Efficacy of Local Minocycline Agents in Treating Peri-Implantitis: An Experimental In Vivo Study in Beagle Dogs

Abstract

Background: Local delivery agents (LDA) have the advantage of delivering the antibiotics at high concentrations to the targeted sites. However, the constant flow of gingival crevicular fluids and saliva may restrict their efficacy. Therefore, the drug sustainability and pharmacodynamic properties of any proposed LDA should be evaluated. Methods: Four dental implants were placed unilaterally in the edentulous mandible of six beagle dogs. Peri-implantitis were experimentally induced using silk-ligatures. Each implant was randomly allocated to receive one of the following four treatments: (i) MC (Chitosan-alginate (CA) minocycline), (ii) MP (CA-without minocycline), (iii) PG (Polyacrylate-glycerin minocycline), and (iv) Control (mechanical debridement only). Mechanical therapies and LDAs were administered into the gingival sulcus two times at a 4-week interval. Drug sustainability as well as clinical, radiographical, and immunohistochemical (IHC) analyses were conducted to evaluate the efficacies of treatments. Results: Reduced mean probing depth was observed in all of the test groups after the second delivery. A minimal marginal bone level change was observed during the treatment period (MP (−0.06 ± 0.53 mm) to PG (−0.25 ± 0.42 mm)). The distribution of IHC cell marker analysis of all targeted antibodies ranged from 6.34% to 11.33%. All treatment outcomes between the test groups were comparable. A prolonged retention of LDA was observed from CA microspheres (MC and MP) at both administrations (p < 0.017) and prolonged sustainability of bacteriostatic effect was observed from MC compared to PG after the second administration (p < 0.05). Conclusions: Prolonged retention of CA microspheres was observed and the longer bacteriostatic effect was observed from the MC group. Mechanical debridement with adjunct LDA therapy may impede peri-implantitis progression, however, prolonged drug action did not lead to improved treatment outcome.

Synergistic antimicrobial effect of photodynamic therapy and chitosan on the titanium‐adherent biofilms of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa: An in vitro study

“…44,45 Among the disinfection processes for this surface, PDT and antibiotic substitutes such as chitosan have recently emerged as promising options for antibacterial treatment and for reducing lipopolysaccharide and, therefore, cell titanium adherence. 32,41 In our study, for all the bacteria studied, PDT induced a lower viable cell count, higher percentage of cells with abnormal morphology, and higher percentage of no bacteria attached to the titanium surface than the control group, with statistically significant differences. As regards S. aureus, Widodo et al, (2016) 46 evaluated the efficacy of different methods (rinsing with PBS or control group, rinsing with 0.2%, chlorhexidine digluconate PDT, the use of cotton pellets, titanium brushes, or titanium brush and PDT) for the decontamination of titanium disc.…”

“…Although in the scientific literature there is no article with which we can compare our results on the bacteria S. aureus, E. coli, and P. aeruginosa; its effectiveness in the treatment of peri-implantitis has been investigated in the last 10 years. [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] In 2020, Yoon et al, 32 evaluated the treatment efficacies of two different local delivery agents (chitosan-alginate minocycline, and poilyacrylate-glycerin minocycline) compared with untreated control implants, in an experimentally induced peri-implantitis study in beagle dogs. The authors concluded that the use of chitosan-alginate minocycline as a local delivery agent constituted an effective treatment for peri-implantitis.…”

“…Photodynamic inactivation of microorganisms is based on the topical or systemic administration of a photosensitizer (PS) followed by low-dose irradiation with visible light of a suitable wavelength, whereby the PS passes from its fundamental state to an excited state. [29][30][31] Also, in recent years, the topical application of chitosan (as a substitute for antibiotics) has been successfully used in the treatment of peri-implantitis, [32][33][34][35][36][37][38] however as with PDT treatment, more scientific evidence is still necessary. Chitosan is a natural linear polysaccharide composed of β-(1-4)-linked D-glucosamine and N-acetyl-D-glucosamine.…”

“…Also, in recent years, the topical application of chitosan (as a substitute for antibiotics) has been successfully used in the treatment of peri‐implantitis, 32–38 however as with PDT treatment, more scientific evidence is still necessary. Chitosan is a natural linear polysaccharide composed of β‐(1‐4)‐linked D‐glucosamine and N‐acetyl‐D‐glucosamine 29 .…”

Peri-Implant Health and the Knowing-Doing Gap—A Digital Survey on Procedures and Therapies

“…Antibiotics alone do not clean the surface, and there is growing concern that microbial resistance might render these agents inefficient in the long term. Guidelines on the use of antibiotics, mainly systemic, now only recommend them as a last resort against more severe cases of infections, but there is a lack of clinical evidence showing antibiotics have any effect at all on the long-term outcome of peri-implant conditions (32)(33)(34).…”