Local antimicrobial therapy after initial periodontal treatment

Aim:  The aim of this single‐blind, randomized, parallel‐designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained‐release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy. Methods: Forty‐seven patients (2...

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Published inJournal of clinical periodontology Vol. 29; no. 6; pp. 540 - 550
Main Authors Salvi, Giovanni E., Mombelli, Andrea, Mayfield, Lisa, Rutar, Alexandra, Suvan, Jean, Garrett, Steven, Lang, Niklaus P.
Format Journal Article
LanguageEnglish
Published Oxford, UK Munksgaard International Publishers 01.06.2002
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Online AccessGet full text
ISSN0303-6979
1600-051X
DOI10.1034/j.1600-051X.2002.290611.x

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Abstract Aim:  The aim of this single‐blind, randomized, parallel‐designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained‐release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy. Methods: Forty‐seven patients (28 females and 19 males) with a mean age of 51 years (range 29–71) underwent a periodontal examination at baseline (i.e. Week 0) and after 18 weeks. This included the assessment of the Plaque Index (PlI), Bleeding on Probing (BOP), Pocket Probing Depths (PPD) and Probing Attachment Levels (PAL) at six sites per tooth. Two to 4 months prior to baseline, all subjects had received initial periodontal therapy including motivation, instruction in oral hygiene practices and full‐mouth scaling and root planing. At the treatment appointment (i.e. Week 2), the patients were randomly assigned to receive either Atridox™, Elyzol® Dental Gel or PerioChip® at all residual periodontal pockets with a probing depth ≥ 5 mm and concomitant BOP. In accordance with the manufacturer's recommendations, Elyzol® Dental Gel was applied for a second time 7 days later. In addition to the clinical evaluation, subgingival microbiological samples were collected prior to treatment (i.e. Week 2) and at Weeks 4 and 18. Analysis of variance/covariance was used to evaluate changes from baseline to Week 18 for the clinical parameters. Results:  Between the baseline and 18‐week examinations, subjects treated with Atridox showed a significantly greater gain in mean PAL of 0.33 mm ± 0.09 (SD) than subjects treated with Elyzol® Dental Gel [0.03 mm ± 0.09 (SD)](p = 0.03). However, the gain in PAL of 0.16 mm ± 0.10 (SD) found after PerioChip® application did not differ significantly from that obtained following the application of AtridoxTM(p = 0.27). Of the sites treated with AtridoxTM, 42% gained ≥ 1 mm PAL and 9% ≥ 2 mm PAL as opposed to the sites treated with Elyzol® Dental Gel, in which 34% gained ≥ 1 mm PAL and 8% gained ≥ 2 mm PAL. Of the sites treated with PerioChip®, 36% gained ≥ 1 mm and 6% gained ≥ 2 mm PAL following a completed initial periodontal therapy. Conclusions:  The application of the three biodegradable sustained release devices tested following initial periodontal therapy resulted in a statistically significant gain in mean PAL for AtridoxTM and a significant reduction in PPD for all three devices during the study period. Furthermore, when sites treated with AtridoxTM were compared with sites treated with Elyzol®, a significant difference in mean PAL gain (0.3 mm) was observed.
AbstractList The aim of this single-blind, randomized, parallel-designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained-release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy. Forty-seven patients (28 females and 19 males) with a mean age of 51 years (range 29-71) underwent a periodontal examination at baseline (i.e. Week 0) and after 18 weeks. This included the assessment of the Plaque Index (PlI), Bleeding on Probing (BOP), Pocket Probing Depths (PPD) and Probing Attachment Levels (PAL) at six sites per tooth. Two to 4 months prior to baseline, all subjects had received initial periodontal therapy including motivation, instruction in oral hygiene practices and full-mouth scaling and root planing. At the treatment appointment (i.e. Week 2), the patients were randomly assigned to receive either Atridox trade mark, Elyzol Dental Gel or PerioChip at all residual periodontal pockets with a probing depth >/= 5 mm and concomitant BOP. In accordance with the manufacturer's recommendations, Elyzol Dental Gel was applied for a second time 7 days later. In addition to the clinical evaluation, subgingival microbiological samples were collected prior to treatment (i.e. Week 2) and at Weeks 4 and 18. Analysis of variance/covariance was used to evaluate changes from baseline to Week 18 for the clinical parameters. Between the baseline and 18-week examinations, subjects treated with Atridox showed a significantly greater gain in mean PAL of 0.33 mm +/- 0.09 (SD) than subjects treated with Elyzol Dental Gel [0.03 mm +/- 0.09 (SD)](p = 0.03). However, the gain in PAL of 0.16 mm +/- 0.10 (SD) found after PerioChip application did not differ significantly from that obtained following the application of Atridox(p = 0.27). Of the sites treated with Atridox, 42% gained >/= 1 mm PAL and 9% >/= 2 mm PAL as opposed to the sites treated with Elyzol Dental Gel, in which 34% gained >/= 1 mm PAL and 8% gained >/= 2 mm PAL. Of the sites treated with PerioChip, 36% gained >/= 1 mm and 6% gained >/= 2 mm PAL following a completed initial periodontal therapy. The application of the three biodegradable sustained release devices tested following initial periodontal therapy resulted in a statistically significant gain in mean PAL for AtridoxTM and a significant reduction in PPD for all three devices during the study period. Furthermore, when sites treated with Atridox were compared with sites treated with Elyzol, a significant difference in mean PAL gain (0.3 mm) was observed.
Aim:  The aim of this single‐blind, randomized, parallel‐designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained‐release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy. Methods: Forty‐seven patients (28 females and 19 males) with a mean age of 51 years (range 29–71) underwent a periodontal examination at baseline (i.e. Week 0) and after 18 weeks. This included the assessment of the Plaque Index (PlI), Bleeding on Probing (BOP), Pocket Probing Depths (PPD) and Probing Attachment Levels (PAL) at six sites per tooth. Two to 4 months prior to baseline, all subjects had received initial periodontal therapy including motivation, instruction in oral hygiene practices and full‐mouth scaling and root planing. At the treatment appointment (i.e. Week 2), the patients were randomly assigned to receive either Atridox™, Elyzol® Dental Gel or PerioChip® at all residual periodontal pockets with a probing depth ≥ 5 mm and concomitant BOP. In accordance with the manufacturer's recommendations, Elyzol® Dental Gel was applied for a second time 7 days later. In addition to the clinical evaluation, subgingival microbiological samples were collected prior to treatment (i.e. Week 2) and at Weeks 4 and 18. Analysis of variance/covariance was used to evaluate changes from baseline to Week 18 for the clinical parameters. Results:  Between the baseline and 18‐week examinations, subjects treated with Atridox showed a significantly greater gain in mean PAL of 0.33 mm ± 0.09 (SD) than subjects treated with Elyzol® Dental Gel [0.03 mm ± 0.09 (SD)](p = 0.03). However, the gain in PAL of 0.16 mm ± 0.10 (SD) found after PerioChip® application did not differ significantly from that obtained following the application of AtridoxTM(p = 0.27). Of the sites treated with AtridoxTM, 42% gained ≥ 1 mm PAL and 9% ≥ 2 mm PAL as opposed to the sites treated with Elyzol® Dental Gel, in which 34% gained ≥ 1 mm PAL and 8% gained ≥ 2 mm PAL. Of the sites treated with PerioChip®, 36% gained ≥ 1 mm and 6% gained ≥ 2 mm PAL following a completed initial periodontal therapy. Conclusions:  The application of the three biodegradable sustained release devices tested following initial periodontal therapy resulted in a statistically significant gain in mean PAL for AtridoxTM and a significant reduction in PPD for all three devices during the study period. Furthermore, when sites treated with AtridoxTM were compared with sites treated with Elyzol®, a significant difference in mean PAL gain (0.3 mm) was observed.
The aim of this single-blind, randomized, parallel-designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained-release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy.AIMThe aim of this single-blind, randomized, parallel-designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three sustained-release biodegradable polymers delivered into periodontal pockets following initial periodontal therapy.Forty-seven patients (28 females and 19 males) with a mean age of 51 years (range 29-71) underwent a periodontal examination at baseline (i.e. Week 0) and after 18 weeks. This included the assessment of the Plaque Index (PlI), Bleeding on Probing (BOP), Pocket Probing Depths (PPD) and Probing Attachment Levels (PAL) at six sites per tooth. Two to 4 months prior to baseline, all subjects had received initial periodontal therapy including motivation, instruction in oral hygiene practices and full-mouth scaling and root planing. At the treatment appointment (i.e. Week 2), the patients were randomly assigned to receive either Atridox trade mark, Elyzol Dental Gel or PerioChip at all residual periodontal pockets with a probing depth >/= 5 mm and concomitant BOP. In accordance with the manufacturer's recommendations, Elyzol Dental Gel was applied for a second time 7 days later. In addition to the clinical evaluation, subgingival microbiological samples were collected prior to treatment (i.e. Week 2) and at Weeks 4 and 18. Analysis of variance/covariance was used to evaluate changes from baseline to Week 18 for the clinical parameters.METHODSForty-seven patients (28 females and 19 males) with a mean age of 51 years (range 29-71) underwent a periodontal examination at baseline (i.e. Week 0) and after 18 weeks. This included the assessment of the Plaque Index (PlI), Bleeding on Probing (BOP), Pocket Probing Depths (PPD) and Probing Attachment Levels (PAL) at six sites per tooth. Two to 4 months prior to baseline, all subjects had received initial periodontal therapy including motivation, instruction in oral hygiene practices and full-mouth scaling and root planing. At the treatment appointment (i.e. Week 2), the patients were randomly assigned to receive either Atridox trade mark, Elyzol Dental Gel or PerioChip at all residual periodontal pockets with a probing depth >/= 5 mm and concomitant BOP. In accordance with the manufacturer's recommendations, Elyzol Dental Gel was applied for a second time 7 days later. In addition to the clinical evaluation, subgingival microbiological samples were collected prior to treatment (i.e. Week 2) and at Weeks 4 and 18. Analysis of variance/covariance was used to evaluate changes from baseline to Week 18 for the clinical parameters.Between the baseline and 18-week examinations, subjects treated with Atridox showed a significantly greater gain in mean PAL of 0.33 mm +/- 0.09 (SD) than subjects treated with Elyzol Dental Gel [0.03 mm +/- 0.09 (SD)](p = 0.03). However, the gain in PAL of 0.16 mm +/- 0.10 (SD) found after PerioChip application did not differ significantly from that obtained following the application of Atridox(p = 0.27). Of the sites treated with Atridox, 42% gained >/= 1 mm PAL and 9% >/= 2 mm PAL as opposed to the sites treated with Elyzol Dental Gel, in which 34% gained >/= 1 mm PAL and 8% gained >/= 2 mm PAL. Of the sites treated with PerioChip, 36% gained >/= 1 mm and 6% gained >/= 2 mm PAL following a completed initial periodontal therapy.RESULTSBetween the baseline and 18-week examinations, subjects treated with Atridox showed a significantly greater gain in mean PAL of 0.33 mm +/- 0.09 (SD) than subjects treated with Elyzol Dental Gel [0.03 mm +/- 0.09 (SD)](p = 0.03). However, the gain in PAL of 0.16 mm +/- 0.10 (SD) found after PerioChip application did not differ significantly from that obtained following the application of Atridox(p = 0.27). Of the sites treated with Atridox, 42% gained >/= 1 mm PAL and 9% >/= 2 mm PAL as opposed to the sites treated with Elyzol Dental Gel, in which 34% gained >/= 1 mm PAL and 8% gained >/= 2 mm PAL. Of the sites treated with PerioChip, 36% gained >/= 1 mm and 6% gained >/= 2 mm PAL following a completed initial periodontal therapy.The application of the three biodegradable sustained release devices tested following initial periodontal therapy resulted in a statistically significant gain in mean PAL for AtridoxTM and a significant reduction in PPD for all three devices during the study period. Furthermore, when sites treated with Atridox were compared with sites treated with Elyzol, a significant difference in mean PAL gain (0.3 mm) was observed.CONCLUSIONSThe application of the three biodegradable sustained release devices tested following initial periodontal therapy resulted in a statistically significant gain in mean PAL for AtridoxTM and a significant reduction in PPD for all three devices during the study period. Furthermore, when sites treated with Atridox were compared with sites treated with Elyzol, a significant difference in mean PAL gain (0.3 mm) was observed.
Author Rutar, Alexandra
Suvan, Jean
Garrett, Steven
Salvi, Giovanni E.
Mombelli, Andrea
Lang, Niklaus P.
Mayfield, Lisa
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Jeffcoat, M. K., Bray, K. S., Ciancio, S. G., Dentino, A. R., Fine, D. H., Gordon, J. M., Gunsolley, J. C., Killoy, W. J., Lowenguth, R. A., Magnusson, N. I., Offenbacher, S., Palcanis, K. G., Proskin, H. M., Finkelman, R. D. & Flashner, M. (1998) Adjunctive use of a subgingival controlled-release chlorhexidine chip reduces probing depth and improves attachment level compared with scaling and root planing alone. Journal of Periodontology 69, 989-997.
Rams, T. E. & Slots, J. (1996) Local delivery of antimicrobial agents in the periodontal pocket. Periodontology 2000 10, 139-159.
Noyan, U., Yilmaz, S., Kuru, B., Kadir, T., Acar, O. & Buget, E. (1997) A clinical and microbiological evaluation of systemic and local metronidazole delivery in adult periodontitis patients. Journal of Clinical Periodontology 24, 158-165.
Slots, J. (1982) Selective medium for isolation of Actinobacillus actinimycetemcomitans. Journal of Clinical Microbiology 15, 606-609.
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Snippet Aim:  The aim of this single‐blind, randomized, parallel‐designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three...
The aim of this single-blind, randomized, parallel-designed clinical trial (RCT) was to evaluate the clinical and microbiological effects of three...
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SubjectTerms Adult
Aged
Aggregatibacter actinomycetemcomitans - growth & development
Analysis of Variance
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Anti-Infective Agents, Local - administration & dosage
Anti-Infective Agents, Local - therapeutic use
biodegradable drug delivery systems
Biodegradation, Environmental
Chlorhexidine - administration & dosage
Chlorhexidine - analogs & derivatives
Chlorhexidine - therapeutic use
Colony Count, Microbial
Delayed-Action Preparations
Dental Plaque Index
Doxycycline - administration & dosage
Doxycycline - analogs & derivatives
Doxycycline - therapeutic use
Female
Follow-Up Studies
Fusobacterium - growth & development
Gingival Hemorrhage - drug therapy
Glycerides - administration & dosage
Glycerides - therapeutic use
Humans
Male
Metronidazole - administration & dosage
Metronidazole - analogs & derivatives
Metronidazole - therapeutic use
microbiological effects
Middle Aged
Periodontal Attachment Loss - drug therapy
periodontal disease
Periodontal Pocket - drug therapy
Periodontal Pocket - microbiology
periodontal therapy
Periodontitis - drug therapy
Periodontitis - microbiology
Porphyromonas - growth & development
Prevotella - growth & development
randomized clinical trial (RCT)
Sesame Oil - administration & dosage
Sesame Oil - therapeutic use
Single-Blind Method
Treatment Outcome
Title Local antimicrobial therapy after initial periodontal treatment
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https://onlinelibrary.wiley.com/doi/abs/10.1034%2Fj.1600-051X.2002.290611.x
https://www.ncbi.nlm.nih.gov/pubmed/12296782
https://www.proquest.com/docview/72122992
Volume 29
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