Clinical and microbial evaluation of dental scaling associated with subgingival minocycline in chronic periodontitis subjects

Abstract

ABSTRACT:The aims of this double-blind randomized clinical trial were to evaluate the presence of periodontal pathogens and the clinical response of periodontal pockets treatment to scaling and root planing (SRP) associated with subgingival minocycline (SM). A total of 36 subjects, 26 to 60 years old (40.7 ± 9.1), who had been previously diagnosed with chronic periodontitis, were included in the present study. Eighteen subjects were selected for the test group (TG), who were treated with SRP plus SM (new treatment), and 18 subjects for the control group (CG) who received SRP plus vehicle (current treatment). Two homologous sites in each subject with a probing depth (PD) ≥ 6 mm were chosen. To evaluate the clinical response after treatment, PD was measured at baseline and at 90 days. Microbiological evaluation was performed to detect 7 periodontal pathogens using polymerase chain reaction at baseline, 30, and 120 days. A mean reduction in PD of 2.8 and 2.1 mm was observed in the TG and CG, respectively. At baseline, P. gingivalis was the most prevalent organism in both test (65.8%) and control (48.6%) groups. After 120 days it fell to 30.8% in TG and to 23.1% in CG. There were no statistically significant differences between the test and control groups concerning PD (p > 0.05 by Wilcoxon test) or presence of periodontal pathogens (p > 0.05 by Wilcoxon and chi-square; p > 0.01 by Signal test). The results observed showed that the new treatment was as effective as the current treatment in reducing periodontal pathogens and PD among chronic periodontitis subjects. DESCRIPTORS: Bacteria; Dental scaling; Minocycline. RESUMO:O objetivo deste estudo randomizado duplo-cego foi avaliar a presença de periodontopatógenos e o comportamento clínico de bolsas periodontais tratadas com raspagem e aplainamento radicular (RAR) associado à minociclina subgengival (MS). Foram incluídos no presente estudo 36 indivíduos de 26 a 60 anos de idade (40,7 ± 9,1), previamente diagnosticados com periodontite crônica. Dezoito indivíduos foram selecionados para o grupo teste (GT), tratado com RAR e MS (novo tratamento), e 18 indivíduos, para o grupo controle (GC), que recebeu RAR e veículo (tratamento convencional). Foram selecionados dois sítios homólogos em cada indivíduo com profundidade de sondagem (PS) ≥ 6 mm para testar a hipótese proposta. Para avaliar o comportamento clí-nico após o tratamento, a mensuração da PS foi realizada inicialmente e após 90 dias. A avaliação microbiana foi realizada para detecção de 7 periodontopatógenos através de reação em cadeia da polimerase, inicialmente e após 30 e 120 dias. Observou-se redução média de 2,8 e 2,1 mm na PS nos grupos teste e controle, respectivamente. Inicialmente, P. gingivalis foi o microrganismo mais prevalente tanto no GT (65,8%) quanto no GC (48,6%). Após 120 dias, houve redução para 30,8% no GT e 23,1% no GC. Não houve diferenças estatisticamente significativas entre os grupos em relação à PS (teste Wilcoxon -p > 0,05) e presença dos periodontopatógenos (teste Wilcoxon e qui-quadra...

Clinical status and detection of periodontopathogens and Streptococcus mutans in children with high levels of supragingival biofilm

“…The polymerase chain reaction (PCR) method was performed according to the protocol described by Cortelli et al 11 (2008), using specific primers for Streptococcus mutans 12 , Aggregatibacter actinomycetemcomitans, 13 Porphyromonas gingivalis, 13 Prevotella intermedia, 13 Campylobacter rectus 13 and Tannerella forsythia. 13…”

Occurrence of Aggregatibacter actinomycetemcomitans in Brazilians with chronic periodontitis

“…2 Particularly, in the oral cavity A. actinomycetemcomitans has been strongly associated with aggressive periodontitis in several epidemiological studies, however, less investigated in chronic periodontitis patients. [3][4][5][6][7][8][9][10] This bacterium expresses several putative virulence factors which enable it to colonize the oral cavity, invade periodontal tissues and evade host defenses. 11 Additionally, different serotypes of A. actinomycetemcomitans have been shown to be associated with periodontal health and disease.…”

A double-blind randomized clinical trial of subgingival minocycline for chronic periodontitis

“…In addition we re-evaluated the occurrence of these pathogens after 1 year without supportive periodontal therapy. The decision to use a local drug delivery system in combination with scaling and root planing was supported by evidence from the dental literature (5,8,9,10,11,(15)(16)(17), indicating that as probing depth increases, scaling and root planing alone becomes less efficient.…”

“…Previously, our group conducted a clinical and microbiological short-term study (from baseline to 120 days), to evaluate the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Campylobacter rectus, Eikenella corrodens and Fusobacterium nucleatum and the clinical response to scaling and root planing associated with subgingival minocycline, in 36 subjects with chronic periodontitis (10). The results indicated that scaling and root planing plus subgingival minocycline was as effective as scaling and root planing plus placebo in reducing both the prevalence of target periodontal pathogens and probing depth.…”