minocycline and Gingivitis

Topics: Adult; Dental Plaque; Female; Gingival Crevicular Fluid; Gingivitis; Humans; Male; Minocycline; Periodontitis; Saliva; Time Factors; Tissue Distribution

The purpose of this study was to conduct a direct comparison of two dose regimens of minocycline to determine 1) whether they achieved crevicular fluid concentrations in a therapeutic range; and 2) the frequency of side effects. In a double-blind design, 30 patients divided into 2 groups were given either 100 mg minocycline or 200 mg minocycline per day for an 8-day period. The concentration of minocycline in the gingival clevicular fluid (GCF) at 8 days was 4.77 micrograms/ml for the 100 mg a day group and 5.97 micrograms/ml for the 200 mg a day group and at 15 days was 4.30 micrograms/ml for the 100 mg a day group and 4.17 micrograms/ml for the 200 mg a day group. There was no significant difference in the antibiotic concentration in the gingival crevicular fluid between the 2 groups. Reported adverse experiences to the minocycline were greater in the 200 mg a day group. Short-term changes in periodontal health as measured by plaque index, gingival index, pocket depth, and bleeding upon probing showed improvements in all parameters over the 15 day period. There were no significant differences in these parameters between the 100 mg a day and 200 mg a day group. At 8 days reduced levels of Porphyromonas gingivalis and Prevotella intermedia were achieved but they were not eliminated from infected subgingival sites in either group. Achieving bacteriostatic concentrations of GCF, fewer side effects, and the potential for better compliance suggests that a single daily dose of 100 mg minocycline should now be investigated for its efficacy in managing periodontal infections manifesting as periodontitis.

Topics: Adult; Aged; Aggregatibacter actinomycetemcomitans; Bacteroides; Colony Count, Microbial; Dental Plaque Index; Dose-Response Relationship, Drug; Double-Blind Method; Female; Gingival Crevicular Fluid; Gingival Hemorrhage; Gingivitis; Humans; Male; Middle Aged; Minocycline; Periodontal Index; Periodontal Pocket; Periodontitis; Placebos; Porphyromonas gingivalis

Here we report a case of generalized aggressive periodontitis treated with periodontal therapy including adjunct antimicrobial therapy and periodontal surgery. The patient was a 22-year-old woman who presented with the chief complaint of gingival recession. Baseline examination revealed generalized plaque deposition and gingival inflammation. Thirty-nine percent of the sites had a probing depth (PD) of 4-6 mm and 2% a PD of ≥7 mm; 63% exhibited bleeding on probing (BOP). Radiographic examination revealed vertical bone loss in the molars and horizontal bone loss in other teeth. Microbiological examination of subgingival plaque revealed the presence of Aggregatibacter actinomycetemcomitans and Tannerella forsythia. Oral health-related quality of life was assessed as a measure of patient-reported outcome. Based on a clinical diagnosis of generalized aggressive periodontitis, initial periodontal therapy and adjunct antimicrobial therapy were implemented. After reducing inflammation and subgingival bacteria, open flap debridement was performed for teeth with a PD of ≥4 mm. Reevaluation showed no sites with a PD of ≥5 mm, a minimal level of BOP, and a marked reduction in the level of the targeted periodontal pathogens. The patient's oral health-related quality of life was slightly worsened during supportive periodontal therapy (SPT). Implementation of adjunct antimicrobial therapy targeting periodontal pathogens and subsequent periodontal surgery resulted in improvement in periodontal and microbiological parameters. This improvement has been adequately maintained over a 2-year period. However, additional care is necessary to further improve the patient's oral health-related quality of life during SPT.

Topics: Adult; Aggregatibacter actinomycetemcomitans; Aggressive Periodontitis; Aluminum Compounds; Alveolar Bone Loss; Anti-Bacterial Agents; Chemotherapy, Adjuvant; Cuspid; Dental Enamel Proteins; Dental Plaque; Dental Plaque Index; Dentin Sensitivity; Female; Fluorides; Furcation Defects; Gingival Recession; Gingivitis; Gram-Negative Bacterial Infections; Humans; Malocclusion; Minocycline; Molar; Oral Hygiene; Pasteurellaceae Infections; Patient Care Planning; Periodontal Debridement; Periodontal Index; Periodontal Pocket; Quality of Life; Silicon Compounds; Tannerella forsythia; Tokyo; Treatment Refusal

Topics: Anti-Bacterial Agents; Bacteremia; Cardiovascular Diseases; Conscious Sedation; Crowns; Dental Implants; Dental Scaling; Gingivitis; Humans; Inflammation Mediators; Minocycline; Periodontitis; Probiotics; Risk Assessment; Thrombosis; Tooth Loss; United States

Dentists generally recognize the importance of periodontal treatment in patients with leukemia, with the most attention paid to preventing the development of odontogenic infection. For physicians, the worst type of infection is one caused by multidrug-resistant bacteria. Here, we report a patient with an abnormal increase in multidrug-resistant opportunistic bacteria in the gingiva during hematopoietic cell transplantation (HCT).. A 53-year-old woman receiving HCT for leukemia had an insufficient blood cell count for invasive periodontal treatment before HCT. Even brushing caused difficulties with hemostasis. Therefore, frequent pocket irrigation and local minocycline administration were performed.. The multidrug-resistant opportunistic bacterium Stenotrophomonas maltophilia was detected first in phlegm 2 days before HCT, and it was detected in a gingival smear and a blood sample 7 and 11 days after HCT, respectively. The patient developed sepsis on day 11 and died 14 days after HCT. Frequent irrigation and local antibiotic application were ineffective against S. maltophilia on the gingiva. Inflammatory gingiva without scaling and root planing showed bleeding tendency, and this interfered with the eradication of this bacterium.. The gingiva in patients undergoing leukemia treatment acts as sites of proliferation and reservoirs for multidrug-resistant opportunistic bacteria. Severe systemic infection by multidrug-resistant bacteria in such patients with leukemia also may involve the gingiva. To prevent abnormal increases in such bacteria on the gingiva, scaling and/or root planing before chemotherapy, which reduces bleeding on brushing during the neutropenic period caused by chemotherapy, may contribute to infection control in such patients, although it was impossible in this case.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Drug Resistance, Multiple, Bacterial; Fatal Outcome; Female; Gingival Diseases; Gingivitis; Gram-Negative Bacterial Infections; Hematopoietic Stem Cell Transplantation; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute; Middle Aged; Minocycline; Opportunistic Infections; Periodontitis; Povidone-Iodine; Sepsis; Stenotrophomonas maltophilia; Transplantation Conditioning; Whole-Body Irradiation

In addition to their antimicrobial properties, tetracyclines have antiinflammatory and pro-anabolic effects on the reparatory potential of connective tissue and bone. The physiologically active androgen 5alpha-dihydrotestosterone (DHT) implicated in matrix synthesis is formed in gingivae from androgen substrates. The aim of this investigation is to study the androgen metabolic response of gingivae to minocycline, in the presence or absence of the anti-androgen finasteride. Chronically inflamed gingival tissue derived from 12 subjects aged 30-50 years and passaged fibroblasts derived from this source, were used for the experiments. Duplicate incubations were performed in Eagle's MEM with 14C-testosterone/14C-4-androstenedione in the presence or absence of minocycline (5-60 microg/ml) or finasteride for 24 h. The androgen substrate 14C-testosterone was metabolised mainly to DHT and 4-androstenedione, while 14C-4-androstenedione was converted mainly to DHT and testosterone. Minocycline at 20-30 microg/ml stimulated the formation of these metabolites from both substrates by 13-25%. In the tissue incubations there were 3- and 2-fold increases in DHT and 4-androstenedione formation (n=12; p<0.01). The anti-androgen finasteride caused significant inhibition of 5alpha-reductase activity on both substrates at 0.1 & 1.0 microg/ml with total inhibition at 10 & 50 microg/ml (n=3; p<0.01). Minocycline-induced stimulation of 5alpha-reductase activity was also inhibited by finasteride (n=4; p<0.02). Since finasteride inhibition of 5alpha-reductase activity is specific for the type 2 isoenzyme associated with anabolic functions of target tissue, this enzyme activity may contribute to some of the cited anabolic tissue responses to minocycline.

Topics: 5-alpha Reductase Inhibitors; Adult; Androgen Antagonists; Androstenedione; Anti-Bacterial Agents; Carbon Radioisotopes; Cells, Cultured; Chronic Disease; Culture Media; Dihydrotestosterone; Dose-Response Relationship, Drug; Enzyme Inhibitors; Fibroblasts; Finasteride; Gas Chromatography-Mass Spectrometry; Gingiva; Gingivitis; Humans; Isoenzymes; Middle Aged; Minocycline; Radiopharmaceuticals; Testosterone

The purpose of this investigation was to evaluate the effect of non-surgical periodontal treatment and adjunctive systemic minocycline therapy on the level of neutral protease activity in whole saliva of adults with periodontitis. A test group of 21 adult patients with moderate to severe periodontitis was compared to a control group of 5 adults with healthy periodontium. Four test groups were examined: 1) scaling and root planing (SRP), probing depth = 4 to 5 mm; 2) SRP, PD > or = 6 mm; 3) SRP and adjunctive systemic minocycline therapy, PD = 4 to 5 mm; 4) SRP and adjunctive systemic minocycline therapy, PD > or = 6 mm. Clinical parameters and levels of neutral protease in whole saliva were assessed at baseline and on the sixth week after the non-surgical periodontal treatment. Neutral protease activity was measured by spectrofluorimetric method. Statistical tests of Mann-Whitney and Spearman Rank correlation coefficient were used in the evaluation of the mean values of measurements. The mean values of protease activity were significantly higher in the test groups than in the control group at baseline. Six weeks after non-surgical therapy, patients with 4 to 5 mm probing depth had approximate values of protease activity comparable to the control group. Hence it can be argued that these patients did not need minocycline HCL as an adjunctive therapy. However, non-surgical therapy had limited effects on both clinical parameters and enzyme activities for subjects with > or = 6 mm probing depth; on the other hand, gingival inflammation and enzyme activities were reduced significantly by the usage of minocycline as adjunctive therapy in these patients. According to our results, neutral protease activity in saliva is related to probing depth and gingival bleeding index, and not related to age and epithelial cell number. For these reasons, systemic minocycline therapy might be useful as an adjunct to non-surgical therapy in the presence of deep pockets, especially for reinfected cases. Further investigations are needed to confirm this suggestion.

Topics: Adult; Age Factors; Anti-Bacterial Agents; Cell Count; Chemotherapy, Adjuvant; Dental Scaling; Endopeptidases; Epithelium; Female; Follow-Up Studies; Gingival Hemorrhage; Gingivitis; Humans; Male; Middle Aged; Minocycline; Periodontal Pocket; Periodontitis; Root Planing; Saliva; Salivary Proteins and Peptides; Spectrometry, Fluorescence

Topics: Adult; Animals; Collagen; Diabetes Mellitus, Experimental; Doxycycline; Gingival Crevicular Fluid; Gingivitis; Humans; Male; Microbial Collagenase; Minocycline; Periodontal Pocket; Rabbits; Rats; Tetracycline; Tetracyclines

The purpose of this investigation was to determine the efficacy of minocycline hydrochloride in the management of subgingival microorganisms and periodontal disease. In a double-blind, split-mouth study, minocycline or placebo was administered systemically for 7 days to 26 adults with moderate-to-serve periodontitis. Four study groups were examined: (i) minocycline-scaled, (ii) minocycline-unscaled, (iii) placebo-scaled, and (iv) placebo-unscaled. The minocycline-scaled group responded most favorably, with improved gingival health for at least 49 days and with marked reductions in total bacterial counts and proportions of spirochetes for at least 70 days (termination of the study). Minocycline administration with no periodontal scaling and root planing also resulted major, long-lasting shifts in the subgingival microflora. Scaling alone was least effective in changing the microflora. The data indicated that minocycline may be a useful adjunct in the treatment of periodontal disease. Further studies are needed, however, to determine the long-term effect of minocycline therapy on the periodontal attachment level.

Topics: Adult; Aged; Bacteria; Dental Scaling; Double-Blind Method; Gingiva; Gingivitis; Humans; Middle Aged; Minocycline; Placebos; Tetracyclines; Time Factors; Tooth Root

The purpose of this study was to determine the passage into and concentration of Minocycline HCl (Minocin) in gingival crevicular fluid (GCF) and the relationship between its concentration of saliva. GCF, serum and changes in periodontal health. Over an 8 day period, 10 adults with periodontal disease received orally 200 mg/day of Minocin and 10 other received 150 mg/day. The parameter evaluated included the DMF, gingival index, plaque index, crevice depth, oral soft tissue evaluation. SMA-12, CBC, prothrombin time, and concentrations of Minocin in serum, saliva and GCF. The DMF score, crevice depth, SMA-12, CBC and prothrombin time were determined on days 1 and 8. All other parameters were evaluated on days 1, 2, 3, 5 and 8. The results of this study showed that Minocin administration resulted in no significant changes in blood chemistry, blood counts and prothrombin time, was effective against oral microorganisms as shown by reductions in plaque scores, produces an improvement in gingival health, is present in serum at therapeutically effective levels when given in doses of either 200 mg or 150 mg per day and is concentrated in gingival crevicular fluid at levels 5 times as high as serum.

Topics: Adult; Female; Gingival Crevicular Fluid; Gingival Pocket; Gingivitis; Humans; Male; Middle Aged; Minocycline; Periodontal Diseases; Periodontal Index; Periodontitis; Saliva; Tetracyclines