Topical and Systemic Antimicrobial Therapy in Guided Tissue Regeneration

Abstract

Local antibiotic administration is more effective than systemic use in preventing membrane contamination, but it does not improve clinical outcomes due to an interference of the vehicle (gel) with gingival tissues which may reduce the potential benefits derived from better control of the bacterial load.

Single‐Flap Approach for Surgical Debridement of Deep Intraosseous Defects: A Randomized Controlled Trial

“…The amount of CAL gain obtained for both treatment groups largely exceeded the amounts reported for conventional access flaps in the treatment of intraosseous periodontal defects 9,26,28 and was comparable to the amounts reported in studies evaluating a minimally invasive approach in association with different regenerative procedures 29‐31 . In particular, the magnitude of CAL gain for the SFA group (4.5 mm) as observed in the present study and a recent randomized clinical trial 14 was comparable to the reconstructive outcome achieved with conventional flap designs in association with membranes 32‐36 or EMD 37‐40 . Moreover, similar reconstructive outcomes were reported in a case series 20 in which a minimally‐invasive flap design with a buccal access was used in conjunction with EMD.…”

Cell-induced response by tetracyclines on human bone marrow colonized hydroxyapatite and Bonelike®

“…In order to control the infection, several methodologies have been proposed. Local control offers many advantages over systemic antibiotic chemotherapy [25,32] and, in addition, the association of antimicrobial activity with a positive modulation of the host response contributes to a more predictable and rapid clinical outcome in bone regeneration therapies [33].…”

“…In this way, the selection of the most effective therapeutic approach, based on several parameters that include the specificity of the pathogenic agents, their sensitivity profile, pharmacokinetics of the drug, local vascular supply, and the presence or absence of a biomaterial and individual factors is essential in order to minimize tissue and function loss, as well as to reduce discomfort and need of further medical/surgical intervention [24]. Also, it is known that local and systemic measures to control the colonization of the surgical wound at the early healing phase, associated with reduction of the infection's spreading, may increase the predictability of the results [25]. Tetracyclines have been proved to be effective in several bone-and joint-related infections [26][27][28].…”

Non-bioabsorbable vs. bioabsorbable membrane: assessment of their clinical efficacy in guided tissue regeneration technique. A systematic review

“…(36,37) However, the variables between the investigations are so extreme that no overall trend or conclusion about the use of antibiotics can be made authoritatively. Zucchelli and colleagues compared topical metronidazole with systemic amoxicillin, finding a CAL gain or 4.8 mm in the former, and 5.3 mm in the latter (37). Yoshinari et al compared 2% minocycline ointment using e-PTFE versus no ointment, and found that the antibiotic usage was associated with about 1.0 mm more CAL (36).…”