Effects of a single episode of subgingival irrigation with tetracycline HCl or chlorhexidine: A clinical and microbiological study

Antibacterial efficacy of a pH-neutral electrolyzed super-oxidized solution for nonsurgical periodontal treatment

Objective

Mouthwash is effective in maintaining oral hygiene in patients; however, there is concern that it may adversely affect human oral mucosa. We evaluated a pH-neutral electrolyzed super-oxidized solution (ESS, tradename OxOral®) combined with dental scaling in periodontitis patients. This longitudinal study was conducted with 34 patients divided into three groups. The control group treated with scaling plus saline, the second with scaling plus ESS mouthwash, and another with scaling plus ESS mouthwash and gel. The plaque index (PI), gingival index (GI), and probing depth (PD) were determined before and after periodontal treatment.

Results

The final PI and GI decreased compared with the initial measurements in the three treatment groups (p < 0.05). Scaling plus ESS mouthwash and gel significantly reduced the final PI, GI, and DP compared to the control group (p < 0.05).

Conclusion

Our study shows the antiseptic properties of ESS with mouthwash and gel. Further studies are needed to verify the results.

In vitro assessment of the antimicrobial activity of tetracycline hydrochloride diluted in three different vehicles against Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum

Background:

The development and progression of periodontal diseases is a result of the dynamic interaction of microorganisms within their habitat, and changes in this habitat generate a dysbiotic state. Fusobacterium nucleatum and Prevotella intermedia are bridging microorganisms between the pioneer communities and other microorganisms responsible for periodontitis such as Porphyromonas gingivalis. Tetracycline hydrochloride (TTC-HCl) is commonly used as a coadjutant in periodontal treatment in the form of an antiseptic. However, there are no clear dilution or concentration protocols.

Objective:

This study aimed to evaluate the in vitro antimicrobial activity of TTC-HCl diluted in sterile water, saline solution, and 2% lidocaine with epinephrine 1:80,000 at concentration of 125, 250, and 500 mg, at three time points– 30, 60, and 120 s – on P. intermedia, F. nucleatum, and P. gingivalis using the Kelsey–Maurer technique.

Materials and Methods:

The antimicrobial activity of TTC-HCl was evaluated at the proposed concentrations and times, dissolved in the different vehicles at pH 1.9 and 7.0, on F. nucleatum, P. intermedia, and P. gingivalis. The Kelsey–Maurer test was used to verify the presence or absence of colony-forming units. Each test was performed in triplicates with its respective viability controls.

Results:

Inhibition of F. nucleatum, P. intermedia, and P. gingivalis was achieved with TTC-HCl at all concentrations, dissolved in distilled water, saline solution, and 2% lidocaine with epinephrine 1:80,000 for all times.

Conclusions:

The results show that TTC-HCl is a good antimicrobial alternative against F. nucleatum, P. intermedia, and P. gingivalis regardless of the vehicle in which it was dissolved, concentration, pH, or time used in this investigation.

In vitro characteristics of human periodontal ligament stem cells incubated with boric acid

OBJECTIVES

To evaluate the influence of boric acid (BA) on various aspects of the human periodontal ligament stem cells (hPDLSCs), including proliferation, migration, and adhesion.

METHODS

BA was prepared at increasing concentrations of 0.5%, 0.75%, 1%, 1.5%, 3%, and 6%, and an [3-(4,5-dimethylthiazol-2-YL)-2,5-diphenyl] (MTT) assay was used to determine the non-toxic concentrations of BA on hPDLSCs. The appropriate concentrations of BA were applied in subsequent experiments to evaluate its effect on three particular aspects of hPDLSCs: proliferation, migration, and adhesion. The proliferation of hPDLSCs was determined with a hemocytometer. The migration of hPDLSCs was evaluated using a scratch assay, followed by analysis of the recorded digital images using the Image-Analysis J 1.51j8 software. The adhesion of hPDLSCs to sterilized root surfaces that retained or lacked a cementum was assessed using the MTT assay.

RESULTS

Non-toxic concentrations of BA against hPDLSCs were 0.5% and 0.75%, allowing a relative growth rate of greater than 75%. Treated hPDLSCs proliferated and migrated uneventfully, with no significant differences to the control group. hPDLSCs adhered to both types of the prepared root surfaces; however, those lacking a cementum allowed more effective adhesion than those retaining it. Qualitatively, the adhesion ability of hPDLSCs was better in the 0.5% rather than the 0.75% BA-treated or control groups.

CONCLUSIONS

BA at concentrations of 0.5% and 0.75% did not impede the proliferation, migration, or adhesion ability of hPDLSCs to root surfaces, indicating that this sterilizing agent could be advanced to clinical trials.

Evaluation of Effectiveness of Photodynamic Therapy With Low-level Diode Laser in Nonsurgical Treatment of Peri-implantitis

Introduction: Side effects related to antibiotic therapy for peri-implantitis are rare in laser therapy (LT); therefore, the aim of this study was to evaluate the effectiveness of LT and photodynamic therapy (PDT) on patients with primary peri-implantitis. Methods: In this randomized clinical trial, 40 implants presenting primary peri-implantitis in 20 patients with a mean age of 52.6 years old were included using the simple sampling technique. Periodontal treatment comprising scaling and root planing (SRP) was accomplished for the whole mouth while mechanical debridement with titanium curettes and air polishing with sodium bicarbonate powder was accomplished around the implants. The implants were randomly divided into two groups and treated with LT (control) and PDT (test). The clinical indices were measured at baseline, 6 weeks and 3 months after treatment. Real-time polymerase chain reaction (PCR) was used for analysis of microbial samples at baseline and 3-month follow-up. Data were analyzed with SPSS 20, using repeated-measures analysis of variance (ANOVA) and Friedman's and Mann-Whitney tests (α = 0.05). Results: Both groups showed statistically significant improvements in terms of bleeding on probing (P < 0.001), probing pocket depth (PPD) (P = 0.006) and modified plaque index (P < 0.001), with no significant differences between the 2 groups (P > 0.05). The number of Aggregatibacter actinomycetemcomitans (P = 0.022), Tannerella forsythia (P = 0.038) and Porphyromonas gingivalis (P = 0.05) in the test group and Porphyromonas gingivalis (P = 0.015) in the control group significantly decreased. Conclusion: The results suggested that LT and PDT have significant short-term benefits in the treatment of primary peri-implantitis.

Different methods for subgingival application of chlorhexidine in the treatment of patients with chronic periodontitis

OBJECTIVE

The aim of this study was to evaluate clinical efficacy of different chlorhexidine gluconate (CHX) preparations applied subgingivally as an adjunct to scaling and root planing (SRP).

MATERIAL AND METHODS

A total of 120 periodontal pockets was included in this randomized, controlled, split mouth designed study. According to protocols used in treatment, periodontal pockets were assigned to experimental and control groups as follows: CHX solution as an addition to SRP versus control SRP group; CHX gel as an addition to SRP versus control SRP; CHX chip as an addition to SRP versus control SRP group. Following clinical parameters were recorded at baseline, one and three months after the baseline: plaque index (PI), probing pocket depth (PPD), bleeding index (BI) and clinical attachment level (CAL).

RESULTS

The most significant improvements were found concerning PI in CHX solution with SRP and CHX gel with SRP groups over controls at one month recall, as well as concerning BI and PPD in CHX chip with SRP group over SRP alone at three-month recall.

CONCLUSION

Results of this study favour combination therapy using CHX chip as an adjunct to SRP due to greater improvements in BI and PPD compared to those obtained by SRP alone in the treatment of chronic periodontitis.

Comparison of the efficacy of subgingival irrigation with 2% povidone-iodine and tetracycline HCl in subjects with chronic moderate periodontitis: A clinico microbiological study

BACKGROUND

This study was performed to evaluate and compare the clinical and antimicrobial efficacy of subgingival irrigation with tetracycline and povidone-iodine as an adjunct to nonsurgical periodontal therapy.

MATERIALS AND METHODS

Twenty subjects with chronic moderate periodontitis were recruited in this split-mouth study with probing pocket depth of >3 and ≤5 mm and clinical attachment loss of 3-4 mm in relation to 16, 36, and 46. In each subject, three selected periodontal pockets were assigned to receive one out of three irrigants (1) sterile water (control) in 16; (2) tetracycline at 10 mg/ml in 36; (3) 2% povidone-iodine in 46, and these sites were designated as Group A, Group B, and Group C, respectively. Plaque score, gingival score, pocket probing depth, and clinical attachment level were evaluated before treatment and at 1 and 3 months posttreatment. Multiplex polymerase chain reaction was used to detect Porphyromonas gingivalis and Tannerella forsythensis which have been implicated as the major risk factors for periodontal disease. Subgingival plaque collected before treatment and at 1 and 3 months posttreatment. Data were analysed using ANOVA and repeated measure ANOVA. Results were considered significant if P < 0.05.

RESULTS

Clinical and microbiological parameters were reduced posttreatment, the reduction being significantly higher in Group B compared to Group C.

CONCLUSION

It can be concluded that chemical and mechanical therapies were of slight benefit in the treatment of chronic moderate periodontitis, and there was an adjunctive effect of significance when scaling and root planing was combined with a single subgingival irrigation with tetracycline or povidone-iodine in lower concentration.

Formulation and evaluation of periodontal in situ gel

Background:

The present study was aimed to develop and optimize in situ gel for the treatment of periodontal disease.

Materials and Methods:

Temperature-sensitive in situ gel containing 0.1% w/v Chlorhexidine hydrochloride was formulated by cold method using different polymers. Preliminary study was carried out to optimize different types and concentration of polymers such as Poloxamer 188, Poloxamer 407, Gellan gum, and Carbopol 934P. Central composite design was employed for optimization of the effect of independent variables such as Poloxamer 407 and Carbopol 934P on responses such as gelation temperature, spreadability, cumulative percentage release at 2 h, and time for 50% drug release (t₅₀ %). Each formulations were evaluated for clarity, pH, gelation temperature, spreadability, drug content, in vitro drug release, t₅₀ %, and cumulative percentage drug release at 2 h.

Results:

Results of evaluation parameters revealed that the drug release, gelation temperature was considerably decreased with increasing t₅₀ % as the concentration of each polymer was increased. The desirability function was utilized to find out optimized formulation of the factorial design. Formulation F6 showed the highest overall desirability of 0.6283 and, therefore, this formulation was considered to be the optimized formulation. The % relative error was calculated, which showed that observed responses were in close agreement with the predicted values calculated from the generated regression equations.

Conclusion:

The clarity, pH, drug content of all formulations was found to be satisfactory. Further, all the formulations showed sustained drug release for a period of 6 h, which satisfied to treat periodontal disease.