Multicenter evaluation of tetracycline fiber therapy: II. Clinical response

Abstract

The safety and efficacy of periodontal disease treatment by intrapocket placement of tetracycline (TC) fibers was investigated in a 60-day multicenter study conducted by selecting 4 sites in each subject with 6-10 mm pockets that bled on probing. Sites were randomly assigned to 1 of 4 test groups: TC fiber therapy, scaling, control fiber (fibers without drug), or untreated. TC fibers and control fibers were placed to fill the pocket and were maintained with a cyanoacrylate adhesive for 10(+/- 2) d. Scaling was performed for a minimum of 5 min under local anesthesia. Following initial tooth cleaning procedures, pocket depth, attachment level and bleeding on controlled-force probing were measured at baseline and at 30 d, and 60 d following therapy. Analysis of data from 107 subjects who had complete clinical data sets indicated that TC fiber therapy significantly decreased pocket depth, increased attachment level, and decreased bleeding on controlled-force probing to a greater extent than observed in all other test groups including scaling. These effects were greater than, and in addition to, effects that occurred due to prophylaxis and improved home care. No serious adverse side-effects attributed to TC fiber therapy were observed. No TC fiber-treated sites abscessed and superinfection was not noted. A transient redness at fiber removal was seen at 21% of the sites. Although fibers were placed without anesthesia, mild pain on initial placement was infrequent (19%) and abated rapidly. The results indicate that TC fiber placement provides a safe and effective means for treatment of periodontal infections.

Local Drug Delivery with Tetracycline Fiber : An Alternative to Surgical Periodontal Therapy

“…The treatment method is primarily the result of more than 20 years of research pioneered by Goodson of Forsyth's Dental Research Center [5][6][7]. The commonly used drug delivery systems are:-a) Tetracycline fiber b) Metronidazole gel c) Chlorhexidine chip d) Minocycline gel e) Doxycycline polymer…”

Effect of Tetracycline Hydrochloride Fibers (Periocol-Tc) on The Level of P. Gingivalis in Chronic Generalized Periodontitis: Clinical & Microbiological Study

“…Systemically administered chemotherapeutic agents achieve relatively low concentrations in pockets, even after high dosages. Local applications of chemotherapeutic in direct contact with the root surface can reduce or eliminate pathogenic organisms that could not be eradicated mechanically (6) .A local route of drug delivery can attain 100-fold higher concentration of an antimicrobial agent in subgingival sites compared with a systemic drug regimen (12) .…”

“…PerioCol®-TC must be stored in a dry place at between 5° C and 25° C. It is gamma sterilized with a shelf life of 2 years. Manufactured by Eucare pharmaceuticals pvt LTD Chennai (6) . The percentage improvement in mean gingival index score in experimental and control groups from Similar findings were observed in the studies conducted by Newman MG et al, 1994 (14) and Chandrashekar KT and Sinha S, 2011 (15) .…”

“…Hence periodontal therapy is necessarily directed at controlling the associated bacterial pathogens (6) . Chemotherapeutic agents have been used as adjuncts in the management of periodontal disease for many years and their role has recently been re-reviewed (7) .…”

Advanced drug delivery approaches against periodontitis

“…Thus placement of the fiber in pocket, its retention in place throughout the course and need for removal on a weekly basis proved troublesome for both the patient and the clinician (Goodson et al, 1991). Johnston and coworkers developed coblended cross-linked polymeric fiber device.…”