Effect of tetracycline and/or scaling on human periodontal disease

Abstract

Twelve adult patients with severe chronic periodontitis were examined prior to treatment, and after 8 and 25 weeks following tbe start of treatment. Six subjects received tetracycline during weeks 1 and 2 and weeks 7 and 8, while the other six did not. All subjects were instructed in oral hygiene and received a series of scaling and root planing treatments on one side only of their dentition. The contralateral side received no scalings at any time. The experiment was designed to provide clinical and microbiological data at the 0‐, 8‐ and 25‐week intervals for at least six sites in each of four groups, namely untreated sites (T0S0), sites which were scaled only (T0S1), sites which received tetracycline only (T1S0) and sites which were scaled and were exposed to tetracycline (T1S1). In addition, biopsies of initially diseased sites which had been treated or left untreated were evaluated by light and electron microscopy at all time intervals. The results indicated that T0S0 sites remained more or less unchanged with respect to all parameters during the 25‐week period, with the exception of a decrease in PII scores due to improved oral hygiene. T0S1 sites showed a marked clinical improvement between time 0 and 8 weeks, i.e. reduced PII and GI scores and reduced probing depth; the microbial flora showed an increase in the proportion of coccoid cells with a concomitant decrease in motile rods and spirochetes; the plasma cell‐dominated infiltrated connective tissue (ICT) showed a significant decrease in the proportion of plasma cells with a corresponding increase in lymphocytes; evidence of collagen deposition was also observed histologically. This 8‐week status persisted after 25 weeks, but in addition the tissues showed an increase in the proportion of fibrobiasts and a decrease in the proportion of lymphoblasts. T1S0 sites showed a similar improvement in the clinical and microbiological parameters at 8 weeks, but tbe ICT showed only a moderate reduction in the proportion of dead and unidentified cells. After 25 weeks, tbe clinical parameters remained unchanged from the 8‐week interval, but the microbial composition and the tissue characteristics showed a significant rebound toward the values observed at baseline. T1S1 sites showed essentially similar changes in the clinical, microbiological and tissue characteristics as the T0S1 sites for all time intervals. However, in the presence of the antibiotic the 8‐week proportions of coccoid cells were higher and those for motile rods and spirocbetes lower. Evaluation of all biopsied sites revealed a positive correlation between the proportion of plasma cells in the ICT and the proportion of spirochetes in the associated microflora. The results suggest that the microflora of healthy and periodontally diseased sites differ and that some of these differences are associated with detectable differences in the composition of the ICT. Mechanical debridement and/or treatment with tetracycline cause changes in the clinical, microbiological and histological parameters. Disco...

A comparative evaluation of the clinical effects of systemic and local doxycycline in the treatment of chronic periodontitis

“…The latter finding suggests that there is no significant difference in PD reduction between mechanical treatment alone and mechanical treatment combined with doxycycline. These findings are consistent with the findings of several previous studies in which no significant difference could be found between mechanical treatment combined with tetracycline or minocycline and mechanical treatment alone (10,11,16). However, contrary findings have also been reported.…”

“…Many studies on clinical effects of both systemic and local tetracyclines have been performed. In some of these studies, tetracyclines made no statistically significant difference on probing depths and clinical attachment levels (10,11,(14)(15)(16)(17)(18)(19) while in others successful clinical results were obtained by tetracycline and minocycline treatments (20)(21)(22)(23)(24)(25)(26)(27)(28). These studies evaluated only systemic or local antibiotic treatments with or without mechanical periodontal treatment.…”

“…Although antibiotics (especially tetracyclines) traditionally have been preferred for the treatment of early onset types of periodontitis, in recent years the concept of using them in the treatment of adult periodontitis has evolved (10)(11)(12)(13). Regarding the side effects of systemic antibiotic treatments, local delivery systems have been developed in the last quarter of the 20th century (3,4).…”

Effect of Systemic Doxycyline Administration on the Subgingival Microbial Flora: A Dark-field Microscopy Study.

“…There is evidence that an increase in the severity of gingivitis is accompanied by an increase in the percentage of spirochetes in the bacterial plaque [8,16,18]. Following periodontal therapy, an increase in coccoid bacteria and a decrease in spirochetes and motile rods has been observed [19][20][21]. It has also been suggested that subjects with treated periodontitis, with elevated levels of spirochetes and/or motile rods, have more frequent localized recurrences of periodontitis than patients with low proportions of these morphotypes [16].…”

Formulation development of smart gel periodontal drug delivery system for local delivery of chemotherapeutic agents with application of experimental design

“…However, drawbacks such as severe side-effects, bacterial resistance (Olsvik, 1991), and poor local concentrations of antimicrobials have limited this route of administration (Loesche, 1996;Slots & Pallasch, 1996;Vandekerckhove et al, 1997). Systemic antibiotic therapy over a long period of time also raises the risk of undesirable side-effects such as nausea, diarrhea, fever, abdominal pain, and pseudomembranous colitis (Listgarten et al, 1978;Slots et al, 1979;Lindhe et al, 1983). Systemic use of antibiotics has been recently reviewed and it was concluded that the evidencebased literature supports the use of systemic antibiotic therapy for refractory and recurrent periodontitis (Ellen & McCulloch, 1996).…”