Periodontal Therapy: Reviewing Subgingival Irrigations and Future Considerations

Controlled‐Release Local Delivery Antimicrobials in Periodontics: Prospects for the Future

“…Patient-applied subgingival local delivery may be accomplished today by a variety of systems designed for subgingival irrigation including automated subgingival irrigation systems as well as syringes with a subgingival cannula for use at home. Numerous studies involving patient-applied subgingival irrigation of periodontal pockets as an adjunct to conventional therapy have demonstrated extremely variable or unremarkable outcomes, regardless of the irrigant used.1115 Reviews of gingival and subgingival irrigation have recently summarized the findings in this area [16][17][18][19] In general it has been repeatedly shown that water irrigation at the gingival margin both prevents and reduces gingivitis and one irrigated has recently received the ADA Seal of Approval for prevention and treatment of gingivitis. Although the addition of antimicrobial agents has provided some additional clinical efficacy over water irrigation alone, the incremental value has been small.…”

Adult periodontitis treated with a new device for subgingival lavage—a randomized controlled clinical trial using a split‐mouth design

“…Lainson et al suggest that improved gingival health after oral irrigation may be the result of altered microbial viability, while Hagiware et al show that pocket irrigation by distilled water is potentially effective in eliminating subgingival plaque. The 2 approaches for the application of subgingival irrigation are either daily irrigation by the patient as part of a home‐based oral hygiene programme and periodic, professionally administered application of irrigation …”

Effect of topical application red betel (piper crocatum) leaf gel on clinical attachment level repair patient with chronic periodontitis

“…When placed into the periodontal pocket, the agent will be able to reduce the amount of subgingival microflora, pocket depth, and clinical signs of inflammation, while local additional therapy will result in better CAL than is possible with scaling and root planning only. 4,13 The administration of antibacterial agents locally can be used as an adjunct therapy to conventional mechanical therapy. In the case of periodontitis, an antibacterial agent that is applied locally to the subgingival would be very useful for treating patients who have a pocket depth of 5 mm or more, bleeding on probing and also who are unresponsive to primary therapy, including scaling and root planing.…”

“…4,5 Use of pharmacotherapeutic agents as an adjunctive therapy in controlling periodontitis is categorized based on the type of administration used, that is, whether local or systemic. 3,4 The potential risks associated with systemically antibiotic therapy include bacterial resistance, emergence of opportunistic infections and the possibility of allergies, while the long-term administration of NSAIDs may also have harmful effects such as indigestion and bleeding, kidney and liver damage, central nerve system disorders, inhibition of platelet aggregation, prolonged bleeding time, bone marrow damage and hypersensitivity reactions. 3 Local antibiotics are shown to provide some benefits, such as delivering the drug to the area of disease activity at concentrations of bactericide and allowing long-term administration of drugs.…”