Subgingival Minocycline Hydrochloride Ointment in Moderate to Severe Chronic Adult Periodontitis: A Randomized, Double‐Blind, Vehicle‐Controlled, Multicenter Study

Abstract

The safety and efficacy of subgingivally-applied 2% minocycline ointment was evaluated in a randomized, double-blind study of 103 adults with moderate to severe periodontitis. Two groups were compared; one received the test minocycline ointment and the other a vehicle control. Both groups had scaling and root planing at baseline, after which the test or control ointments were applied with an applicator into the periodontal pockets at baseline, and at 2, 4, and 6 weeks. Assessment of clinical response was made by measuring probing depth and probing attachment level and gingival bleeding. These measurements were made at baseline prior to scaling and root planing, and at weeks 4 and 12. Microbiological assessment of the subgingival flora was carried out with DNA probes at baseline, and at weeks 2, 4, 6, and 12 to identify and quantify Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans. Subgingival minocycline ointment resulted in statistically significantly greater reduction of P. gingivalis at weeks 2, 4, 6, and 12; P. intermedia at weeks 2, 4, 6, and 12; and A. actinomycetemcomitans at weeks 6 and 12. Probing depth reductions were seen for both groups at weeks 4 and 12; however, this reduction was statistically significantly greater in subjects treated with minocycline ointment. Reduction in gingival index and probing attachment gain were seen in both groups, however, the differences between the groups were not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

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.…”

“…In 1993, a study (15) reported that concentrations of P. gingivalis and P. intermedia were lower after minocycline ointment treatment than after scaling and root planing in combination with placebo ointment at 2, 4, 6, and 12 weeks post-treatment, as well as the concentration of A. actinomycetemcomitans at 6 and 9 weeks. Another study (16) demonstrated a significant reduction in the prevalence of periodontal pathogens over a 15-month period, but no significant reduction was observed when local delivery of minocycline was used.…”

Local Drug Delivery in the Treatment of Periodontitis: A Review.

“…Commercially it is available as DENTOMYCIN in European Union and PERIOCLINE in JAPAN. The concentration of minocycline in the periodontal pocket is about 1300μg/ml, 1 hr after single topical application of 0.05 ml ointment and is reduced to 90μg/ml after 7 hrs 16 . Steenberghe et al showed that combined therapy provided a better result than SRP alone at sites >7 mm deep 16.…”

“…The concentration of minocycline in the periodontal pocket is about 1300μg/ml, 1 hr after single topical application of 0.05 ml ointment and is reduced to 90μg/ml after 7 hrs 16 . Steenberghe et al showed that combined therapy provided a better result than SRP alone at sites >7 mm deep 16. Timmerman et al reported that there was no benefit of employing 2% minocycline gel as an adjunct to SRP to reduce probing depths at deep site 17 .…”

Perioceutics in the management of Periodontal Disease

“…36 It was shown that combination of minocycline ointment with nonsurgical therapy like scaling and root planing showed significantly better results than debridement done alone. Metronidazole: widely used as monotherapy and in combination with other antibiotics for the management for gingivitis, acute necrotizing ulcerative gingivitis, chronic periodontitis and Aggressive periodontitis • ELYZOL is an oil based gel form contains 25% metronidazole.…”