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VOLUME 9 , ISSUE 7 ( November, 2008 ) > List of Articles

RESEARCH ARTICLE

Comparative Evaluation of Subgingivally Delivered 10% Doxycycline Hyclate and Xanthan-based Chlorhexidine Gels in the Treatment of Chronic Periodontitis

Ashish Verma, Rajan Gupta, Nymphea Pandit, Shweta Aggarwal

Citation Information : Verma A, Gupta R, Pandit N, Aggarwal S. Comparative Evaluation of Subgingivally Delivered 10% Doxycycline Hyclate and Xanthan-based Chlorhexidine Gels in the Treatment of Chronic Periodontitis. J Contemp Dent Pract 2008; 9 (7):25-32.

DOI: 10.5005/jcdp-9-7-25

License: CC BY-NC 3.0

Published Online: 01-11-2008

Copyright Statement:  Copyright © 2008; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

The aim of this study was to evaluate and compare the efficacy of subgingivally delivered 10% doxycycline hyclate and xanthan based chlorhexidine gels when used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.

Methods and Materials

A randomized, controlled, single center study was conducted involving 90 sites in 30 patients suffering from moderate to advanced chronic periodontitis. Each patient contributed three sites which were randomized to three treatment groups: SRP + insertion of doxycycline gel [SRP+DH], SRP + insertion of chlorhexidine gel [SRP+CHX]), and SRP alone [SRP]. Gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline, 1 month, and 3 months post therapy.

Results

All treatments showed significant reductions in PPD and CAL at 1 and 3 months when compared to baseline values (p<0.001). At 3 months, sites treated with SRP+DH and SRP+CHX showed an additional reduction in PPD of 0.86 ± 1.0 mm and 0.66 ± 1.58 mm, respectively, significantly greater than SRP alone (p<0.02). Differences in mean PPD reduction between SRP+DH and SRP+CHX were not significant (p=0.46). At 3 months, differences in relative CAL between both SRP+DH (0.80 ± 0.92) and SRP+CHX (0.63 ± 1.47) and SRP alone were statistically significant (p<0.02). Differences in relative CAL between SRP+DH and SRP+CHX were not significant (p=0.54).

Conclusion

The results suggest treatment with 10% doxycycline hyclate and xanthan based chlorhexidine gels as an adjunct to SRP improves PPD and CAL patients with periodontitis compared to SRP alone.

Clinical Significance

The use of local drug therapy may refocus the need for surgical periodontal therapy toward deeper pockets.

Citation

Gupta R, Pandit N, Aggarwal S, Verma A. Comparative Evaluation of Subgingivally Delivered 10% Doxycycline Hyclate and Xanthan-based Chlorhexidine Gels in the Treatment of Chronic Periodontitis. J Contemp Dent Pract 2008 November; (9)7:025-032.


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  1. Antimicrobials in periodontal practice. Dent Clin North America; 1996; 38:719-731.
  2. Pharmacokinetic principles controlling efficacy of oral therapy. J Dent Res 1989; 68(spec issue):1625-1632.
  3. Clearance of a topically applied flouroscien gel from periodontal pocket. J Clin Periodontol 1990; 17:613-615.
  4. Comparison of the pharmacokinetic profiles of two locally administered doxycycline gels in crevicular fluid and saliva. J Clin Periodontol 2004; 31:286-292.
  5. The role of local drug delivery in the management of periodontal diseases: A comprehensive review. J Periodontol 1998; 69:507-520.
  6. Therapy with adjunctive doxycycline local delivery in patients with type 1 diabetes mellitus and periodontitis. J Clin Periodontol 2004; 31:648-653.
  7. Anticollagenolytic potential of tetracycline in long term treatment of reactive arthritis. Arthritis Rheumatoid 1992; 35:195-198.
  8. Comparison of interstitial collagenase from human gingival, sulcular fluid and polymorphonuclear leukocyte. J Periodontal Res 1998; 23:386-393.
  9. Topical application of doxycycline on periodontally involved root surfaces in vitro: Comparative analysis of substantivity on cementum and dentin. J Periodontol 1991; 62:312-316.
  10. Non-surgical periodontal therapy using a novel chlorhexidine based xanthan gel; a split mout study. Int Poster J Dent Oral Med 2005; 7:286-291.
  11. Utilization of locally delivered doxycycline in non-surgical treatment of chronic periodontitis. A comparative multi-center trial of 2 treatment approaches. J Clin Periodontol 2001; 28:753-761.
  12. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964; 22:121-135.
  13. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963; 21:533-551.
  14. Non-surgical periodontal therapy with adjunctive topical doxycycline: a double blind randomized controlled multicenter study. (1). Study design and clinical results. J Clin Periodontol 2002; 29:108-117.
  15. Two multi-center studies evaluating locally delivered doxycycline hyclate, placebo control, oral hygiene, and scaling and root planing in the treatment of periodontitis. J Periodontol 1999; 70:490-503.
  16. Controlled local delivery of antimicrobials in the treatment of periodontitis. Dent Clin North America 1998; 42:263-283.
  17. Costerton JW. Establishment of aging biofilms: possible mechanism of bacterial resistance to antibiotic therapy. Antimicrobial agents and chemotherapy 1992; 36:1347-1351.
  18. Multicentre evaluation of tetracycline fibre therapy: i experimental design, methods and baseline data. J Periodontal Res 1991; Jul;26(4)361-70.
  19. Multicentre evaluation of tetracycline fibre therapy: ii experimental design, methods and baseline data. J Periodontol Res 1991; 26(4):371-79.
  20. Validity issues in split mouth trials. J Clin Periodontol 1992; Oct;19 (9 Pt 1):625-7.
  21. Clinical microbiological and immunological characteristics of subjects with refractory periodontitis. J Clin Periodontol 1991; 18:291-299.
  22. Effect of tetracycline and or scaling on human disease. J Clin Periodontol 1978; 5:246-271.
  23. Metronidazole dental gel as an alternative to scaling and root planning in the treatment of localized juvenile periodontitis and its efficacy period. Eur J Oral Sci. 1999; 107: 415-421.
  24. Treatment of periodontal in diabetic reduced glycated reduced hemoglobin. J Periodontol 1997; 68(8):713-719.
  25. Periodontal probe precision using 4 different periodontal probes. J Clin Periodontol. 1996 Feb;23(2):76-82.
  26. Description and clinical evaluation of a new computerized periodontal probe. J Clin Periodontol 1998; 15:137-144.
  27. Effect of non-surgical periodontal treatment with or without doxycycline on the periodontium of type 1 diabetic patients. J Clin Periodontol 2005; 32:915-920.
  28. Site specific chlohexidine – a periodontal alternative. Gen Dent 2001; 49(1):84-88.
  29. Periodontal diseases pathogenesis. Ann Periodontol. 1996 Nov;1(1):821-78.
  30. Effects of smoking on local delivery of controlled release doxycycline as compared to scaling and root planing. J Clin Periodontol 1999; 26:683-691.
  31. Multi-center comparative evaluation of subgingivally delivered sanguinarine and doxycycline in the treatment of periodontitis. II. Clinical results. J Periodontol 1997; 68:119-126.
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