Evaluation of Different Local Drug Delivery Systems in the Management of Chronic Periodontitis: A Comparative Study

Abstract

Aim: The present study aimed to assess the use of various local drug delivery systems in the management of chronic periodontitis. Materials and methods: A total of 60 patients aged around 30-55 years were included. The subjects who were enrolled under took a phase I therapy that included scaling and root planing (SRP). Patients who satisfied the conditions for selection to enter the trial were assigned randomly to three groups, with each group consisting of 20 participants as follows: group I: controlled-release drugs-chlorhexidine gel, group II: metronidazole gel, group III: tetracycline fibers. The plaque index (PI), gingival index (GI), and periodontal pocket depth (PPD) were recorded after 1st week as the baseline data and were recorded again after 15 days and 30 days post-baseline. Results: The mean GI scores were 1.32 ± 0.10, 0.88 ± 0.16, and 0.76 ± 0.12, at baseline, 15 days, and 30 days, respectively, in group I. In group II, the mean GI score reduced to 1.09 ± 0.83 at 30 days from 1.48 ± 0.27 at baseline. Likewise, in group III the mean GI score reduced to 0.90 ± 0.62 at 30 days from 1.38 ± 0.06 at baseline. All the groups demonstrated a statistically significant difference at various intervals. The mean PI score decreased to 0.90 ± 0.78 at 15 days from 1.46 ± 0.22 at baseline in group III. A statistically significant difference at different intervals was seen in group III only. In all groups, the intergroup comparison of PPD was found to be statistically significant. Conclusion:This study demonstrated that although thorough SRP is an effective treatment method for elimination of chronic periodontal pockets, improved results can be obtained by adjunctive use of locally administered chlorhexidine gel, metronidazole gel, and tetracycline fibers. Clinical significance: The use of the adjunctive local drug delivery system along with mechanical cleansing in the treatment of periodontal pockets in chronic periodontitis is therapeutically beneficial.

Tıbbi Bitkilerin Doku Şartlandırıcılara İlave Edilmesiyle Antibakteriyel ve Antifungal Etkinlik Sağlanabilir Mi?

“…26 Ashrafi ve ark. 27 28 Bu çalışmada, nane yaprağı ekstresinin ağız hastalıklarına neden olan oral mikroorganizmalara karşı antimikrobiyal aktivite gösterdiği ve geleneksel tedavi için alternatif bir ilaç olarak uygulanabileceği sonucuna ulaşılmıştır. 28…”

Evaluation of different local drug delivery systems in the management of chronic periodontitis: A comparative study

“…The periodontal diseases are not just confined to the oral cavity but also affects the systemic diseases through its spread into the systemic circulation. 2 The periodontal disease starts as gingivitis which is the infection is confined only to the gingival tissues and if left untreated it may progress to periodontitis which is the infection spreads to the periodontal ligament, alveolar bone and causes destruction of the supporting periodontal tissues by pocket formation. This favours the growth of various micro-organisms such as Prevotella intermedia, Aggregatibacter actinomycetem comitans, Porphyromonas gingivalis, Tanerella forsythia etc.…”

“…3 As the bacterial biofilm extends deep into the subgingival tissues the patients find it difficult to clean in those areas and may lead to microbial deposits sub-gingivally. 2 The standard treatment involves scaling and root planing which removes the sub gingival microbial deposits effectively and the gingival health is maintained. Sometimes the treated areas may show regrowth of the microorganisms and the non-surgical periodontal treatment alone cannot eliminate the micro-organisms in mild periodontitis cases due to the difficulty in reaching the subgingival areas which are deeper and in complex root morphologies.…”

“…The local drug delivery systems also have low side effects, less drug resistance, avoidance of first pass metabolism, reduction in the dosage and patient compliance and are easy to apply and ensures complete penetration into the pocket areas and thus removing the periodontal pathogens responsible for periodontitis. 2,3 The various local drug delivery agents are used individually or in combination with non-surgical periodontal therapy. These include tetracycline, minocycline, doxycycline, metronidazole, chlorhexidine, simvastatin and alendronate gels.…”

“…These include tetracycline, minocycline, doxycycline, metronidazole, chlorhexidine, simvastatin and alendronate gels. 2…”