Meticulous scaling and root planing (SRP) is the treatment of choice for almost all types of periodontitis, but SRP may have shortcomings for treating persistent localized periodontitis. A double-center, single-blind, randomized, controlled study by Bosco, et al evaluated the microbiologic profile and clinical parameters of persistent periodontal pockets after treatment with tetracycline solution. The study involved 37 patients who had at least 4 nonadjacent sites of persistent periodontal pockets with probing depth of at least 5 mm and bleeding on probing. The patients were randomly divided into a test group and a control group. In the test group, 2 teeth received 4 applications of tetracycline solution (100 mg/mL) with a microbrush, and the other 2 teeth received the same application of tetracycline solution plus one session of SRP. In the control group, 2 teeth received one session of SRP, and the other 2 teeth received 4 applications of saline with a microbrush plus one session of SRP. Following treatment, probing depth, bleeding on probing, visible plaque index, gingival bleeding index, gingival recession, clinical attachment level, and subgingival plaque samples were measured at baseline and 1, 3, and 6 months. The study found that all therapies yielded statistically significant data on clinical measurements with no significant differences among groups. Bacteria decreased in both groups, but only in the test group did Porphyromonas gingivalis, Tannerella forsythia, and Actinobacillus actinomycetemcomitans significantly decrease for up to 6 months. The study concludes that tetracycline solution applied with a microbrush may be an alternative treatment of persistent periodontal pockets with additional microbiologic benefits. This treatment may support conventional therapy of nonresponding sites or when vigorous mechanical therapy should be avoided.
(Source: Quintessence International, Volume 40, Number 1, 2009)
