Doxycycline, Gingival index, Local drug delivery, Microbiology, Probing depth.
Citation Information :
Shelke A, Gadhiya N, Narkhede S, Laddha R, Mahajania M, Shetty GP. Effect of Subgingival Doxycycline Placement on Clinical and Microbiological Parameters in Inflammatory Periodontal Disease: Both in Vivo and in Vitro Studies. J Contemp Dent Pract 2018; 19 (10):1228-1234.
Aim: To evaluate the effect of subgingival placement of doxycycline in the form of a resorbable membrane on the clinical and microbiological parameters in the treatment of inflammatory periodontal disease.
Material and methods: We evaluated the effects of a controlled release system containing doxycycline both in vivo and in vitro conditions. Drug systems were prepared for both, and a total of 19 patients were included in the study with age range from 35 to 50 years. Clinical parameters like gingival index, probing depth, attachment loss, and gingival shrinkage were evaluated along with microbiological evaluation as well for a period of 10 weeks.
Results: In vitro study showed that the doxycycline hydroxypropyl methylcellulose films are capable of releasing the drug in a sustained way with respect to time. It was observed that the gingival index score, periodontal probing depth, and gingival shrinkage showed low levels at the doxycycline-treated sites as compared to the placebo group. The microbial culture results also showed a marked reduction in the total anaerobic count post-treatment and till the end of the 10 week study period in the doxycycline-treated group. Thus, overall results showed that 30% doxycycline methylcellulose strips have significant effects and benefits on clinical and microbial parameters in more than 5 mm deep periodontal pockets.
Conclusion: We conclude that 30% doxycycline both in vivo and vitro study has proven to be an effective antibiotic of choice both clinically and microbiologically.
Clinical significance: Doxycycline has proven to have great promise as an antibiotic of choice. Thus, there is a significant advantage in the clinical use of doxycycline formulation for both the therapist and the patient. It can help dental professionals as an additional means to maintain an improved clinical health in periodontal problems of their patients. With this new therapeutic modality, we can augment the ability to treat periodontitis more effectively.
Nibali L. Aggressive Periodontitis: microbes and host response, who to blame?, Virulence 2015; 6: 223-22.
Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clinical microbiology reviews, 2001;14(4):727-752.
Dzink JL, Suchow R. The predominant cultivable microbes of active and inactive lesions and destructive periodontal diseases. J clinical periodontol, 1988;15:316-323.
Chahboun H, Arnau MM, Herrera D, Sanz M, Ennibi O.K., Bacterial profile of aggressive periodontits in morocco: a cross sectional study. BMC oral health, 2015;15-25.
Purnima S. kumar. Diversity of Oral biofilms in periodontal heath and disease, pathogenesis of periodontal diseases. 10.1007/978-3-319-53737-5_2, (9-20), 2017.
Offenbacher S, Odle B. The microbial morphotypes associated with periodontal health and adult periodontitis composition and distribution. J clinical periodontology 1985;12:736-749.
Haffajee AD, Socransky S.S. Clinical, microbial and immunological features of subjects with destructive periodontal diseases. J clinical periodontol, 1987;6:35-38.
Dzink JL, Tanner AC. Gram negative species associated with active destructive periodontal lesions. J clinical periodontol 1985;12:648-659.
Newman UG, Socranscy SS. Predominant of cultiviable microbiota in periodontosis. J periodontol, 1988;59:366- 372.
C.Nonnenmacher, R.Mutters, L.Floresde Jacoby. Microbiological characteristics of subgingival microbiota in adult periodontitis, localized juvenile periodontitis and rapidly progressive periodontitis subjects. Clinical Microbiology and Infection 2001;7(4),213-217.
Patil V, Mali R, Mali A. Systemic anti-microbial agents used in periodontal therapy. J Indian Soc Periodontol2013; 17:162-8
Barca E, Cifcibasi E, Cintan S. Adjunctive use of antibiotics in periodontal therapy. Journal of Istanbul University Faculty of Dentistry. 2015;49(3):55-62.
Kulkarni GV, Wilson K, Lee A. Randomised placebo controlled trial of doxycycline effets on the microflora of recurrent periodontitis lesions in high risk patients. J periodontol 1991;62:197-202.
N.S. Tamashiro, P.M. Duarte, T.S. Miranda, S.S. Maciel, L.C. Figueiredo, M. Faveri and M. Feres, Amoxicillin Plus Metronidazole Therapy for Patients with Periodontitis and Type 2 Diabetes, Journal of Dental Research, 2016;95(7), 829.
Bouswma O, Payonk G. Low dose doxycycline-Effects on clinical parameters in adult periodontitis. J dent res, 1992;11:21-25.
Nair SC, Anoop KR. Intraperiodontal pocket: An ideal route for local antimicrobial drug delivery. Journal of Advanced Pharmaceutical Technology and Research. 2012;3(1): 9-15.
Demiral K, Baer PN. Topical application of doxycycline on periodontally involved root surfaces in vitro. Comparative analysis of substantivity on cementum and dentine. Jperiodontol, 1991;62(5):30-35.
Gonnenozcan, Levent Tanner. Use of membranes containing 20% chlorhexidine and 40% doxycycline for treatment of chronic periodontal pockets. Jnihonuniv school dent, 1994;36(3):191-198.
Hulami HA, Babay N, Awartani F, Anil S. The effect of locally delivered doxycycline as an adjunctive therapy to scaling and root planing in smokers. The Saudi Dental Journal 2011;23,143–148.
Addy M., Langeroudi M. Comparison of the immediate effects on the subgingival microflora of acrylic strips containing 40% chlorhexidine, metronidazole or tetracycline. J clinical periodontol, 1984;1:379-386.
Wesley SJ. Microbial Evaluation of a Single Subgingival Irrigation with Chlorhexidine and Benzydamine in Advanced Periodontitis. World J Dent 2014;5(1):37-41.
Sachdeva S, Agarwal V. Evaluation of commercially available biodegradable tetracycline fiber therapy in chronic periodontitis. J Ind Soc Periodontol. 2011;15:130-35.
Tsalikis L, Sakellari D, Dagalis P, Boura P, Konstantinidis A. Effects of doxycycline on clinical, microbiological and immunological parameters in well-controlled diabetes type-2 patients with periodontal disease: a randomized, controlled clinical trial. J Clin Periodontol. 2014 Oct;41(10):972-80
Stabholz A, Sela MN. Clinical and microbiological effects of sustained release of chlorhexidine in periodontal pockets. J clinical periodontol, 1986;3(8):783-788.
Ahamed S, Jalaluddin Md, Khalid I, Moon N, Shafi TK, Ali FM. The Use of Controlled Release Locally Delivered 10% Doxycycline Hyclate Gel as an adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis: Clinical and Microbiological Results. J Contemp Dent Pract 2013;14(6):1080-1086.
Greenstein G. The role of bleeding upon probing in the diagnosis of periodontal disease. A literature review. J periodontol 1984;55(12):684-8.
Feres M, Haffajee AD, Goncalves C, Allard KA, Som S, Smith C, Goodson JM and Socransky SS. Systemic doxycycline administration in the treatment of periodontal infections. Effect on the subgingival microbiota. J Clinical Periodontol 1999;26:775–783.
Xajigeorgiou, C., Sakellari, D., Slini, T., Baka, A. and Konstantinidis, A. Clinical and microbiological effects of different antimicrobials on generalized aggressive periodontitis. J Clinical Periodontol 2006;33:254–264.