ethyl-cellulose and Periodontal-Pocket

Ethylcellulose inserts of niridazole fabricated by casting were studied for in vitro release and in vivo clinical effectiveness. The in vitro drug release was steady and sustained for over 7 days and followed diffusion kinetics. Selected batch, EN3, was evaluated clinically in patients with periodontitis for 6 months. A significant improvement (alpha < or = 0.05) in clinical indices from baseline was observed. Intergroup study revealed a significant (alpha < or = 0.01) change in the bleeding index, gingival index, plaque index, calculus criteria, and pocket depth. Significant reduction in total bacterial count in gingival crevicular fluid was observed before and postdevice insertion, as well as between control and treatment groups.

Topics: Adolescent; Adult; Biological Availability; Cellulose; Delayed-Action Preparations; Dental Calculus; Dental Plaque; Drug Delivery Systems; Female; Follow-Up Studies; Hemorrhage; Humans; Male; Middle Aged; Niridazole; Orphan Drug Production; Periodontal Diseases; Periodontal Index; Periodontal Pocket; Periodontitis; Pilot Projects; Single-Blind Method; Time Factors; Treatment Outcome

The present study compared the effectiveness of two antimicrobials, tetracycline and metronidazole, in reducing subgingival microorganisms in periodontal pockets using an ethyl cellulose strip as the delivery medium. The study involved 30 patients, with a minimum of 3 periodontal pockets with probing depths > 6 mm throughout the oral cavity. Patients were given supragingival scaling and then divided into 5 groups, depending on the length of time the medication was in place. Sites were marked for tetracycline, metronidazole, and placebo. Sites were wiped and isolated, and baseline microbiology samples were taken for Gram staining and culture methods. After treatment, subgingival microbiological samples were taken again. The ethyl cellulose strips were removed and analyzed for any remaining drug. Results showed that tetracycline and metronidazole can both be applied locally to periodontal sites using ethyl cellulose strips and markedly suppress the subgingival bacteria over a period of several days. The tetracycline showed a faster release; however, the metronidazole required a lesser concentration to achieve complete reduction of the subgingival flora.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Local; Antitrichomonal Agents; Cellulose; Colony Count, Microbial; Dose-Response Relationship, Drug; Drug Delivery Systems; Female; Hardness; Humans; Male; Metronidazole; Microbial Sensitivity Tests; Middle Aged; Periodontal Pocket; Tetracycline; Time Factors

The release of chlorhexidine from an ethyl cellulose-based dosage form (SRD) has been shown to be effective in the reduction of the flora associated with periodontal pockets as well as in reducing probing depths. In this study, treatment with this dosage form was compared to routine maintenance therapy (RMT) in a 2-year, split mouth clinical trial. Ten patients with 84 pockets greater than or equal to 5 mm who had not received any periodontal therapy or systemic antibiotics over the last 6 months were included. The patients all received a full mouth scaling and root planing together with through oral hygiene instruction. Two months later (baseline) plaque index (P1I), bleeding on probing (BOP), pocket probing depth (PD), and attachment levels (AL) were assessed at all selected sites. Pockets on the control side then received RMT while the experimental pockets were treated with the SRD only. Treatment was repeated every 3 months for 2 years. The SRD treatment resulted in an improvement of greater than or equal to 3 mm in PD of at least 1 pocket in 8 of 10 patients, while RMT resulted in a similar improvement in only 1 of 10 patients (P = 0.012). Similarly a gain of attachment of greater than or equal to 3 mm was found in at least 1 SRD pocket in 8 of 10 patients. The RMT resulted in a similar improvement in only 2 patients (P = 0.012).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Cellulose; Chlorhexidine; Delayed-Action Preparations; Dental Plaque; Dental Plaque Index; Dental Prophylaxis; Dental Scaling; Epithelial Attachment; Female; Gingival Hemorrhage; Humans; Male; Oral Hygiene; Periodontal Index; Periodontal Pocket; Root Planing

The purpose of this study was to develop a sustained release device containing metronidazole for insertion within periodontal pockets and to examine the release kinetics in vitro and in vivo. Cast films of ethyl cellulose with or without polyethylene glycol, containing metronidazole, were prepared and exhibited sustained release. Release rate of metronidazole from the film was measured by means of a UV spectrophotometer, and kinetics of release in vitro was found to conform to Higuchi's diffusional model. The microbiological results proved that embedding metronidazole in ethyl cellulose film does not inhibit the biological activity. The release kinetics in vivo correlated with in vitro results, exhibiting a sustained release of metronidazole over a period of three days from 30% metronidazole with polyethylene glycol or 40% metronidazole in ethyl cellulose chloroform cast. This study demonstrates that, by embedding metronidazole in ethyl cellulose, it is possible to obtain sustained release of the drug within the periodontal pocket for three days.

Topics: Bacteroides fragilis; Cellulose; Delayed-Action Preparations; Equipment Design; Humans; In Vitro Techniques; Kinetics; Metronidazole; Periodontal Pocket; Polyethylene Glycols