Topical application of the controlled release strips containing ofloxacin (PT-01) in periodontal therapy

The association of periodontopathic bacteria in the subgingival plaque with human periodontal disease has been well established. However, past attempts at reducing the level of pathogenic bacteria by using antibiotics as well as other antibacterial substance, so far, have not been fully successful. In this study, the effect of topical application of ofloxacin (OFLX), a synthetic antibiotic, was evaluated in relation to the clinical parameters. For this purpose, the new developed controlled release strips containing OFLX (PT-01), in which there were structurally immediate- and sustained-releasing portions, were used. 147 adult patients suffering from moderate to severe periodontitis were selected for this study. The patients had received no periodontal treatment previously and had taken no antibiotics within the preceding 6 months. Three different sites with a deep probing pocket depth (greater than or equal to 5 mm) were randomly selected in each patient, and were divided into three groups, i.e., PT-01 applied site (T), placebo-applied site (P) and control site (C). Periodontal treatments consisted of oral hygiene instruction and supragingival scaling on day 0 and 7, and subgingival scaling and root planing on day 14. PT-01 was applied in the periodontal pocket weekly on day 0 to 35, and clinical parameters on each site were recorded weekly. The results showed that, during first 14 days, significant reduction in the percentage of the sites which showed bleeding on probing, pus discharge or mobility of the tooth was observed in the PT-01 applied site. However in placebo and/or control group, no significant change in any parameters was observed in this period. While, after subgingival scaling and root planing, significant improvement was found at all sites in every clinical parameter. Especially, PT-01 applied sites showed significant improvement in the gingival index and bleeding on probing, compared to placebo-applied or control sites. These results suggest that weekly insertion of PT-01 in the periodontal pocket along with the subgingival scaling and root planing could have significant effect on the improvements in the gingival inflammation. Taken together, weekly application of PT-01 might have ameliorating effect as adjuncts of mechanical subgingival plaque control in the periodontal treatment.     

Effectiveness of local delivery of ofloxacin using controlled-release strips (PT-01) in periodontal patients. Part 1. PT-01 application among treatment plans for periodontal disease

Three different sites which have more than 5 mm pocket were randomly selected in each periodontal patient and were divided into three groups: PT-01 treated site, placebo treated site and control site. After application of either PT-01 or placebo twice for two weeks, subgingval scaling and root planing were performed. Then PT-01 and the placebo were applied weekly to the periodontal pocket for four weeks and clinical and microbiological evaluations were made. The results obtained were as follows: 1. On clinical evaluation, significant improvement was found in the PT-01 treated site in comparison with the placebo treated and/or control site. 2. On microbiological evaluation, slight improvement was found in the PT-01 treated site, whereas there was no significant difference among the three sites.     

Metronidazole: application in periodontal disease

Metronidazole is effective against certain anaerobic infections such as Bacteroides gingivalis and Spirochetes with clinical signs of rapidly progressive periodontitis and refractory adult periodontitis. The use of Metronidazole in adjuvant with scaling, root planing, and personal oral hygiene instruction caused a significant improvement of the periodontium.     

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牙周炎造成的骨缺损以及骨形态的改变在很大程度上影响牙周治疗效果.牙周基础治疗对骨组织再生的影响有限,而牙周骨外科手术因其备受肯定的疗效已被广泛应用于临床,通过牙周骨外科手术达到牙周组织缺损的修复重建成为牙周临床治疗领域的关注热点.     

犬类动物模型在牙周病研究中的应用现状

牙周病是一种常见的感染性口腔疾病,直接危害口腔健康,是造成中国成年人失牙的最重要原因。由于牙周病临床表现复杂,为进一步探讨牙周病的发病机制、病理学特点以及治疗效果和疗效的评价,单凭临床观察是远远不够的,为此,动物模型被广泛应用。近几年来犬类动物模型广泛应用于牙周病研究,本文就犬类动物模型在牙周病研究中的应用现状进行综述。     

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目的探讨牙周固位纤维与流动树脂结合固定牙周病松动牙的应用效果。方法选择2006年10月至2008年11月在沈阳市口腔医院牙周黏膜科门诊就诊的33例牙周病患者,对其松动牙实施牙周固位纤维与流动树脂结合进行固定。结果33例患者的松动牙经牙周固位纤维与流动树脂结合固定后,6个月复诊时固定成功率为100%,12个月复诊时固定成功率为90.91%。取得了比较满意的效果,患牙松动基本消除或转为无松动,可以胜任正常的咀嚼功能。结论牙周固位纤维在晚期牙周病松动牙齿固定中能有效地固定和保存松动牙,值得临床推广和应用。     

光敏树脂夹板在松动牙固定中的应用

目的：采用光敏树脂粘合夹板技术固定松动牙，探讨松动牙的保存治疗途径。方法：选择32例牙周病患者对其松动的前牙及前磨牙实施光敏树脂粘合夹板技术进行固定，固定的原则和冠桥义齿相类似，固定一个松牙必须有稳固的邻牙为基础，如有必要可多用基牙。结果：32例患者的松动牙经光敏树脂夹板固定后，经6－12个月的随访观察，取得比较满意的效果，松动基本消除或转为无松动，可以胜任正常的咀嚼功能。结论：光敏树脂粘合夹板能有效地固定和保存松动牙，值得临床应用。     

A 4-quadrant comparative study of periodontal treatment using tetracycline-containing drug delivery fibers and scaling

The present study describes results on selected clinical and microbiological parameters obtained by periodontal treatment with ethylene vinyl acetate fibers containing 25% by weight tetracycline hydrochloride placed into the periodontal pocket alone or in combination with scaling. Supragingival plaque control was maintained throughout the study by weekly professional cleaning and 0.2% chlorhexidine mouthrinses. Controls included untreated sites and sites treated by conventional scaling alone in a 4-quadrant split-mouth design. The experiment was conducted on 95 teeth from 10 subjects with periodontal pockets greater than or equal to 6 mm which initially bled on probing. All treatments resulted in changes indicative of effective therapy. Pocket depth was reduced, bleeding on probing decreased and gingival index scores decreased. Parallel to the clinical changes, all treatments reduced total bacterial numbers, % black-pigmented Bacteroides, motile bacteria, non-motile rods, and produced a proportionate increase in cocci. Fiber therapy with or without scaling reduced bacterial counts by approximately 2 orders of magnitude when evaluated at 62 days post-therapy. The combination of fiber therapy with scaling was particularly effective, suggesting a possible synergy between these forms of therapy. The combined therapy eliminated bleeding on probing, and black-pigmented Bacteroides, and produced the greatest mean reduction in pocket depth.     

Microflora cultivable from minocycline strips placed in persisting periodontal pockets

OBJECTIVE: The microflora that develops on minocycline strips, used as an adjunct in non-surgical periodontal therapy was studied. DESIGN AND METHODS: Minocycline (1.4 mg in polycaprolactone vehicle) and control strips were applied into all residual pockets (PD > or = 5mm, > or =2 pockets/subject) of patients with chronic periodontitis 1 month after a course of non-surgical periodontal therapy. Strips were inserted and retained for 3 days, changed to new strips for 3 more days and then removed. Strips were recovered from 14 (eight test, six control) of the 34 participants at day 0 (strip inserted, left for 30 s, removed), days 3 and 6, for (i) anaerobic culture, (ii) coliforms culture, using MacConkey agar, (iii) yeast culture, using Sabouraud's dextrose agar. RESULTS: The mean anaerobic cfu/strip (x10(5); control/test) were 2/6, 24/2, 11/2 at days 0, 3 and 6, respectively (P > 0.05). The corresponding mean proportion of Gram-negative rods and fusiforms were 27%/21%, 27%/15% and 55%/8%. The proportions of Gram-negative rods on test strips by day 6 were significantly reduced (P < 0.05). A significantly increased prevalence of Streptococcus mitis biovar 1 was found on spent test strips (control versus test; 0% versus 38%, Fisher exact test, P = 0.01). Coliform prevalence at days 0, 3 and 6 on control/test strips were 0/13%, 50%/38% and 50%/13%. Yeasts were occasionally isolated. CONCLUSIONS: The findings indicated that the minocycline strips but not the control strip supported a microbial colonisation compatible with periodontal health by day 6.     

Clinical expression of TNF-α in smoking-associated periodontal disease

Abstract. The level of TNF-α in gingival crevicular fluid (GCF) was analyzed with respect to smoking in patients with untreated moderate to severe periodontal disease including 30 current smokers, 19 former smokers and 29 non-smokers, in the age range 31–79 years, Concomitantly the occurrence of the periopathogens Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg) and Prevotella intermedia (Pi) and the GCF levels of albumin, IgA and IgG were analyzed. With regard to clinical characteristics, there were no statistically significant differences between smoking groups. The occurrence of patients positive for the periopathogens Aa, Pg and Pi was 28.2%, 41.0% and 91.0%, respectively. There were no statistically significant differences between smoking groups with regard to occurrence or relative frequency of these periopathogens. An exception was a significantly lower occurrence of Aa in former smokers as compared to non-smokers. The chief novelty of the study was the observation of a clearly increased level of TNF-α in GCF associated with smoking. Both current and former smokers exhibited significantly higher levels of TNF-α in comparison to non-smokers, whereas the levels of albumin, IgA and IgG were the same irrespective of smoking. In conclusion, the present observations in patients with moderate to severe periodontal disease suggest that smoking is associated with elevated GCF levels of the cytokine TNF-α.