Effect of scaling and root planing with and without minocycline HCl microspheres on periodontal pathogens and clinical outcomes: A randomized clinical trial

Abstract

BackgroundThis study tests the effects of scaling and root planing (SRP) versus SRP plus minocycline hydrochloride microspheres (SRP+MM) on 11 periodontal pathogens and clinical outcomes in Stage II‐IV Grade B periodontitis participants.MethodsSeventy participants were randomized to receive SRP (n = 35) or SRP+MM (n = 35). Saliva and clinical outcomes were collected for both groups at baseline before SRP, 1‐month reevaluation, and at 3‐ and 6‐month periodontal recall. MM were delivered to pockets ≥5 mm immediately after SRP and immediately after the 3‐month periodontal maintenance in the SRP+MM group. A proprietary saliva test* was utilized to quantitate 11 putative periodontal pathogens. Microorganisms and clinical outcomes were compared between groups using generalized linear mixed‐effects models with fixed effects and random effects terms. Mean changes from baseline were compared between groups via group‐by‐visit interaction tests.ResultsSignificant reduction in Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia, Parvimonas micra, and Eikenella corrodens were identified at the 1‐month reevaluation after SRP+MM. Six months after SRP with a re‐application of MM 3 months after SRP, Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Eikenella corrodens were significantly reduced. SRP+MM participants had significant clinical outcome reductions in pockets ≥5 mm at the reevaluation, 3‐ and 6‐month periodontal maintenance, and clinical attachment loss gains at the 6‐month periodontal maintenance.ConclusionMM delivered immediately after SRP and reapplication at 3 months appeared to contribute to improved clinical outcomes and sustained decreased numbers of Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Eikenella corrodens at 6 months.

Effect of non‐surgical periodontal therapy on salivary histone deacetylases expression: A prospective clinical study

“…The observation of significant changes in HDAC expression exclusively at the 6-month recall could suggest that HDACs tend to reflect the periodontal tissue changes after a longer period, which correlates with continued periodontal healing observed for 6-9 months following NSPT in advanced disease (Arnett et al, 2023;Badersten et al, 1984). Despite the identification of differential HDAC expression in saliva following periodontal treatment, the exact cell types responsible for these changes could not be determined using this methodology (salivary expression), which warrants further investigation.…”

Advances in the prevention and treatment of Alzheimer’s disease based on oral bacteria

“…Consequently, an emerging strategy that involves the synergistic utilization of scaling and root planning (SRP) with the integration of local drug delivery systems (LDDSs) or sustained-release drug delivery techniques ( 67 ). Notably, research has demonstrated that patients receiving adjunctive treatment of scaling and root planning utilizing minocycline hydrochloride microspheres displayed a notable reduction in both counts of periodontal pathogens and levels of periodontal attachment loss, surpassing the outcomes observed in the control group ( 68 ). Nanocarriers offer advantages in enhancing drug solubility and dissolution rate, improving oral bioavailability, and reducing side effects and dosing frequency ( 69 ), and they may have a potential role in improving cognitive function in AD ( 70 ).…”

Advances in Hydrogels for Periodontitis Treatment

“…Minocycline microspheres (MM) are approved by the US Food and Drug Administration as an adjunct to mechanical scaling to reduce the depths of periodontal pockets in patients with periodontitis . In the study by Arnett et al, mechanical scaling and MM treatment reduced the number of periodontal pathogens, improved the clinical outcome of patients with periodontitis, and reduced the depths of periodontal pockets when compared to mechanical scaling alone. The preparation methods for microspheres are complicated; additionally, their physical and chemical properties, such as spheroid formation, encapsulation efficiency, and drug loading, are easily affected by the preparation methods, which can cause a burst release effect and adversely influence the therapeutic effect. − …”