Clinical and Microbiologic Effects of Local Tetracycline Irrigation on Periodontitis

Abstract

This investigation was conducted on seven individuals referred for treatment of moderate adult periodontitis. Twenty-eight sites with an average probing depth of 5.6 +/- 0.9 mm were evaluated. One tooth per jaw quadrant was randomly assigned to receive one of the following treatments: (I) no treatment, i.e., control; (II) saline irrigation; (III) tetracycline irrigation and (IV) scaling and root planing (SC/RP). A plaque control program was instituted one week prior to the experimental period and reinforced throughout the eight-week study. Irrigation was performed every 48 hours during the first two weeks of the experiment for Groups II and III, and the single treatment of SC/RP was carried out immediately following the baseline examination for Group IV. Clinical and microbiologic changes were monitored every two weeks using plaque and gingival indices, gingival fluid flow, probing depths, bleeding on probing and dark-field microscopic examination of the subgingival microbial flora. The tetracycline and SC/RP treatment modalities resulted in statistically significant clinical and microbiological improvements when compared with the control. Tetracycline irrigation alone and SC/RP alone had a similar effect in changing the subgingival microflora from one associated with disease to one associated with health. Thus, these treatment modalities are effective methods of producing statistically significant alterations in the subgingival microflora. The property of substantivity may contribute to the sustained duration of the effect of locally delivered tetracycline.

Effect of Systemic Doxycyline Administration on the Subgingival Microbial Flora: A Dark-field Microscopy Study.

“…The present findings are in accordance with previous studies that have shown the same significant effect of tetracyclines on subgingival microbial flora mornhoSince spirochetes and motile rods are considered to have important roles in the pathogenesis of periodontal disease [6,8,16,23], the decrease in the percentages of these microorganisms in the subgingival microbial flora from periodontally diseased pockets would have important implications for periodontal treatment. Therefore, it can be suggested that doxycycline has a signigicant effect on the morphotypes of pathological bacteria associated with periodontal disease, and it can be recommended as an adjunct to traditional periodontal therapy.…”

“…In particular, extensive studies have been conducted with metranidazole and tetracyclines [7,[9][10][11][12]22,23]. Due to their high concentration in gingival crevicular fluid, their ability to bind to bone and inhibit tissue collagenase, tetracyclines are the most recommended group of antibiotics for treatment of periodontal disease [13,24,25].…”

Use of Membranes Containing 20% Chlorhexidine and 40% Doxycycline for Treatment of Chronic Periodontal Pockets.

“…The decrease in the percentages of motiles and the increase in the percentages of cocci were highly significant in the treatment groups compared with the control group. Fig.2 Rate of release ( ƒÊg/h) of DOXY and CHx from HPMC membranes Table 1 Summary of the statistical differences between all the groups at each visit for the measurement parameters determined by analysis of variance Table 2 Mean and standard deviation of pocket depth in the treatment and control groups at the baseline (Visit 0) and for each visit up to 10 w (Visit 4) Table 3 Mean and standard deviation of gingival shrinkage for the treatment and control groups at the baseline (Visit 0) and at each visit up to 10 w (Visit 4) Table 4 Mean and standard deviation of the bleeding score for the treatment and control groups at the baseline (Visit 0) and at each visit up to 10 w (Visit 4) Table 5 Mean and standard deviation of crevicular fluid flow in the treatment and control groups at the baseline (Visit 0) and at each visit up to 10 w (Visit 4) Table 6 Mean and standard deviation of the percentage of curved and motile rods and spirochaetes in the treatment and control groups at the baseline (Visit 0) and at each visit up to 10 w (Visit 4) [24][25][26] and concentration in crevicular fluidi [11] , but also their fibroblast-stimulating activity [27,28] , enhancement of bone regeneration [29][30][31] , substantivity to mineralized tissues [32], and anticollagenolytic activity [33,34].…”

The Role of Subgingival Irrigations in the Treatment of Periodontitis

“…Silverstein et al 46 reported on the effects of professional irrigation using a Hamilton syringe containing 5 mg/ ml tetracycline hydrochloride on untreated periodontal pockets when used every 48 hours for 2 weeks. Eight weeks posttreatment, the changes observed in subgingival microflora and clinicial indices were similar to those observed following scaling and root planing alone.…”