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Query: UMLS:C0031099 (periodontitis)
 12,489 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In periodontitis, root surface alterations have been observed in the cementum due to the presence of toxic substances mainly endotoxins of various microorganisms. Elimination of endotoxins from diseased root surfaces by root planing and demineralisation procedures seem to be essential for new attachment procedures. In this study the effects of citric acid and tetracycline HCl on periodontally involved root surfaces which had been scaled and root planed were evaluated by scanning electron microscopy. Our results showed that scaled, root planed and citric acid treated surfaces were relatively even with many dentinal tubules. The planed and tetracycline HCl treated root surfaces, however showed an irregular cemental surface with some debris, whilst the control surfaces found to be irregular with a considerable amount of debris.
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PMID:The effects of various agents on root surfaces (a scanning electron microscopy study). 181 May 87

In vitro tests in our laboratory have shown that 40% tetracycline HCl in a white petrolatum carrier (TTC-WP) has potential as a sustained release, autodissipating system. The present study tested subgingival placement of TTC-WP via syringe in vivo. Quadrants (2 diseased sites in each) in 9 patients with moderate/severe periodontitis were randomly assigned to receive the following treatments: (1) TTC-WP; (2) WP only; (3) scaling and root planing; (4) untreated control. TTC release into gingival crevicular fluid (GCF) over time (baseline, 1, 8, 24, 72 and 168 h) was measured using an agar diffusion bioassay. Clinical parameters and subgingival bacterial morphotypes (darkfield analysis) were also evaluated over time (baseline, 2, 4, 8, 12 weeks). Results indicated that TTC-WP was easily placed into periodontal pockets and biologically effective TTC was released into GCF for at least 3 days (mean concentration = 115.8 +/- 43.1 micrograms/ml at 3 days). TTC-WP reduced probing pocket depths and bleeding on probing relative to baseline measurements for 8-12 weeks post-treatment, and reduced %s of motile rods and spirochetes, with an accompanying increase in cocci, for 2-8 weeks. Similar effects were noted in the scaled and root-planed sites, but for a longer duration. TTC-WP and WP were clinically dissipated after 2 weeks and no adverse tissue reactions were observed. From these findings, subgingival TTC-WP cannot replace scaling and root planing therapy, but has characteristics useful in subgingival plaque control.
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PMID:Intracrevicular application of tetracycline in white petrolatum for the treatment of periodontal disease. 220 6

In the present study we examined alterations in the proportions of cultivable flora of A. actinomycetemcomitans (A.a.) in subgingival plaque of 25 patients with different forms of periodontitis, 7 days after systemic administration of 200 mg/d Minocycline-HCl. Remarkable shifts in the flora were apparent. Sites with low or extremely low initial levels of A.a. (less than 10%) showed an increase in mean proportions from 2.7% to 15.7% (p less than 0.01). A.a. was eliminated in only 18% of sites after 1 week of minocycline therapy. Subgingival scaling resulted in 80% of sites without detectable A.a. However, if present, the organism accounted for 51% of the cultivable microflora, on average. Our data emphasize the importance of a sufficiently extended period of antibiotic therapy and efficient mechanical debridement of all tooth surfaces to eliminate the organism.
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PMID:[Concentrations of A. actinomycetemcomitans in subgingival plaque following short-term minocycline therapy]. 226 72

Actinobacillus actinomycetemcomitans is an oral bacterium which is being encountered with increasing frequency in infective endocarditis. This organism occurs in high numbers in periodontitis lesions of patients with localized juvenile periodontitis (periodontosis). It is present infrequently, and only in low numbers in most other individuals. Its common resistance to penicillin, erythromycin and vancomycin represents a clinical problem in patients at risk of developing endocarditis after dental treatment. However, the high activity of tetracyclines against A. actinomycetemcomitans may be useful in prophylactic endocarditis considerations by allowing a suppression of the organism prior to the institution of recommended prophylactic protocols. In this study, we determined the effect of systemic tetracycline-HCl therapy (1 gm/day) on the oral A. actinomycetemcomitans population in five localized juvenile periodontitis patients who were heavily infected with the organism. A. actinomycetemcomitans could not be detected in samples of subgingival and supragingival dental plaque and cheek mucosal surfaces following 14 days of administration of systemic tetracycline. The organism was still undetectable 3 weeks after therapy but it reappeared at a few oral sites at week 8 post-treatment. On the basis of this data, it is proposed that the prophylactic endocarditis therapy of patients with high numbers of penicillin-resistant A. actinomycetemcomitans include a two-stage approach: first, the systemic administration of tetracycline for 14 days, and second, institution of a conventional prophylactic protocol during the time of dental treatment.
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PMID:Suppression of penicillin-resistant oral Actinobacillus actinomycetemcomitans with tetracycline. Considerations in endocarditis prophylaxis. 657 27

Twenty patients were selected for antibiotic treatment due to poor response to conventional therapy. Ten patients were evaluated after taking 250 mg/day of tetracycline for 2 to 7 years. Ten other patients who had been on tetracycline for at least 2 years were evaluated 6 months to 2 years after stopping the antibiotic. Subgingival plaque was cultured anaerobically on nonselective media (ETSA) and ETSA with 1 microgram/ml of tetracycline HCl. Pocket depth, plaque and gingivitis were scored. Those patients on tetracycline had no bleeding on probing despite residual pockets ranging from 3 to 7 mm. Gram-negative anaerobic rods made up to 49.8% of the microflora of these patients, with Fusobacterium nucleatum dominating. B. melaninogenicus, and B. gingivalis were not detected in the samples. Five of ten patients off tetracycline bled on probing and had pocket depths in the same range as those on tetracycline. The microflora of tetracycline-off sites was predominately Gram-negative rods (63.1% with B. gingivalis and F. nucleatum 7.3% and 3.1% of the flora respectively). In tetracycline-on samples 76.6% of the isolates were resistant to 1 microgram/ml of tetracycline compared to 25.9% in the patients off tetracycline and 7.1% resistant organisms in 14 untreated control samples from periodontitis patients not exposed to any long-term tetracycline therapy. Long-term, low-dose tetracycline was associated with a healthy clinical condition and diverse Gram-negative anaerobic flora resistant to the antibiotic. After discontinuing tetracycline the clinical and bacterial status was more characteristic of disease.
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PMID:The effect of long-term low-dose tetracycline therapy on the subgingival microflora in refractory adult periodontitis. 695 55

Scanning electron microscopy was used to evaluate surface characteristics of periodontitis-exposed instrumented human cementum and dentin surfaces following topical application of tetracycline HCl (TTC). Specimens were randomly assigned to application of sterile saline for 1 minute (control); TTC (10 mg/ml) for 1 minute and 4 minutes, respectively; and TTC (100 mg/ml) for 1 minute and 4 minutes, respectively. Solutions were applied with a cotton pellet using a burnishing technique. Control specimens exhibited an amorphous irregular surface smear layer. TTC treatment of cementum for 1 minute resulted in a relatively debris-free, nonhomogeneous surface. The 4-minute application resulted in a surface exhibiting a densely fibrillar, mat-like texture. Dentin specimens conditioned for 1 minute showed a smooth surface with many tubule openings partially occluded by debris. The 4-minute treatment exposed a 3-dimensional network of intertubular and peritubular collagen fibrils. No consistent morphologic differences were observed between cementum or dentin specimens treated with TTC at concentrations of 10 and 100 mg/ml, respectively. The results suggest that topical application of TTC produces morphologic alterations of periodontitis-exposed cementum and dentin that appear related to application interval rather than concentration of the drug.
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PMID:Effect of tetracycline HCl on periodontally-affected human root surfaces. 747 11

This study was undertaken to provide histologic observations on the effectiveness of citric acid and tetracycline HCl root surface demineralization when used in conjunction with guided tissue regeneration (GTR) procedures. Eight beagle dogs with naturally-occurring periodontitis were initially treated with scaling and root planing. Four weeks later, 12 mandibular quadrants were treated surgically with modified Widman flap and expanded polytetrafluoroethylene (ePTFE). The teeth in 4 of the quadrants were randomly root conditioned with tetracycline HCl, while those in 4 additional quadrants were randomly treated with citric acid. ePTFE membranes were sutured in place. The beagles received prophylaxis (chlorhexidine and toothbrushing) 3 times a week. After 6 weeks, the membranes were removed; prophylaxes continued for 4 months. Histological evaluation revealed new cementum on the root surfaces. A new periodontal ligament with fibers inserting into the new cementum was noted. Statistical evaluation of the buccolingual measurements demonstrated membranes alone resulted in significantly more new connective tissue and new bone formation than membranes with root conditioning agents. Within the furcation, no significant differences were found. However, there was a trend for more bone formation with membranes alone. Within the limits of this study it may be concluded that GTR utilizing an ePTFE membrane results in new connective tissue attachment and bone regeneration in the beagle dog. Root surface demineralization with citric acid or tetracycline HCl does not enhance the results achieved with GTR when used alone.
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PMID:Guided tissue regeneration with dentin biomodification. 829 90

Previous in vitro studies have suggested that tetracycline-HCl (TTC-HCl) is adsorbed and actively released from root dentin. The aim of the current study was to evaluate the binding to and release of TTC-HCl from human root dentin surfaces in vivo, and to evaluate the clinical utility of TTC-HCl irrigation as an adjunct to scaling and root planing. Experiment I utilized two contralateral mandibular single-rooted teeth which were examined in four adults with severe generalized periodontitis. One tooth in each patient was carefully scaled and root planed, under local anesthesia, and the other used as an unscaled control. Each subgingival root surface was irrigated for 5 min with an aqueous TTC-HCl solution at a concentration of 100 mg/ml. Gingival crevicular fluid samples were collected on paper strips for the next three weeks. The TTC-HCl concentrations in each sample were determined by the inhibition zone of B. cereus cultured on agar plates. The TTC-HCl concentrations in gingival crevicular fluid collected 15 min after irrigation were 3100 +/- 670 micrograms/ml from the scaled lesions and 4700 +/- 1300 micrograms/ml from the unscaled root surfaces. The antibiotic concentrations decreased logarithmically over the next 7 days; 1500 +/- 270 micrograms/ml and 1100 +/- 330 micrograms/ml at 2 h, 880 +/- 350 micrograms/ml and 1300 +/- 360 micrograms/ml at 6 h and 19 +/- 5 micrograms/ml and 31 +/- 26 micrograms/ml at 1 week for scaled and unscaled root surfaces, respectively. Results for week two and three indicated an average of over 8 micrograms/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Topical application of tetracycline-HCl in human periodontitis. 843 37

Controlled local delivery of antibiotics has been shown to reduce periodontopathic micro-organisms with minimal side-effects. Clinical studies in our laboratory have shown that 25% tetracycline HCl delivered from poly(D,L-lactide/glycolide) film strips (25 TTC-PLGA) released therapeutic concentrations of tetracycline for 10 days. The present pilot study compared the intracrevicular delivery of 25% tetracycline HCl incorporated in these biodegradable film strips to scaling and root planing (SRP) in 10 adult periodontitis patients, who in spite of therapy and regular supportive periodontal treatment (SPT), continued to possess 5 bleeding periodontal pockets at least 5 mm deep. Sites were randomly selected to receive the following treatments: (1) 25 TTC-PLGA, (2) control strips without TTC (PLGA), (3) SRP, and (4) untreated control. Film-strip retention was augmented with a suture/cement technique, followed by strip removal after 2 weeks. Clinical parameters and subgingival bacterial morphotypes (darkfield analysis) were evaluated over time (0, 2.4, 8, 12, 26 weeks). Results indicated that, compared to baseline, 25 TTC-PLGA film strips caused significant (p < or = 0.01): (1) probing depth reduction for 26 weeks, (2) a clinical attachment level gain for 12 weeks, (3) lower %s of spirochetes for 4 weeks and motile rods for 8 weeks (p < or = 0.05), and (4) an accompanying increase in cocci for 4 weeks. In the scaled and root planed sites, probing depth was the only finding that demonstrated a significant change from baseline (p < or = 0.01). Controls and PLGA showed isolated reductions in probing depth and % of motile organisms. From these findings, applications of intracrevicular 25 TTC-PLGA, when compared to scaling and root planing, appears to have an enhanced antibacterial effect and a similar clinical effect in SPT patients. The results of this study indicate further investigation of 25 TTC-PLGA film strips should be undertaken using more subjects and sophisticated microbiological and clinical measurements.
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PMID:Response to intracrevicular controlled delivery of 25% tetracycline from poly(lactide/glycolide) film strips in SPT patients. 855 Aug 63

The present study was carried out to examine the distribution of six periodontopathic bacteria in deep periodontal pockets and to reconfirm the effect of Periocline on these periodontopathic bacteria. Samples from sixty-two periodontal pockets were collected at pocket depths of over 4 mm in twenty-one periodontitis patients aged 43 to 75 years. After sampling, Periocline was applied topically to the selected pockets once a week for four weeks and reexamined. The detected rates of the periodontopathic bacteria were Capnocytophaga sputigena (37.1%), Prevotella intermedia (22.6%), Porphyromonas gingivalis (22.6%), Fusobacterium nucleatum (20.1%), Actinobacillus actinomycetemcomitans (9.7%) and Eikenella corrodens (4.8%). The distribution of the bacteria was compound because two or three bacterial species were found to coexist. In view of the MIC of minocycline-HCI for these bacteria, increase of most of the measured bacteria was suppressed by the concentration of drugs, including Periocline. However, clinical strains of P. i. were considered to have low susceptibility to minocycline-HCl. In view of the effect of topical application of drugs, no significant differences were found. From these results, it was suggested that Periocline contained effective concentration of minocycline-HCl.
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PMID:[Subgingival distribution of periodontopathic bacteria in periodontic patients and susceptibility of these bacteria to minocycline-HCl]. 858 61


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