Evaluation of the long‐term efficacy and safety of locally‐applied minocycline in adult periodontitis patients

Abstract

The objectives of the present study were to establish in a long-term investigation the safety as well as the clinical and microbiological efficacy of scaling and rootplaning combined with local application of 2% minocycline hydrochloride-gel versus placebo-gel in patients with moderate to severe chronic adult periodontitis. This was an 18 months, randomized, double-blind, parallel, comparative study, in which 20 healthy patients with moderate to severe chronic periodontitis participated. At baseline, all patients received professional oral hygiene-instruction and supra- and subgingival scaling and root planing. The minocycline-gel was applied subgingivally baseline, 2 weeks, 1, 3, 6, 9 and 12 months. Microbiological evaluation was carried out using DMDx to identify the following bacteria: Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum and Treponema denticola. In addition standard microbiological techniques were used for the detection of P. gingivalis, P. intermedia, P. micros, A. actinomycetemcomitans, C. rectus, F. nucleatum, C. albicans and Enterobacteriaceae. Results showed a statistically significant improvement for all clinical parameters irrespective of the treatment modality. No differences were observed between test and control with regard to probing depth and attachment level. The DMDx data showed a significant reduction in both the numbers and the prevalence over the 15 months period, but no significant difference between groups. Culture data showed that at baseline two-third were positive for P. gingivalis and P. intermedia. Analysis over the 18 month period showed no significant difference between the two treatment modalities. C. albicans and Enterobacteriaceae were detected only in small proportions at each time interval in a limited number of patients. No adverse reactions were observed during the trial period. The present patient group responded favourably to scaling and rootplaning, but did not benefit from an effect of local of minocycline. Subgingival debridement in combination with oral hygiene instruction by itself has been shown to be effective. It remains to be studied whether local application of minocycline can be effective as an adjunct to mechanical therapy in sites that respond poorly to conventional treatment.

The Antimicrobial Treatment of Periodontal Disease: Changing the Treatment Paradigm

“…B. forsythus was present in 53% of the sites and, together with P. gingivalis, accounted for 23.6% and 26.7% of the cultivable flora. The indirect fluorescent antibody technique is more likely than other techniques to detect A. actinomycetemcomitans in plaque samples (Loesche et al, 1992b tones et al, 1994;Timmerman et al, 1996;Bollen et al, 1998).…”

Improved drug loading and antibacterial activity of minocycline-loaded PLGA nanoparticles prepared by solid/oil/water ion pairing method

“…19 In addition, minocycline is a good candidate for local antibiotic delivery. 28,29 In this study, minocycline was chosen to be incorporated into PLGA nanoparticles. Due to the high hydrophilicity of minocycline and its rapid partitioning to the aqueous phase, preparation of minocycline PLGA nanoparticles remains a real challenge.…”

Clinical and microbial evaluation of dental scaling associated with subgingival minocycline in chronic periodontitis subjects

“…The high sensitivity of PCR may partially explain these findings, and the differences in the microbial profiles could be observed if a quantitative microbiological instead of a PCR approach had been chosen. Similarly, Timmerman et al 19 (1996) showed a significant reduction in the prevalence of periodontal pathogens over a 15-month period, but no significant reduction was observed when local delivery of minocycline was used.…”