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Background:Modern concepts of treating inflammatory periodontal disease aim at changes in the subgingival ecosystems within the periodontal pockets to alter the complex microbial community into a microbiota compatible with good periodontal health. Systemic antimicrobial therapy, although effective, involves a relatively high dose with repeated intakes over a prolonged period of time to achieve the required inhibitory concentrations in the sulcular fluid. The adjunctive use of local drug delivery may provide a beneficial response, especially in specific areas where conventional forms of therapy might fail. The aim of this study was to compare the efficacy of two local drug delivery systems, one containing metronidazole and the other containing tetracycline hydrochloride as adjuncts to mechanotherapy in the treatment of chronic periodontitis.Materials and Methods:There were three groups that were labeled as group A (Scaling + Tetracycline), group B (Scaling + Metronidazole), and group C (Scaling alone). A microbiological analysis was carried out to determine the efficacy of these systems in changing the pathogenic flora in deep pockets. In addition, a multiplex polymerase chain reaction was carried out to confirm the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis (Pg), and Tannerella forsythensis in the flora associated with chronic periodontitis.Results:There was clinical improvement in groups A and B, which correlated with an improvement in the microbiological parameters; these results were sustained for 90 days following therapy. In Group C, the flora showed a shift towards baseline at the end of 90 days.Conclusions:According to this study, both the local antibiotic therapies resulted in greater improvement in microbiological parameters when used as an adjunct to mechanotherapy as compared to mechanotherapy alone.

Context:Local drug delivery agents. Aims: To clinically evaluate the efficacy of Chlorhexidine chip (PerioCol™ CG) with Tetracycline fibers (Periodontal Plus AB™). Settings and Design: Randomized controlled, split mouth study design with an observation period of six months. Materials and Methods: Patients were allocated in 3 experimental treatment groups, Group A: SRP + CHX Chip, Group B: SRP + Tetracycline fibers, and Group C: SRP alone (control group). 420 bleeding sites in 35 patients (18 females and 17 males) with chronic periodontitis (5-8mm probing depth), were evaluated clinically for pocket probing depth (PD), Clinical Attachment level (CAL), and Bleeding on Probing (BoP). Statistical Analysis: T-test and CV. Results: All the treatment groups were found to be efficacious as demonstrated by improvement in PD, CAL, and BoP. In the short term, CHX group showed increased gain of CAL but on long term observation the Tetracycline fiber group showed better consistent clinical results in comparison to the other two groups. Conclusions: Group B (SRP + Tetracycline fibers) resulted in better optimum clinical results in comparison to the other two treatment groups.

To evaluate the efficacy of platelet-rich plasma concentrate in the management of a cirumferential, infrabony defect associated with an endoperio lesion in a maxillary canine. A 45 year-old male patient with an endoperio lesion in the left maxillary canine was initially treated with endodontic therapy. Following the endodontic treatment, the circumferential, infrabony defect was treated using platelet-rich plasma and an alloplastic bone substitute. At the end of three months, there was a gain in the clinical attachment level and reduction in probing depth. Radiographic evidence showed that there was significant bony fill. The results were maintained at the time of recall nine months later.