sandvik
- Department of Periodontology; Institute of Clinical Odontology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Per Gjermo
- Department of Periodontology; Institute of Clinical Odontology; Faculty of Dentistry; University of Oslo; Oslo Norway
| | - Vibeke Baelum
- Department of Dentistry, Oral Epidemiology & Public Health; Institute of Odontology; Aarhus University; Aarhus Denmark
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61
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Riefler JF. Clinical trial subjects: "panning gold". Front Public Health 2013; 1:53. [PMID: 24350222 PMCID: PMC3859931 DOI: 10.3389/fpubh.2013.00053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 06/26/2013] [Indexed: 11/28/2022] Open
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Kinney JS, Morelli T, Oh M, Braun TM, Ramseier CA, Sugai JV, Giannobile WV. Crevicular fluid biomarkers and periodontal disease progression. J Clin Periodontol 2013; 41:113-120. [PMID: 24303954 DOI: 10.1111/jcpe.12194] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 09/29/2013] [Accepted: 11/02/2013] [Indexed: 12/23/2022]
Abstract
AIM Assess the ability of a panel of gingival crevicular fluid (GCF) biomarkers as predictors of periodontal disease progression (PDP). MATERIALS AND METHODS In this study, 100 individuals participated in a 12-month longitudinal investigation and were categorized into four groups according to their periodontal status. GCF, clinical parameters and saliva were collected bi-monthly. Subgingival plaque and serum were collected bi-annually. For 6 months, no periodontal treatment was provided. At 6 months, patients received periodontal therapy and continued participation from 6 to 12 months. GCF samples were analysed by ELISA for MMP-8, MMP-9, Osteoprotegerin, C-reactive Protein and IL-1β. Differences in median levels of GCF biomarkers were compared between stable and progressing participants using Wilcoxon Rank Sum test (p = 0.05). Clustering algorithm was used to evaluate the ability of oral biomarkers to classify patients as either stable or progressing. RESULTS Eighty-three individuals completed the 6-month monitoring phase. With the exception of GCF C-reactive protein, all biomarkers were significantly higher in the PDP group compared to stable patients. Clustering analysis showed highest sensitivity levels when biofilm pathogens and GCF biomarkers were combined with clinical measures, 74% (95% CI = 61, 86). CONCLUSIONS Signature of GCF fluid-derived biomarkers combined with pathogens and clinical measures provides a sensitive measure for discrimination of PDP (ClinicalTrials.gov NCT00277745).
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Affiliation(s)
- Janet S Kinney
- Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Thiago Morelli
- Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Currently, Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Min Oh
- Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Thomas M Braun
- Biostatistics Department, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
| | - Christoph A Ramseier
- Currently, Department of Periodontology, School of Dental Medicine, University of Berne, Freiburgstrasse 7, CH-3010 Bern, Switzerland
| | - Jim V Sugai
- Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - William V Giannobile
- Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
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Prevention of inflammation-mediated bone loss in murine and canine periodontal disease via recruitment of regulatory lymphocytes. Proc Natl Acad Sci U S A 2013; 110:18525-30. [PMID: 24167272 DOI: 10.1073/pnas.1302829110] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The hallmark of periodontal disease is the progressive destruction of gingival soft tissue and alveolar bone, which is initiated by inflammation in response to an invasive and persistent bacterial insult. In recent years, it has become apparent that this tissue destruction is associated with a decrease in local regulatory processes, including a decrease of forkhead box P3-expressing regulatory lymphocytes. Accordingly, we developed a controlled release system capable of generating a steady release of a known chemoattractant for regulatory lymphocytes, C-C motif chemokine ligand 22 (CCL22), composed of a degradable polymer with a proven track record of clinical translation, poly(lactic-co-glycolic) acid. We have previously shown that this sustained presentation of CCL22 from a point source effectively recruits regulatory T cells (Tregs) to the site of injection. Following administration of the Treg-recruiting formulation to the gingivae in murine experimental periodontitis, we observed increases in hallmark Treg-associated anti-inflammatory molecules, a decrease of proinflammatory cytokines, and a marked reduction in alveolar bone resorption. Furthermore, application of the Treg-recruiting formulation (fabricated with human CCL22) in ligature-induced periodontitis in beagle dogs leads to reduced clinical measures of inflammation and less alveolar bone loss under severe inflammatory conditions in the presence of a diverse periodontopathogen milieu.
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Pandit N, Dahiya R, Gupta R, Bali D, Kathuria A. Comparative evaluation of locally delivered minocycline and metronidazole in the treatment of periodontitis. Contemp Clin Dent 2013; 4:48-53. [PMID: 23853452 PMCID: PMC3703694 DOI: 10.4103/0976-237x.111615] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective: The aim of this study was to evaluate and compare the efficacy of subgingivally delivered Minocycline microspheres and 25% Metronidazole gel when used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Materials and Methods: A randomized, controlled, single center study was conducted involving 60 sites in 20 patients suffering from moderate to advanced chronic periodontitis. Each patient contributed three sites which were randomized to three treatment groups: SRP + insertion of Minocycline microspheres at day 1 (Group A), SRP + insertion of Metronidazole gel at day 1 and at day 7 (Group B), and SRP alone (Group C). Gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at day 1, 1 month, and 3 months post therapy. Results: All treatments showed significant reductions in PPD and CAL at 1 and 3 months when compared to baseline values (P < 0.001). At 3 months, sites treated with minocycline showed an additional reduction in PPD of 0.85 ± 0.03 mm, significantly greater than SRP alone. Differences in mean PPD reduction between Group B and Group C and between Group A and Group B were not significant. At 3 months, difference in CAL gain between Group A and C was 0.50 ± 0.45, which was statistically significant and between Group B and C was 0.35 ± 0.11, which was not found to be statistically significant (P = 0.20). Differences in relative CAL between Group A and Group B were also not found to be statistically significant (P = 0.53). Conclusion: The results concluded that treatment with Minocycline microspheres and Metronidazole gel improve PPD and CAL in patients with periodontitis compared to SRP alone.
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Affiliation(s)
- Nymphea Pandit
- Department of Periodontology and Implantology, D.A.V. (c) Dental College, Model Town, Yamuna Nagar, Haryana, India
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Eick S, Renatus A, Heinicke M, Pfister W, Stratul SI, Jentsch H. Hyaluronic Acid as an Adjunct After Scaling and Root Planing: A Prospective Randomized Clinical Trial. J Periodontol 2013; 84:941-9. [DOI: 10.1902/jop.2012.120269] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Martinez V, Szekely B, Lemarié J, Martin F, Gentili M, Ben Ammar S, Lepeintre JF, Garreau de Loubresse C, Chauvin M, Bouhassira D, Fletcher D. The efficacy of a glial inhibitor, minocycline, for preventing persistent pain after lumbar discectomy: a randomized, double-blind, controlled study. Pain 2013; 154:1197-203. [PMID: 23706627 DOI: 10.1016/j.pain.2013.03.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/24/2013] [Accepted: 03/20/2013] [Indexed: 12/12/2022]
Abstract
Minocycline strongly inhibits microglial activation, which contributes to central sensitization, a major mechanism underlying chronic pain development. We hypothesized that the perioperative administration of minocycline might decrease persistent pain after lumbar discectomy. We randomly assigned 100 patients undergoing scheduled lumbar discectomy to placebo and minocycline groups. The minocycline group received 100mg minocycline orally, twice daily, beginning the evening before surgery and continuing for 8 days. The primary outcome was the change in lower limb pain intensity at rest between baseline and 3 months. Secondary outcomes were pain intensity on movement, the incidence of persistent pain and chronic neuropathic pain, back pain intensity at rest and on movement, and changes in Neuropathic Pain Symptom Inventory, Brief Pain Inventory, and Roland-Morris scores at 3 months. An intention-to-treat analysis was performed for patients assessed from the day before surgery to 3 months. The decrease in lower limb pain intensity was similar in the placebo and minocycline groups, both at rest -1.7 ± 1.6 vs -2.3 ± 2.4 and on movement -2.5 ± 2.1 vs -3.4 ± 2.9. The incidence and intensity of neuropathic pain and functional scores did not differ between the minocycline and placebo groups. Exploratory analysis suggested that minocycline might be effective in a subgroup of patients with predominantly deep spontaneous pain at baseline. Perioperative minocycline administration for 8 days does not improve persistent pain after lumbar discectomy.
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Affiliation(s)
- Valéria Martinez
- Department of Anesthesiology, Assistance Publique Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France.
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Is change in probing depth a reliable predictor of change in clinical attachment loss? J Am Dent Assoc 2013; 144:171-8. [DOI: 10.14219/jada.archive.2013.0096] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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68
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Matesanz-Pérez P, García-Gargallo M, Figuero E, Bascones-Martínez A, Sanz M, Herrera D. A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis. J Clin Periodontol 2013; 40:227-41. [PMID: 23320860 DOI: 10.1111/jcpe.12026] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2012] [Indexed: 12/30/2022]
Abstract
AIMS To update the existing scientific evidence on the efficacy of local antimicrobials as adjuncts to subgingival debridement in the treatment of chronic periodontitis. MATERIAL AND METHODS Fifty-six papers were selected, reporting data from 52 different investigations. All the studies reported changes in probing pocket depth (PPD) and clinical attachment level (CAL) and most in plaque index (PlI) and/or bleeding on probing (BOP). Meta-analyses were performed with the data retrieved from the studies fulfilling the inclusion criteria. RESULTS The overall effect of the subgingival application of antimicrobials was statistically significant (p = 0.000) for both changes in PPD and CAL with a weighted mean difference (WMD) of -0.407 and -0.310 mm respectively. No significant differences occurred for changes in BOP and PlI. Subgingival application of tetracycline fibres, sustained released doxycycline and minocycline demonstrated a significant benefit in PPD reduction (WMD between 0.5 and 0.7 mm). The rest of the tested outcomes demonstrated a high heterogeneity. The local application of chlorhexidine and metronidazole showed a minimal effect when compared with placebo (WMD between 0.1 and 0.4 mm). CONCLUSIONS The scientific evidence supports the adjunctive use of local antimicrobials to debridement in deep or recurrent periodontal sites, mostly when using vehicles with proven sustained release of the antimicrobial.
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Affiliation(s)
- Paula Matesanz-Pérez
- Graduate Periodontology, Faculty of Odontology, University Complutense, Plaza Ramon y Cajal s/n, Madrid, Spain
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Tariq M, Iqbal Z, Ali J, Baboota S, Talegaonkar S, Ahmad Z, Sahni JK. Treatment modalities and evaluation models for periodontitis. Int J Pharm Investig 2012; 2:106-22. [PMID: 23373002 PMCID: PMC3555006 DOI: 10.4103/2230-973x.104394] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is the most common localized dental inflammatory disease related with several pathological conditions like inflammation of gums (gingivitis), degeneration of periodontal ligament, dental cementum and alveolar bone loss. In this perspective, the various preventive and treatment modalities, including oral hygiene, gingival irrigations, mechanical instrumentation, full mouth disinfection, host modulation and antimicrobial therapy, which are used either as adjunctive treatments or as stand-alone therapies in the non-surgical management of periodontal infections, have been discussed. Intra-pocket, sustained release systems have emerged as a novel paradigm for the future research. In this article, special consideration is given to different locally delivered anti-microbial and anti inflammatory medications which are either commercially available or are currently under consideration for Food and Drug Administration (FDA) approval. The various in vitro dissolution models and microbiological strain investigated to impersonate the infected and inflamed periodontal cavity and to predict the in vivo performance of treatment modalities have also been thrashed out. Animal models that have been employed to explore the pathology at the different stages of periodontitis and to evaluate its treatment modalities are enlightened in this proposed review.
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Affiliation(s)
- Mohammad Tariq
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Zeenat Iqbal
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Javed Ali
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Sanjula Baboota
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Sushama Talegaonkar
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Zulfiqar Ahmad
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Jasjeet K Sahni
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
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71
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Jung DY, Park JC, Kim YT, Yon JY, Im GI, Kim BS, Choi SH, Cho KS, Kim CS. The clinical effect of locally delivered minocycline in association with flap surgery for the treatment of chronic severe periodontitis: a split-mouth design. J Clin Periodontol 2012; 39:753-9. [DOI: 10.1111/j.1600-051x.2012.01908.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2012] [Indexed: 11/30/2022]
Affiliation(s)
| | - Jung-Chul Park
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
| | | | - Je-Young Yon
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
| | - Gun-Il Im
- Department of Orthopaedic Surgery; Ilsan Hospital; Dongguk University; Goyang; Korea
| | - Byung-Soo Kim
- School of Chemical and Biological Engineering; Seoul National University; Seoul; Korea
| | - Seong-Ho Choi
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
| | - Kyoo-Sung Cho
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
| | - Chang-Sung Kim
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
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72
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Nair SC, Anoop KR. Intraperiodontal pocket: An ideal route for local antimicrobial drug delivery. J Adv Pharm Technol Res 2012; 3:9-15. [PMID: 22470888 PMCID: PMC3312733 DOI: 10.4103/2231-4040.93558] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Periodontal pockets act as a natural reservoir filled with gingival crevicular fluid for the controlled release delivery of antimicrobials directly. This article reflects the present status of nonsurgical controlled local intrapocket delivery of antimicrobials in the treatment of periodontitis. These sites have specialty in terms of anatomy, permeability, and their ability to retain a delivery system for a desired length of time. A number of antimicrobial products and the composition of the delivery systems, its use, clinical results, and their release are summarized. The goal in using an intrapocket device for the delivery of an antimicrobial agent is the achievement and maintenance of therapeutic drug concentration for the desired period of time. Novel controlled drug delivery system are capable of improving patient compliance as well as therapeutic efficacy with precise control of the rate by which a particular drug dosage is released from a delivery system without the need for frequent administration. These are considered superior drug delivery system because of low cost, greater stability, non-toxicity, biocompatibility, non-immunogenicity, and are biodegradable in nature. This review also focus on the importance and ideal features of periodontal pockets as a drug delivery platform for designing a suitable dosage form along with its potential advantage and limitations. The microbes in the periodontal pocket could destroy periodontal tissues, and a complete knowledge of these as well as an ideal treatment strategy could be helpful in treating this disease.
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Affiliation(s)
- Sreeja C. Nair
- Department of Pharmaceutics, Amrita School of Pharmacy, AIMS Healthcare Campus, Kochi, India
| | - K. R. Anoop
- Department of Pharmaceutics, Amrita School of Pharmacy, AIMS Healthcare Campus, Kochi, India
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73
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Rao SK, Setty S, Acharya AB, Thakur SL. Efficacy of locally-delivered doxycycline microspheres in chronic localized periodontitis and on Porphyromonas gingivalis. ACTA ACUST UNITED AC 2011; 3:128-34. [PMID: 22180217 DOI: 10.1111/j.2041-1626.2011.00110.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to assess the efficacy and effect of locally-delivered doxycycline microspheres with scaling and root planing in periodontal pocket therapy and on Porphyromonas gingivalis, respectively. METHODS Twenty sites with a probing pocket depth of 4-6 mm were divided into two groups: a control group consisting of scaling and root planing, with one application of doxycycline microspheres only at baseline, and a test group consisting of scaling and root planing, with an application of doxycycline microspheres at baseline and 1 and 3 months. Clinical readings included the plaque index, gingival index, probing pocket depth, and relative attachment level. Rapid polymerase chain reaction method was used for the detection of P. gingivalis. RESULTS A statistically-significant reduction in probing pocket depth and attachment gain was found in both groups; the test group showed a significant reduction in probing pocket depth and attachment gain compared with the control at 3 and 6 months. P. gingivalis cell count in the test group was significantly reduced at all the time periods, except from 1 to 3 months. CONCLUSION Local drug delivery of doxycycline microspheres significantly improved the treatment outcomes in periodontal pocket therapy and reduced P. gingivalis in the periodontal pocket.
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Affiliation(s)
- Sampath K Rao
- Department of Periodontics, Saraswati Dhanvantri Dental College and Hospital, Parbhani, Maharashtra, India.
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74
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Álvarez AL, Espinar FO, Méndez JB. The Application of Microencapsulation Techniques in the Treatment of Endodontic and Periodontal Diseases. Pharmaceutics 2011; 3:538-71. [PMID: 24310596 PMCID: PMC3857082 DOI: 10.3390/pharmaceutics3030538] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 08/09/2011] [Accepted: 08/24/2011] [Indexed: 11/12/2022] Open
Abstract
In the treatment of intracanal and periodontal infections, the local application of antibiotics and other therapeutic agents in the root canal or in periodontal pockets may be a promising approach to achieve sustained drug release, high antimicrobial activity and low systemic side effects. Microparticles made from biodegradable polymers have been reported to be an effective means of delivering antibacterial drugs in endodontic and periodontal therapy. The aim of this review article is to assess recent therapeutic strategies in which biocompatible microparticles are used for effective management of periodontal and endodontic diseases. In vitro and in vivo studies that have investigated the biocompatibility or efficacy of certain microparticle formulations and devices are presented. Future directions in the application of microencapsulation techniques in endodontic and periodontal therapies are discussed.
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Affiliation(s)
- Asteria Luzardo Álvarez
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Ciencias, Universidad de Santiago de Compostela, 27002 Lugo, Spain; E-Mail:
| | - Francisco Otero Espinar
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain; E-Mail:
| | - José Blanco Méndez
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Ciencias, Universidad de Santiago de Compostela, 27002 Lugo, Spain; E-Mail:
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain; E-Mail:
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Gelesko S, Long L, Faulk J, Phillips C, Dicus C, White RP. Cryotherapy and topical minocycline as adjunctive measures to control pain after third molar surgery: an exploratory study. J Oral Maxillofac Surg 2011; 69:e324-32. [PMID: 21802812 DOI: 10.1016/j.joms.2011.03.059] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 03/03/2011] [Accepted: 03/22/2011] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the impact of cryotherapy or topical minocycline on patients' perceptions of recovery from pain after third molar surgery in an exploratory comparative-effectiveness study. PATIENTS AND METHODS Subjects aged at least 14 years who were having all 4 third molars removed were enrolled in 3 separate institutional review board-approved studies. Study groups included subjects treated with a passively applied cold wrap for 24 hours postoperatively, subjects treated with topical minocycline during surgery, and subjects enrolled in a nonconcurrent comparison group who had received neither topical minocycline nor directed cryotherapy. Third molar surgery was performed in all cases by trained surgeons using the same protocol. An exact Kruskal-Wallis test was used to compare the distributions of the worst and average pain scores and a Fisher exact test to compare verbal responses from Gracely pain scales among the 3 groups for postsurgical days (PSDs) 1 to 3. RESULTS This study comprised 51 cryotherapy subjects (2005-2009), 63 minocycline subjects (2003-2004), and 92 comparison-group subjects (2002-2006) who were treated at academic centers and in community practices across the United States (N = 206). Demographic descriptors were similar among all groups. For PSDs 1 through 3 (unadjusted), the highest scores for worst pain (6-7 [out of 7] on Likert-type scale) were reported less frequently in each of the study groups than in subjects in the comparison group, although the numbers of subjects reporting the highest scores were few. The distribution of pain outcomes was significantly different among the 3 groups for worst pain and affective words on PSD 1 (P = .04 for both). However, the small number of subjects who reported the highest pain scores precluded adequate multivariate statistical analyses for all outcomes on PSD 1 to 3. CONCLUSIONS Data from this exploratory study suggest that adjunctive therapy to decrease postoperative pain-cryotherapy or topical minocycline-might be effective at moderating the patient's highest pain levels after third molar surgery. The topic should be studied further in a multicenter, prospective, randomized trial.
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Affiliation(s)
- Savannah Gelesko
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Oregon Health and Science University, Portland, OR, USA
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76
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Kawar N, Gajendrareddy PK, Hart TC, Nouneh R, Maniar N, Alrayyes S. Periodontal disease for the primary care physician. Dis Mon 2011; 57:174-83. [PMID: 21569880 DOI: 10.1016/j.disamonth.2011.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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77
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Rios HF, Lin Z, Oh B, Park CH, Giannobile WV. Cell- and gene-based therapeutic strategies for periodontal regenerative medicine. J Periodontol 2011; 82:1223-37. [PMID: 21284553 DOI: 10.1902/jop.2011.100710] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Inflammatory periodontal diseases are a leading cause of tooth loss and are linked to multiple systemic conditions, such as cardiovascular disease and stroke. Reconstruction of the support and function of affected tooth-supporting tissues represents an important therapeutic endpoint for periodontal regenerative medicine. An improved understanding of periodontal biology coupled with current advances in scaffolding matrices has introduced novel treatments that use cell and gene therapy to enhance periodontal tissue reconstruction and its biomechanical integration. Cell and gene delivery technologies have the potential to overcome limitations associated with existing periodontal therapies, and may provide a new direction in sustainable inflammation control and more predictable tissue regeneration of supporting alveolar bone, periodontal ligament, and cementum. This review provides clinicians with the current status of these early-stage and emerging cell- and gene-based therapeutics in periodontal regenerative medicine, and introduces their future application in clinical periodontal treatment. The paper concludes with prospects on the application of cell and gene tissue engineering technologies for reconstructive periodontology.
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Affiliation(s)
- Hector F Rios
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109–1078, USA.
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78
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Mombelli A, Cionca N, Almaghlouth A. Does adjunctive antimicrobial therapy reduce the perceived need for periodontal surgery? Periodontol 2000 2010; 55:205-16. [DOI: 10.1111/j.1600-0757.2010.00356.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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79
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Flemmig TF, Petersilka G, Völp A, Gravemeier M, Zilly M, Mross D, Prior K, Yamamoto J, Beikler T. Efficacy and safety of adjunctive local moxifloxacin delivery in the treatment of periodontitis. J Periodontol 2010; 82:96-105. [PMID: 20843236 DOI: 10.1902/jop.2010.100124] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Moxifloxacin exerts excellent antibacterial activity against most putative periodontal pathogens and has been shown to kill bacteria in biofilm and host cells. METHODS Patients with chronic periodontitis were randomly assigned to receive a single subgingival application of a 0.125%, 0.4%, or 1.25% moxifloxacin gel or placebo gel immediately after full-mouth scaling and root planing (SRP). Clinical efficacy measurements were assessed in sites with baseline probing depth (PD) of ≥5.4 mm at 6 weeks and 3 months and any adverse events were determined. In addition, putative periodontal pathogens and resistance of subgingival bacteria against moxifloxacin were assessed. RESULTS Data of 57 patients were included in the statistical analysis. In all treatment groups, the PD decreased from baseline to 3 months, with the greatest reduction seen in patients treated with moxifloxacin 0.4% (1.5 ± 0.6 mm; P = 0.023 compared to placebo), followed by patients receiving moxifloxacin 1.25% (1.2 ± 0.4), moxifloxacin 0.125% (1.1 ± 1.1), and placebo (1.0 ± 0.6). No linear trend for PD reduction with increasing moxifloxacin concentrations was found. Porphyromonas gingivalis showed the greatest reduction in prevalence among the assessed pathogens, without any significant intergroup differences. No correlation or systematic relationship between adverse events, including bacterial resistance against moxifloxacin, and the investigational gels was found. CONCLUSIONS In periodontal pockets with PD of ≥5.4 mm, a single subgingival administration of a 0.4% moxifloxacin gel as an adjunct to SRP may result in additional PD reduction compared to SRP alone. In addition, the investigated moxifloxacin gels seem to be safe.
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Affiliation(s)
- Thomas F Flemmig
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA 98195–7444, USA.
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80
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Corrêa MG, Campos MLG, Benatti BB, Marques MR, Casati MZ, Nociti FH, Sallum EA. The impact of cigarette smoke inhalation on the outcome of enamel matrix derivative treatment in rats: histometric analysis. J Periodontol 2010; 81:1820-8. [PMID: 20629543 DOI: 10.1902/jop.2010.100200] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tobacco use is the most significant risk factor of periodontal disease. Clinical evidence has demonstrated that tobacco may negatively influence the results after surgical and non-surgical periodontal therapy. Enamel matrix derivative (EMD) have been used in periodontal regenerative procedures resulting in improvement of clinical parameters. The effect of EMD in the presence of tobacco compounds is unclear. Thus, the aim of the present study is to evaluate the impact of cigarette smoke inhalation (CSI) on the results of EMD treatment. METHODS Twenty-two Wistar rats were assigned to two groups: Group 1, CSI (n = 11); Group 2, non-exposed (n = 11). Thirty days after initiation of CSI, fenestration defects were created at the buccal aspect of the first mandibular molar. The study followed a split-mouth design. After the surgeries the defects were randomly assigned to two subgroups: non-treated control and treated with EMD. The animals were sacrificed 21 days later and the percentage of defect fill, density of newly formed bone, and new cementum formation were histometrically assessed. The number of osteoclasts was determined by tartrate-resistant acid phosphatase. RESULTS CSI was associated with less bone density compared to the non-exposed group. EMD provided an increased defect fill and new cementum formation in both groups. The number of tartrate-resistant acid phosphatase-positive osteoclasts was significantly higher in the CSI non-treated control group compared to the non-treated control of the non-exposed animals. CONCLUSIONS EMD may provide increased defect fill and cementum formation in the presence or absence of CSI. However, tobacco smoke produced a detrimental effect on bone healing when density of newly formed bone was considered.
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Affiliation(s)
- Mônica G Corrêa
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
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81
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Non-surgical chemotherapeutic treatment strategies for the management of periodontal diseases. Dent Clin North Am 2010; 54:13-33. [PMID: 20103470 DOI: 10.1016/j.cden.2009.08.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Periodontal diseases are initiated by subgingival periodontal pathogens in susceptible periodontal sites. The host immune response toward periodontal pathogens helps to sustain periodontal disease and eventual alveolar bone loss. Numerous adjunctive therapeutic strategies have evolved to manage periodontal diseases. Systemic and local antibiotics, antiseptics, and past and future host immune modulatory agents are reviewed and discussed to facilitate the dental practitioner's appreciation of this ever-growing field in clinical periodontics.
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Agnihotri R, Bhat KM, Bhat GS, Pandurang P. Periodontal management of a patient with severe aplastic anemia: a case report. SPECIAL CARE IN DENTISTRY 2009; 29:141-4. [PMID: 19938255 DOI: 10.1111/j.1754-4505.2009.00079.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This article describes the periodontal management of a patient with severe aplastic anemia. A 51-year-old female patient was hospitalized with aplastic anemia and was referred for the management of her cyclosporine-induced gingival enlargement and bleeding from her gums. She also complained of pain in the palatal area and the mandibular anterior region. The patient was managed successfully with supra- and subgingival instrumentation, local drug delivery (LDD), electrosurgery, repeated oral hygiene instruction, and constant supervision. The treatment resulted in dramatic improvement in the patient's oral health and quality of life. This report highlights the importance of nonsurgical therapy followed by electrosurgery for the management of residual gingival enlargement.
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Affiliation(s)
- Rupali Agnihotri
- Department of Periodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India.
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83
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Johannsen A, Tellefsen M, Wikesjö U, Johannsen G. Local Delivery of Hyaluronan as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis. J Periodontol 2009; 80:1493-7. [DOI: 10.1902/jop.2009.090128] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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84
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Dannewitz B, Lippert K, Lang NP, Tonetti MS, Eickholz P. Supportive periodontal therapy of furcation sites: non-surgical instrumentation with or without topical doxycycline. J Clin Periodontol 2009; 36:514-22. [DOI: 10.1111/j.1600-051x.2009.01414.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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85
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Renvert S, Lindahl C, Roos-Jansåker AM, Lessem J. Short-Term Effects of an Anti-Inflammatory Treatment on Clinical Parameters and Serum Levels of C-Reactive Protein and Proinflammatory Cytokines in Subjects With Periodontitis. J Periodontol 2009; 80:892-900. [DOI: 10.1902/jop.2009.080552] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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86
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Matsumoto S, Ogawa H, Soda S, Hirayama S, Amarasena N, Aizawa Y, Miyazaki H. Effect of antimicrobial periodontal treatment and maintenance on serum adiponectin in type 2 diabetes mellitus. J Clin Periodontol 2009; 36:142-8. [PMID: 19207890 DOI: 10.1111/j.1600-051x.2008.01359.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS The aims of this study were to evaluate the effect of mechanical periodontal treatment with local application of minocycline (APT) on serum adiponectin as a marker of insulin resistance improvement in type 2 diabetes mellitus (T2DM) patients and to investigate if effect of APT on serum adiponectin level was sustained by periodontal maintenance (PM). MATERIAL AND METHODS Twenty-seven T2DM patients were randomly assigned into test or control groups. Test received scaling with ultrasonic devices at baseline and APT biweekly for 2 months while control received scaling at baseline and mechanical tooth cleaning (MPT) at the same interval. At 6 months, all patients received mechanical tooth cleaning as PM. Periodontal examination and blood measurements were performed at baseline, 4 and 9 months. RESULTS Adiponectin concentrations in test had significantly increased by 31.4% after APT (p=0.024) and by 30.4% after PM (p=0.002) compared with baseline. The percentage of >or=4 mm probing depths (PD) had shown 8.3% and 9.3% reduction after APT and PM (p=0.046, 0.02) in test while 5.0% reduction after MPT in control group (p=0.031). CONCLUSIONS Our results suggested that APT and PM not only improve periodontal disease but also increase serum adiponectin in T2DM patients.
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Affiliation(s)
- Sayaka Matsumoto
- Divison of Preventive Dentistry, Department of Oral Health Science, Graduate School of Medical and Dental Sciences, Niigata University, Gakkocho-Dori Niigata, Japan
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Gopinath V, Ramakrishnan T, Emmadi P, Ambalavanan N, Mammen B, Vijayalakshmi. Effect of a controlled release device containing minocycline microspheres on the treatment of chronic periodontitis: A comparative study. J Indian Soc Periodontol 2009; 13:79-84. [PMID: 20407655 PMCID: PMC2847129 DOI: 10.4103/0972-124x.55844] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 07/09/2009] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Adjunctive therapy with locally delivered antimicrobials has resulted in improved clinical outcomes. The aim of this study was to evaluate the efficacy and safety of locally administered minocycline microspheres (Arestin) in the treatment of chronic periodontitis. MATERIALS AND METHODS A total of 60 sites from 15 patients in the age group of 35-50 years, who had periodontal pockets measuring 5-8 mm and had been diagnosed with chronic periodontitis, were selected for the study. The selected groups were randomly assigned to either the control group (group A) or the treatment/test group (group B). Only scaling and root planing were done at the base line visit for the control sites followed by local application of Arestin (1 mg). Clinical parameters such as plaque index, gingival index, and gingival bleeding index were recorded at baseline, day 30, day 90, and day 180 in the selected sites of both the groups. Probing pocket depth also was recorded at baseline, day 90, and day 180 for both the groups. RESULTS A statistically significant reduction was observed in both groups. Group B showed better results than Group A and these differences were statistically significant. CONCLUSION The results of this study clearly indicate that treatment with scaling and root planing plus minocycline microspheres (Arestin) is more effective and safer than scaling and root planing alone in reducing the signs of chronic periodontitis.
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Affiliation(s)
- V. Gopinath
- Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospital, Poonamalee High Road, Velapanchavadi, Chennai - 77, India
| | - T. Ramakrishnan
- Professor, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
| | - Pamela Emmadi
- Professor and Head, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
| | - N. Ambalavanan
- Professor, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
| | - Biju Mammen
- Associate Professor, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
| | - Vijayalakshmi
- Lecturer, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduravoyal, Chennai - 95, India
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Lai S, Zee KY, Lai M, Corbet E. Clinical and Radiographic Investigation of the Adjunctive Effects of a Low-Power He-Ne Laser in the Treatment of Moderate to Advanced Periodontal Disease: A Pilot Study. Photomed Laser Surg 2009; 27:287-93. [DOI: 10.1089/pho.2007.2206] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S.M.L. Lai
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - K.-Y. Zee
- Faculty of Dentistry, The University of Sydney, Westmead, New South Wales, Australia
| | - M.K. Lai
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - E.F. Corbet
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
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Norowski PA, Bumgardner JD. Biomaterial and antibiotic strategies for peri-implantitis: a review. J Biomed Mater Res B Appl Biomater 2009; 88:530-43. [PMID: 18698626 DOI: 10.1002/jbm.b.31152] [Citation(s) in RCA: 195] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Dental implants have 89% plus survival rates at 10-15 years, but peri-implantitis or dental implant infections may be as high as 14%. Peri-implantitis can limit clinical success and impose health and financial burdens to patients and health providers. The pathogenic species associated with periodontitis (e.g., Fusobacterium ssp, A. actinomycetemcomitans, P. gingivalis) are also associated with peri-implantitis. Incidence of peri-implantitis is highest within the first 12 months after implantation, and is higher in patients who smoke or have poor oral health as well as with calcium-phosphate-coated or surface-roughened implants. Biomaterial therapies using fibers, gels, and beads to deliver antibiotics have been used in the treatment of Peri-implantitis though clinical efficacy is not well documented. Guided tissue regeneration membranes (e.g., collagen, poly-lactic/glycolic acid, chitosan, ePTFE) loaded with antimicrobials have shown success in reosseointegrating infected implants in animal models but have not been proven in humans. Experimental approaches include the development of anti-bioadhesion coatings, coating surfaces with antimicrobial agents (e.g., vancomycin, Ag, Zn) or antimicrobial releasing coatings (e.g., calcium phosphate, polylactic acid, chitosan). Future strategies include the development of surfaces that become antibacterial in response to infection, and improvements in the permucosal seal. Research is still needed to identify strategies to prevent bacterial attachment and enhance normal cell/tissue attachment to implant surfaces.
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Affiliation(s)
- P Andrew Norowski
- Biomedical Engineering Department, Herff College of Engineering, University of Memphis and Joint Biomedical Engineering Program, University of Memphis - University of Tennessee Health Science Center, Memphis, Tennessee, USA.
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90
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Gad HA, El-Nabarawi MA, Abd El-Hady SS. Formulation and Evaluation of Secnidazole or Doxycycline Dento-Oral Gels. Drug Dev Ind Pharm 2008; 34:1356-67. [DOI: 10.1080/03639040802122944] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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91
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Abstract
There are many types of diseases associated with the oral cavity. As an adjunct to professional oral dental care, various drug delivery systems have been developed to improve the treatment or prevention of these diseases. In this manuscript, the current status of drug delivery strategies for these common orofacial diseases is reviewed. Biomineral-binding drug delivery and on-demand drug release are suggested to be considered in the future design of drug delivery systems for orofacial diseases. Apparently, this research field deserves much more attention from both pharmaceutical scientists and dental health professionals.
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Affiliation(s)
- Xin-Ming Liu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6025, USA
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92
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Houri-Haddad Y, Halabi A, Soskolne WA. Inflammatory response to chlorhexidine, minocycline HCl and doxycycline HCl in an in vivo mouse model. J Clin Periodontol 2008; 35:783-8. [DOI: 10.1111/j.1600-051x.2008.01290.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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93
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Leiknes T, Leknes KN, Böe OE, Skavland RJ, Lie T. Topical use of a metronidazole gel in the treatment of sites with symptoms of recurring chronic inflammation. J Periodontol 2008; 78:1538-44. [PMID: 17668973 DOI: 10.1902/jop.2007.060501] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Bacterial plaque accumulation at the dentogingival junction and in periodontal pockets is the major etiologic factor in all manifestations of periodontal disease. The aim of this study was to evaluate whether a locally delivered 25% metronidazole gel after scaling and root planing (SRP) would enhance the treatment outcome over SRP alone in periodontal pockets with symptoms of recurring chronic inflammation. METHODS Twenty-one maintenance-care patients, 10 men and 11 women, having at least one pair of contralateral anatomically matching proximal tooth surfaces showing probing depth > or = 5 mm and bleeding on probing (BOP), were included in the study. The sites were randomized to be treated with SRP plus 25% metronidazole gel (test sites) or with SRP alone (control sites) in a split-mouth design. Clinical evaluations were performed immediately pretreatment (baseline) and at 3 and 6 months post-treatment. RESULTS Both treatments yielded a statistically significant (P = 0.001) reduction in probing depth (1.9 and 1.8 mm), gain of attachment level (1.6 and 1.0 mm), and reduction of BOP (38.1% and 33.3%) for test and control sites, respectively, at 6 months. There was no statistically significant difference between the treatments for any of the clinical parameters. CONCLUSION This study indicates that a locally applied 25% metronidazole gel does not improve the treatment outcome over SRP alone in sites with recurring chronic inflammation in maintenance-care patients.
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Affiliation(s)
- Tom Leiknes
- Department of Oral Science-Periodontology, Faculty of Dentistry, University of Bergen, Bergen, Norway
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94
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Hellström MK, McClain PK, Schallhorn RG, Bellis L, Hanlon AL, Ramberg P. Local minocycline as an adjunct to surgical therapy in moderate to severe, chronic periodontitis. J Clin Periodontol 2008; 35:525-31. [DOI: 10.1111/j.1600-051x.2008.01219.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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95
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Bogren A, Teles RP, Torresyap G, Haffajee AD, Socransky SS, Wennström JL. Locally Delivered Doxycycline During Supportive Periodontal Therapy: A 3-Year Study. J Periodontol 2008; 79:827-35. [DOI: 10.1902/jop.2008.070515] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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96
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Renvert S, Lessem J, Dahlén G, Renvert H, Lindahl C. Mechanical and Repeated Antimicrobial Therapy Using a Local Drug Delivery System in the Treatment of Peri-Implantitis: A Randomized Clinical Trial. J Periodontol 2008; 79:836-44. [DOI: 10.1902/jop.2008.070347] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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97
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Tomasi C, Koutouzis T, Wennström JL. Locally Delivered Doxycycline as an Adjunct to Mechanical Debridement at Retreatment of Periodontal Pockets. J Periodontol 2008; 79:431-9. [DOI: 10.1902/jop.2008.070383] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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98
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Cortelli JR, Aquino DR, Cortelli SC, Carvalho-Filho J, Roman-Torres CVG, Costa FO. A double-blind randomized clinical trial of subgingival minocycline for chronic periodontitis. J Oral Sci 2008; 50:259-65. [DOI: 10.2334/josnusd.50.259] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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99
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100
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Grossi SG, Goodson JM, Gunsolley JC, Otomo-Corgel J, Bland PS, Doherty F, Comiskey J. Mechanical Therapy With Adjunctive Minocycline Microspheres Reduces Red-Complex Bacteria in Smokers. J Periodontol 2007; 78:1741-50. [PMID: 17760544 DOI: 10.1902/jop.2007.070118] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Smoking increases the risk for periodontal disease and reduces the healing response. We examined the antimicrobial and clinical effects of scaling and root planing (SRP) with and without minocycline HCl 1 mg microspheres (MM) relative to smoking status in subjects with periodontitis. METHODS A total of 127 subjects (46 never smokers, 44 former smokers, and 37 current smokers) with moderate to advanced periodontitis were randomized to receive MM + SRP (N = 62) or SRP alone (N = 65). Subgingival plaque samples collected at baseline and day 30 were examined for the presence of 40 periodontal bacteria by DNA probe analysis. RESULTS MM + SRP reduced red-complex bacteria (RCB) numbers and proportions to a greater extent than SRP alone, irrespective of smoking status. RCB numbers were not reduced by SRP in current smokers. The difference in the reduction in numbers of RCB by SRP relative to MM + SRP in current smokers was statistically significant (P <0.05). Numbers and proportions of orange complex bacteria (OCB) were reduced in all groups treated with MM + SRP. Proportions of OCB increased in current smokers treated with SRP alone. In current smokers, MM + SRP significantly reduced probing depth (PD), increased clinical attachment level (CAL), and reduced bleeding on probing (BOP) to a greater extent than SRP alone (P <0.05). CONCLUSIONS SRP alone was ineffective at reducing numbers or proportions of RCB or OCB in current smokers, whereas MM + SRP significantly reduced both. MM + SRP also improved PD, BOP, and CAL to a greater extent than SRP alone independent of smoking status.
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Affiliation(s)
- Sara G Grossi
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
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