minocycline and Periodontal-Diseases

Perio treatment has evolved beyond simple scaling with hand instruments. Ultrasonics and diode lasers have improved both the efficiency of treatment as well as treatment prognosis to arresting the disease process and gaining clinical attachment and decreasing pocket depth. Add to this the benefits of adjunct medicaments both at time of treatment via site placement and during routine home care by the patient, and we are able to tip treatment outcome in a more favorable direction. Periodontology has been closely linked to systemic health both as a causative agent to health issues and as a secondary site for some medical conditions. Dentistry has truly--and finally--become a part of total healthcare.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Chlorhexidine; Dental Instruments; Doxycycline; Humans; Laser Therapy; Minocycline; Periodontal Diseases; Periodontics; Ultrasonic Therapy

From the literature we can draw conclusions regarding the local use of minocycline in periodontal diseases. This review article attempts to evaluate the role of local delivery of minocycline HCl in the management of periodontal diseases. The efficacies of several local delivery devices of minocycline like minocycline films, strips, gels/ointment, microspheres and nanoparticles are discussed. The functional characteristics of local delivery devices of minocycline, their effectiveness as monotherapy, and comparison with scaling and root planning (SRP) are discussed in detail. Methods for the analysis of minocycline in various biological fluids, clinical trials and patents relevant to the local use of minocycline HCl in dental diseases have also been addressed in the article, conceptualizing the fact that direct application of minocycline into the diseased periodontal sulcus is an attractive treatment approach.

Topics: Animals; Clinical Trials as Topic; Drug Delivery Systems; Humans; Minocycline; Periodontal Diseases

Antimicrobial agents, systemic and/or local, are thought by some to be effective agents for treating periodontal infections. Here the authors determine the costs and benefits of local delivery agents for treating periodontal disease. Applying this cost-benefit analysis to patient care, however, will depend upon a clinician's expertise and a patient's value system.

Topics: Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Local; Cellulose; Chlorhexidine; Cost-Benefit Analysis; Doxycycline; Drug Approval; Drug Costs; Drug Delivery Systems; Gels; Glycerides; Humans; Metronidazole; Microspheres; Minocycline; Periodontal Diseases; Randomized Controlled Trials as Topic; Research Design; Risk Assessment; Sesame Oil; Tetracycline; Treatment Outcome

Periodontal therapy has the primary aim of halting periodontal disease progression. Clinical trials over the years have indicated that meticulous scaling and root planing in conjunction with a patient's proper plaque control can arrest periodontitis, but this therapy is not always completely effective and thus adjunctive therapies need to be considered. Local delivery of antibacterial agents into periodontal pockets has been extensively developed and investigated since the late 1970s and many systems have been designed to maintain high levels of antimicrobial agents in the crevicular fluid with minimal systemic uptake. More recently subgingival antimicrobial delivery systems have become available to the practising periodontist for clinical use. These systems, employ different antimicrobial agents but also different delivery systems which influence the concentration of available drug over time. The dental profession is confused by the wide variety of available slow release subgingival antimicrobial devices on the market and clearly comparative independent assessment of these therapies is needed. This review will summarise the findings of a comparative study on three commonly available periodontal local delivery antimicrobial systems on sites with previously unsuccessful mechanical therapy. The slow release devices studied adjunctively with root planing were: Actisite, Dentomycin and Elyzol, compared to root planing alone. Substantivity of an antimicrobial system is the ability of the system to maintain an effective concentration of drug over time which may be the most significant difference between the three delivery systems rather than the type of antimicrobial drug used. Although all three locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regime of scaling and root planing plus tetracycline fibre placement gave the greatest reduction in probing pocket depth over the six months after treatment.

Topics: Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents; Biocompatible Materials; Cellulose; Delayed-Action Preparations; Dental Scaling; Disease Progression; Drug Delivery Systems; Gingival Crevicular Fluid; Glycerides; Humans; Metronidazole; Minocycline; Periodontal Diseases; Periodontal Pocket; Root Planing; Sesame Oil; Tetracycline

One of the most prevalent infectious diseases that dental practitioners have to treat is periodontal disease. Antimicrobial and antibiotic agents have been developed that can be applied topically with no deleterious side-effects and reaching greater concentrations at the disease site than such agents given systemically. Used in conjunction with the mechanical debridement of deep pockets of disease, these agents appear to enhance the effectiveness of treatment. This approach is likely to feature more and more in the routine management of periodontal disease.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Local; General Practice, Dental; Humans; Metronidazole; Minocycline; Periodontal Diseases; Tetracyclines

Periodontal diseases are bacterial infections and antimicrobial agents appear to offer great potential in their treatment and prevention. One such chemotherapeutic agent is minocycline. The aim of this paper is to review the literature on this antibiotic concerning in vitro and in vivo studies, its pharmacokinetics and secondary effects.

Topics: Bacteria, Anaerobic; Humans; Minocycline; Periodontal Diseases

The aim of this study was to evaluate changes in clinical parameters and levels of inflammatory biomarkers in plasma in periodontal patients with poorly controlled type 2 diabetes mellitus (T2DM) after non-surgical periodontal therapy. Twenty-eight poorly controlled T2DM patients were randomly assigned to treatment with scaling and root planning (SRP) and SRP + subgingival minocycline administration. Clinical parameters, including the probing depth (PD), bleeding on probing (BOP), plaque score (PS), clinical attachment level (CAL), and plasma interleukin (IL)-6, soluble receptor of advanced glycation end products (sRAGE), chronic reactive protein (CRP), and hemoglobin A1c (HbA1c) were measured before and after a 6-month treatment period. Significant changes in PD, BOP, PS, and CAL were found in both groups. The latent growth curve model showed an overall reduction in the log HbA1c level in the SRP group (-0.082, p = 0.033). Small changes in the log sRAGE level and log CRP level in plasma were found in both groups. IL-6 in the plasma increased in the SRP group, but slightly decreased in the SRP+minocycline group (0.469 pg/ml, p = 0.172). Non-surgical periodontal therapy with or without subgingival minocycline application may achieve significant periodontal improvement and moderate improvement in HbA1c, but had no significant effect on plasma levels of IL-6, CRP, or sRAGE in patients with poorly controlled T2DM. For patients with both periodontal diseases and diabetes, non-surgical periodontal treatments may be helpful in their diabetic control.

Topics: Administration, Topical; Adult; Aged; Anti-Bacterial Agents; C-Reactive Protein; Dental Plaque Index; Dental Scaling; Diabetes Mellitus, Type 2; Female; Follow-Up Studies; Gingival Hemorrhage; Glycated Hemoglobin; Glycation End Products, Advanced; Humans; Interleukin-6; Male; Middle Aged; Minocycline; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Pocket; Receptor for Advanced Glycation End Products; Receptors, Immunologic; Root Planing

Recent studies have demonstrated the effectiveness of locally delivered antibiotics adjunctive with scaling and root planing (SRP) in patients with chronic periodontitis. Specifically, several studies have demonstrated the efficacy of minocycline microspheres (Arestin). The objective of the current study was to evaluate the use of Arestin in a study using private practices all over the United States and adopting a predefined protocol. Eight hundred ninety-five dentists and 2805 patients participated in the largest reported trial in chronic periodontal disease in private practice. The protocol outlined that patients were to have SRP at baseline with one application of Arestin in all pockets > or = 5 mm, a recall visit three months later that included a second application of Arestin, and a final assessment after 6 months. One thousand ninety five patients were treated in accordance with the protocol, and 1710 patients returned for a second assessment but only received one therapeutic intervention. Mean pocket depth reduction from baseline in the 1710 patients was 1.82 mm (p < 0.0001) and for the 1095 patients at 6 months it was 1.94 mm (p < 0.0001). Similar results were obtained in smokers, diabetes patients and patients with a history of cardiovascular disease. After 1 treatment 62% of sites had decreased to less than 5 mm and after two treatments the corresponding number was 67%. There were no serious adverse events in the study. This study demonstrated that a large study could be conducted in a private practice setting, that Arestin and SRP were effective in reducing pocket depth, and that adherence to the protocol yielded additional benefits.

Topics: Anti-Infective Agents, Local; Female; Humans; Male; Middle Aged; Minocycline; Periodontal Diseases; Periodontal Pocket; Statistics, Nonparametric

Studies indicate that a dual pathway between diabetes mellitus and periodontal disease exists. Elimination of periodontal infection by using systemic antibiotics in conjunction with scaling and root planing (SRP) improved metabolic control in diabetic patients, as defined by reduction in glycated haemoglobin or reduction in insulin requirements (Grossi and Genco, 1998). The aim of this randomised pilot clinical trial was to determine if type 1 diabetes patients with periodontitis will experience a reduction in HbA1c levels when treated with locally delivered minocycline microspheres (Arestin) as an adjunct to scaling and root planing. Twenty adult patients with poorly controlled diabetes (HbA1c 7.5%) and adult periodontitis, as determined by the presence of four teeth with 5 mm periodontal pockets, two of which had 6-9 mm pockets and bleeding on probing, were included in the study. All patients received full mouth SRP at baseline. Arestin was administered to all pockets > or => or = 5 mm at baseline and again at 12 weeks in the test group. Probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and HbA1c were evaluated at baseline and at weeks 6, 12, 18 and 24. The results demonstrated that local administration of Arestin as an adjunct to scaling and root planing is significantly more effective in reducing probing depths and providing a gain in clinical attachment levels than scaling and root planing alone in type 1 diabetic patients. Hb1Ac was reduced in all patients; however the difference between the test and control groups was not significant.

Topics: Adult; Anti-Bacterial Agents; Blood Glucose; Diabetes Mellitus, Type 1; Female; Humans; Male; Middle Aged; Minocycline; Periodontal Diseases; Pilot Projects; Single-Blind Method

Topics: Anti-Infective Agents, Local; Double-Blind Method; Humans; Minocycline; Ointments; Periodontal Diseases; Tetracyclines

Periodontal pathogenic bacteria promote the destruction of periodontal tissues and cause loosening and loss of teeth in adults. However, complete removal of periodontal pathogenic bacteria, at both the bottom of the periodontal pocket and the root bifurcation area, remains challenging. In this work, we explored a synergistic antibiotic and photothermal treatment, which is considered an alternative strategy for highly efficient periodontal antibacterial therapy.. Mesoporous silica (MSNs) on the surface of Au nanobipyramids (Au NBPs) were designed to achieve the sustained release of the drug and photothermal antibacterials. The mesoporous silica-coated Au NBPs (Au NBPs@SiO. We designed a new near-infrared light (NIR)-activated hybrid hydrogel that offers both sustained release of antibacterial drugs and photothermal treatment. Such sustained release pattern yields the potential to rapidly eliminate periodontal pathogens in the periodontal pocket, and the photothermal treatment maintains low bacterial retention after the drug treatment.

Topics: Animals; Anti-Bacterial Agents; Cell Line, Tumor; Cell Survival; Delayed-Action Preparations; Drug Liberation; Gold; Hydrogels; Lasers; Methacrylates; Mice; Minocycline; Nanostructures; Periodontal Diseases; Phototherapy; Porphyromonas gingivalis; Silicon Dioxide

Periodontal diseases remain a challenge due to a complex interplay of factors involving a chronic inflammatory activation and bacteria internalization in periodontal cells. In this work, chitosan-nanoparticles loaded with minocycline (MH-NPs), a tetracycline with antimicrobial and anti-inflammatory effects, were developed for in situ delivery in the periodontal milieu aiming to improve drug effectiveness. A general cytocompatibility evaluation and a detailed approach to address the cellular uptake process, trafficking pathways and the modulation of relevant inflammatory gene expression was conducted using human gingival fibroblasts. Results show that MH-NPs with an adequate cytocompatible profile can be internalized by distinct endocytic processes (macropinocytosis and clathrin-mediated endocytosis). The ability to modulate autophagy with the delivery within the same endosomal/lysosomal pathway as periodontal pathogens was observed, which increases the intracellular drug effectiveness. Porphyromonas gingivalis LPS-stimulated cultures, grown in the presence of MH-NPs, were found to express significantly reduced levels of inflammation-related markers (IL-1b, TNFα, CXCL-8, NFKB1). These nanoparticles can be potentially used in periodontal disease treatment conjoining the ability of intracellular drug targeting with significant anti-inflammatory effects.

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents; Cells, Cultured; Chitosan; Drug Delivery Systems; Fibroblasts; Gingiva; Humans; Inflammation; Minocycline; Nanoparticles; Periodontal Diseases; Porphyromonas gingivalis

To study redox responses of cultured osteoblasts, mediated by bacterial lipopolysaccharide (LPS), glucose (G), glucose-oxidised low density lipoprotein (GLDL) and minocycline (M) using radiolabelled steroid markers of redox status and wound healing. The clinical relevance of this concept in periodontitis patients with cardiometabolic risk markers is addressed.. A well differentiated osteoblastic cell-line was cultured in Eagle's MEM in confluent monolayer, in 24 well multiwell plates. Radiolabelled testosterone was used as the steroid substrate. Experiments were set up with controls in the absence of agents, optimal concentrations (previously determined) of G, GLDL, LPS, M, GLDL+LPS and the latter combined with M (n = 8). At the end of a 24h incubation period, the reaction was terminated and the medium analysed for yields of the steroid metabolite 5α-dihydrotestosterone (DHT), the redox marker relevant to wound healing, the weaker androgen 4-androstenedione (4-A) and the diols. Analysis entailed thin layer chromatography and radioisotope scanning.. The yields of DHT showed 1.4-fold and 2.3-fold decreases in response to GLDL and LPS respectively and a 1.3-fold reduction in response to the combination, when compared with controls in the absence of agents. Minocycline stimulated the yield of DHT by 1.4-fold, and when combined with GLDL+LPS, the decreased yield was overcome and raised to 2-fold above the combination in response to the addition of minocycline (n = 8; p < 0.001), when compared with controls. The trends in the yields of 4-A and diols were inversely related to each other with increases and decreases over controls respectively, in keeping with enzymic pathways.. Decreased yields of the oxidative stress marker DHT in response to LPS, G and GLDL were overcome in the presence of minocycline, which demonstrates its potential role as an adjunctive therapeutic agent in an environment of oxidative stress. These applications could be extrapolated to periodontal disease and co-existing cardiometabolic risk markers, in the context of its antiinflammatory and antioxidant actions relevant to healing. In this paper, recent patents relevant to adjunctive therapeutic management of periodontal disease co-existing with cardiometabolic risk markers are addressed. There have been significant advances in therapeutic interventions for overcoming oxidative stress-inducing mechanisms that are common to these disease entities.

Topics: Androstenedione; Anti-Inflammatory Agents; Antioxidants; Biomarkers; Cardiovascular Diseases; Cells, Cultured; Chromatography, Thin Layer; Dihydrotestosterone; Gas Chromatography-Mass Spectrometry; Glucose; Humans; Lipopolysaccharides; Lipoproteins, LDL; Metabolic Diseases; Minocycline; Osteoblasts; Oxidation-Reduction; Oxidative Stress; Periodontal Diseases; Testosterone; Time Factors; Wound Healing

Topics: Anesthetics, Local; Anti-Bacterial Agents; Coronary Disease; Doxycycline; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Minocycline; Mouthwashes; Periodontal Diseases; Prilocaine; Toothpastes

Topics: Acne Vulgaris; Anti-Bacterial Agents; Female; Humans; Minocycline; Periodontal Diseases; Pigmentation Disorders

Porphyromonas gingivalis is found in subgingival biofilm and is associated with periodontal disease. Bacteria in biofilms are able to resist higher antimicrobial concentrations than in suspension. Little is known about the susceptibility of P. gingivalis in biofilms to antimicrobial agents. The effects of chlorhexidine gluconate, minocycline hydrochloride, and metronidazole on P. gingivalis biofilms were examined in vitro.. P. gingivalis strain 381 biofilms were prepared on 32 hydroxyapatite disks. At 0, 24, 72, and 144 hours after perfusion of the three antimicrobial agents, two disks from each device were used to assess the antimicrobial effects by adenosine triphosphate (ATP) bioluminescence, and for morphological investigation by scanning electron microscopy (SEM).. Close relationships were found between the results of the ATP analyses and the SEM observations in all groups examined. A significant decrease (P < 0.001) in ATP content was found between the chlorhexidine-treated and control groups. The extracellular matrix structure and P. gingivalis cells were altered in the presence of chlorhexidine. Minocycline hydrochloride also caused a decrease (P < 0.05) in the ATP content and morphological change on P. gingivalis biofilms. Metronidazole showed no significant efficacy against P. gingivalis biofilms.. Chlorhexidine gluconate was effective at reducing the viability of P. gingivalis 381 cells in biofilms, while minocycline hydrochloride and metronidazole exhibited weaker effects.

Topics: Adenosine Triphosphate; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Local; Biofilms; Chlorhexidine; Durapatite; Extracellular Matrix; Humans; Luminescent Measurements; Metronidazole; Microscopy, Electron, Scanning; Minocycline; Periodontal Diseases; Porphyromonas gingivalis; Time Factors

The management of periodontal diseases has included both non-surgical and surgical treatment options. Non-surgical treatment traditionally has referred to the role of mechanical instrumentation of the root surface with either scalers or curettes. However, the introduction of locally delivered anti-microbial medications, which can be placed directly into a periodontal pocket, has provided the practitioner with another treatment option. This article looks at the different locally delivered anti-microbial medications being used in the non-surgical management of periodontal diseases.

Topics: Absorbable Implants; Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents; Cellulose; Chlorhexidine; Contraindications; Delayed-Action Preparations; Dental Scaling; Doxycycline; Drug Delivery Systems; Drug Implants; Humans; Minocycline; Periodontal Diseases; Periodontal Pocket; Root Planing; Subgingival Curettage; Tetracycline

The incidence of beta-lactamase production in anaerobic gram-negative rods isolated from 93 pus specimens of orofacial odontogenic infections and the antimicrobial susceptibility of these isolates against 11 antibiotics were determined. A total of 191 anaerobic gram-negative rods were isolated from the specimens. Beta-lactamase was detected in 35.6% of the black-pigmented Prevotella and 31.9% of the nonpigmented Prevotella. However, no strains among the other species isolated produced beta-lactamase. Ampicillin, cefazolin and cefotaxime showed decreased activity as regards beta-lactamase-positive Prevotella strains, whereas the activity of ampicillin/sulbactam, cefmetazole, and imipenem continued to be effective against such strains. All tested beta-lactam antibiotics were effective against Porphyromonas and Fusobacterium. Erythromycin showed decreased activity against nonpigmented Prevotella and Fusobacterium. Clindamycin, minocycline and metronidazole were powerful antibiotics against which anaerobic gram-negative rods could be tested. The present study showed that beta-lactamase-positive strains were found more frequently in the Prevotella strains than in any of the other species of anaerobic gram-negative rods. The effectiveness of adding sulbactam to ampicillin was demonstrated, as well as the difference in cephalosporin activity against beta-lactamase-positive strains.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ampicillin Resistance; Anti-Bacterial Agents; Bacteroidaceae Infections; beta-Lactam Resistance; beta-Lactamases; Cefmetazole; Cephalosporin Resistance; Cephamycins; Chi-Square Distribution; Clindamycin; Erythromycin; Fusobacterium; Gram-Negative Anaerobic Straight, Curved, and Helical Rods; Gram-Negative Bacterial Infections; Humans; Imipenem; Metronidazole; Middle Aged; Minocycline; Periodontal Diseases; Porphyromonas; Prevotella; Sulbactam; Thienamycins; Tooth Diseases

Tumor necrosis factor-alpha (TNF-alpha) may play an important role in insulin resistance. In this study, we hypothesized that TNF-alpha produced due to periodontal inflammation synergistically affects insulin resistance as well as TNF-alpha produced from adipose tissues in insulin-resistant type 2 diabetes patients. Therefore, to understand the effects of antimicrobial periodontal therapy on serum TNF-alpha concentration and subsequent metabolic control of diabetes, we examined the periodontal and diabetic status on 13 type-2 diabetes patients.. These patients were treated with local minocycline administration in every periodontal pocket around all existing teeth once a week for a month. Before and after treatment, the number of total bacteria in the periodontal pockets and circulating TNF-alpha concentration were measured and the HbA1c value was assessed.. Antimicrobial therapy significantly reduced the number of microorganisms in periodontal pockets (P <0.01). After treatment, the circulating TNF-alpha level was significantly reduced (P <0.015). The HbA1c value was also reduced significantly (P <0.007). In addition, the 6 patients who were not receiving insulin therapy demonstrated decreased fasting insulin levels (P <0.03), and HOMA-R (P <0.03) indices. The average reductions in circulating TNF-alpha concentration and HbA1c value were 0.49 pg/ml and 0.8%, respectively.. The results indicate that anti-infectious treatment is effective in improving metabolic control in diabetics, possibly through reduced serum TNF-alpha and improved insulin resistance.

Topics: Adult; Aged; Anti-Bacterial Agents; Blood Glucose; Body Mass Index; Dental Plaque; Diabetes Mellitus, Type 2; Fasting; Female; Follow-Up Studies; Glycated Hemoglobin; Humans; Insulin; Insulin Resistance; Male; Middle Aged; Minocycline; Periodontal Diseases; Periodontal Index; Periodontal Pocket; Periodontitis; Statistics as Topic; Statistics, Nonparametric; Tumor Necrosis Factor-alpha

Topics: Administration, Topical; Anti-Bacterial Agents; Drug Approval; Drug Carriers; Humans; Microspheres; Minocycline; Periodontal Diseases; United States; United States Food and Drug Administration

Topics: Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents, Local; Cellulose; Chlorhexidine; Delayed-Action Preparations; Doxycycline; Drug Delivery Systems; Humans; Minocycline; Periodontal Diseases; Tetracycline; Treatment Outcome

The antimicrobial minocycline has matrix-stimulatory effects on connective tissue and bone. The aim here was to study the effect of minocycline on 5alpha reduction of androgen substrates to 5alpha-dihydrotestosterone (DHT) in periosteal fibroblasts and the influence of the antiandrogen finasteride on this conversion. Confluent cultures of periosteal fibroblasts established from oral periosteum isolated from the bone surface were incubated in duplicate in multiwell dishes with two androgen substrates, [(14)C]-testosterone/[(14)C]-4-androstenedione, in the presence or absence of serial concentrations of minocycline or the antiandrogen finasteride or the two in combination for 24 h. The metabolites formed were solvent-extracted with ethyl acetate, separated by thin-layer chromatography and quantified using a radioisotope scanner. Both androgen substrates were metabolized to DHT and 4-androstenedione or testosterone. Minocycline stimulated the synthesis of DHT from these substrates by 75-83% at 20-30 microg/ml (n=4; p<0.01). Finasteride inhibited the 5alpha-reductase activity of these substrates by 3-5-fold at 1 microg/ml and 40-80% at 0.01 and 0.1 microg/ml (n=4; p<0.01), with little change in 17beta-hydroxysteroid dehydrogenase activity. Minocycline and finasteride in combination showed an intermediate response with one substrate. As finasteride inhibits the type 2, 5alpha-reductase isoenzyme associated with anabolic functions, these findings demonstrate target-tissue androgen metabolic activity in periosteal fibroblasts at baseline and in response to minocycline. This has implications for the reparatory potential of the diseased periodontium during adjunctive treatment with minocycline.

Topics: 17-Hydroxysteroid Dehydrogenases; 5-alpha Reductase Inhibitors; Adult; Androgen Antagonists; Androgens; Androstenedione; Anti-Bacterial Agents; Carbon Radioisotopes; Cells, Cultured; Chromatography, Thin Layer; Dihydrotestosterone; Enzyme Inhibitors; Female; Fibroblasts; Finasteride; Humans; Male; Minocycline; Periodontal Diseases; Periosteum; Radiopharmaceuticals; Testosterone; Wound Healing

This in vitro study compares, by scanning electron microscope (SEM) examination, the surface effects of various topical applications of tetracycline on the instrumented dentin root surface of human teeth. Eighty-two (82) dentin samples were prepared from periodontally-compromised teeth planned for extraction. Solutions of tetracycline HCl, doxycycline, minocycline, sumycin, and a saline control were prepared and applied to the dentin samples for 0.5, 1, 3, 5, and 10 minutes. Each solution pH was measured: tetracycline HCI (pH 1.6), doxycycline (pH 2.2), minocycline (pH 3.8), sumycin (pH 4.4), and saline (pH 5.1). A tetracycline periodontal fiber was also evaluated at 1, 4, 7, and 10 days of exposure for dentin surface effects. Tetracycline HCI removed the dentin smear layer leaving clean and open tubules significantly better than other solutions tested in as little as 30 seconds. Doxycycline and minocycline produced similar results to each other, which were significantly better than sumycin and saline, but not as effective as tetracycline HCl. Smear layer removal was attained by doxycycline and minocycline in five to ten minutes; however, sumycin and the saline control ineffectively removed the surface smear layer and dentinal tubules remained partially to totally occluded by debris. The periodontal fiber did not significantly alter the surface smear layer. Results of this study suggest that tetracycline HCl is the best current tetracycline form for root surface conditioning as measured by its ability to affect both dentin smear layer removal and dentin tubule exposure.

Topics: Administration, Topical; Anti-Bacterial Agents; Dentin; Doxycycline; Drug Carriers; Follow-Up Studies; Humans; Microscopy, Electron, Scanning; Minocycline; Periodontal Diseases; Placebos; Root Planing; Smear Layer; Subgingival Curettage; Tetracycline; Time Factors; Tooth Root

We previously reported that both local and systemic factors relevant to the pathogenesis of periodontal disease can increase gingival collagenase activity in rats. Since the degradation of extracellular matrix is an essential feature of periodontal disease and this tissue breakdown requires multiple enzyme interactions, the current study was carried out to determine the effects of bacterial endotoxin (LPS) (a local factor) and diabetes (a systemic factor) on a panel of matrix-degrading enzymes (collagenase, gelatinase, elastase, and beta-glucuronidase) in the gingiva of rats. In addition, the effects of therapy with a semisynthetic tetracycline (minocycline) were investigated. Ten male, Sprague-Dawley rats were made diabetic by IV injection of streptozotocin. Four of the ten rats then received minocycline (10 mg/day) by oral gavage on a daily basis for 3 weeks. Nineteen nondiabetic rats served as controls and 9 of them received 10 microliters of E. coli LPS (10 mg/ml) by injection into the labial gingiva every other day during the last week of the study. The other 10 nondiabetic rats were sham injected with saline into the gingiva. At the end of the 3 week experimental period, gingival tissue and skin were dissected from each rat and extracted for enzyme analysis. Our results showed that diabetes markedly increased the four matrix-degrading enzyme activities in both gingiva and skin. In contrast, local LPS injection increased these enzyme activities in the gingiva alone. Systemic therapy with minocycline completely ameliorated these elevated enzyme levels in diabetic rats in both gingiva and skin. Minocycline added in vitro to the enzyme assay systems containing skin extract from diabetic rats also inhibited collagenase and gelatinase activities, but no inhibition was observed for elastase and beta-glucuronidase activities, indicating that the MMPs and other enzymes were inhibited by minocycline, during diabetes, by indirect and indirect mechanisms, respectively.

Topics: Alveolar Bone Loss; Animals; Anti-Bacterial Agents; Blood Glucose; Body Weight; Collagen; Diabetes Mellitus, Experimental; Extracellular Matrix; Gingiva; Injections; Lipopolysaccharides; Male; Minocycline; Periodontal Diseases; Rats; Rats, Sprague-Dawley; Skin

Topics: Administration, Topical; Drug Resistance, Microbial; Drug Resistance, Multiple; Helicobacter pylori; Humans; Metronidazole; Minocycline; Periodontal Diseases; Tetracycline Resistance

Periodontal disease is a major cause of tooth loss. The underlying pathology is inflammation caused by bacterial plaque affecting the supporting structures of the teeth. Conventional treatment involves mechanical debridement of calcified plaque (calculus) by the dentist combined with meticulous oral hygiene by the patient. A more recent approach is to apply antimicrobial drugs locally to the diseased gingival tissue after debridement. Two antibiotic preparations, minocycline 2% gel (Dentomycin-Lederle) and metronidazole 25% gel (Elyzol-Dumex), are now licensed for the treatment of patients with periodontal disease. Are these treatments an advance on conventional therapy?

Topics: Gels; Humans; Metronidazole; Minocycline; Oral Hygiene; Periodontal Diseases

The aims of this retrospective study were to assess the incidence of infection after periodontal surgery, in relation to the type of surgical procedure, and the effectiveness of prophylactic tetracycline administration. Nineteen (4.4%) of 445 surgical procedures in patients who were given no tetracycline resulted in signs of infection, while two (3.8%) in patients who were treated with tetracycline resulted in signs of infection. There was no statistically significant difference between these incidences, suggesting that there is no reason for routine tetracycline prophylaxis in periodontal surgery. There was no statistically significant difference in the incidence of infection whether or not bone (ostectomy or osteoplasty) or tooth extraction was involved in the surgical procedure.

Topics: Adolescent; Adult; Aged; Chi-Square Distribution; Chlorhexidine; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Minocycline; Periodontal Diseases; Premedication; Retrospective Studies; Surgical Wound Infection; Tetracycline

Topics: Adult; Aggregatibacter actinomycetemcomitans; Dental Plaque; Dental Plaque Index; Female; Humans; Minocycline; Periodontal Diseases; Periodontal Index; Periodontal Pocket; Periodontitis; Porphyromonas gingivalis; Tetracycline

A large number of bacterial species are found in the periodontal pocket. It has been shown that the composition of the subgingival microbiota can differ significantly between individual pockets in one patient, as well as between different subjects. These different types of microfloras can be characterized by indicator bacteria. These indicator bacteria are strongly associated with active periodontal breakdown. Therefore, these microorganisms can be useful in the periodontal treatment of individual patients. It also supports the use of antibiotics in specific forms of periodontal disease. The application of microbiological data in diagnosis and treatment planning in four severe periodontitis patients is illustrated.

Topics: Actinobacillus; Bacteroides; Humans; Microbial Sensitivity Tests; Minocycline; Patient Care Planning; Periodontal Diseases; Periodontitis

In 15 adult patients with severely advanced periodontal disease unrelated to localized juvenile periodontitis high numbers of A. actinomycetemcomitans (A. a.) were identified in samples of subgingival plaque (median log CFU 5.13). In order to correlate clinical conditions with bacteriological findings, in every patient 2 deep periodontal pockets were treated with a 3-phase regimen of minocycline administration, mechanical, and surgical periodontal therapy. A. a. was eliminated by minocycline alone in 2 cases. Minocycline in combination with subgingival scaling resulted in 6 patients in A. a. negative samples. Following termination of minocycline therapy, frequently increasing numbers of A. a. were observed. Patients showed significant gain in clinical attachment or reduction of probing pocket depth during different phases of therapy, but only if A. a. was suppressed close to or below the lower limit of detection (5 CFU/ml). Considerable problems with elimination of A.a. may be connected with frequently observed recurrent periodontal disease in these patients.

Topics: Actinobacillus; Adult; Colony Count, Microbial; Dental Plaque; Female; Humans; Male; Minocycline; Periodontal Diseases; Recurrence

Topics: Anti-Infective Agents, Local; Humans; Minocycline; Ointments; Periodontal Diseases; Tablets; Tetracyclines

Topics: Administration, Topical; Delayed-Action Preparations; Dental Plaque; Dental Scaling; Humans; Minocycline; Periodontal Diseases; Pilot Projects; Tetracyclines

Topics: Anti-Bacterial Agents; Dental Plaque; Microbial Sensitivity Tests; Minocycline; Periodontal Diseases

Topics: Humans; Minocycline; Periodontal Diseases; Pilot Projects; Random Allocation; Tetracyclines

Two antimicrobial agents, 9-aminoacridine (0.2%) and minocycline (0.2%), were evaluated for their efficacy in inhibiting root surface caries, bone loss, and microflora in rice rats. A solution of 5000 ppm fluoride was used as a positive control for the inhibition of root surface caries, and double-distilled water was used as a negative control group. Each rat was treated by having its molar teeth swabbed 2 X per day with the prescribed agent in its group for nine weeks. Root caries reduction in the minocycline and fluoride groups was not significantly different, but the reduction was significantly greater than in the 9-aminoacridine group, with the caries score in all three groups being significantly less than that in the water control. Bone loss reduction for the minocycline group was significantly greater than that for any other group.

Topics: Alveolar Process; Aminacrine; Aminoacridines; Animals; Arvicolinae; Bacteria; Bone Resorption; Dental Caries; Female; Male; Minocycline; Periodontal Diseases; Rats; Sodium Fluoride; Streptococcus sanguis; Tetracyclines; Tooth Root

In a series of experiments, Golub et al. demonstrated that tetracyclines, but not other antibiotics, can inhibit mammalian collagenases and proposed that this property could be useful in treating diseases, such as periodontal disease (but also included certain medical conditions, e.g., corneal ulcers) characterized by excessive collagen degradation (J Periodont Res 1983, 1984 and 1985; Experientia 1984; Cornea 1984). One effect was the dramatic reduction of tissue collagenase activity within the gingival crevicular fluid (GCF) of periodontal pockets after administering a standard regimen of a tetracycline (e.g., 200 mg minocycline or 1000 mg tetracycline/day). The preliminary studies described below determined the effect of (1) low-dose (LD; 40-80 mg/day) orally administered minocycline on GCF collagenase activity and on the subgingival microflora (Exp. I), and (2) tetracycline-loaded monolithic fibers (TF) on collagenase activity in vitro (Exp. II). In Exp. I, GCF collagenase activity was reduced by 45 to 80% 2 weeks after initiating LD minocycline therapy, an effect that lasted for at least several weeks after stopping drug treatment. No consistent change in the relative proportions of G(+), G(-) and motile subgingival microorganisms was detected as a result of LD treatment suggesting that the reduction in GCF collagenase activity was a direct inhibition of the enzyme by the drug. In Exp. II, 3- and 6-mm lengths of TF in vitro established tetracycline concentrations in 250 microliters of 132 micrograms/ml, from 3-mm lengths, and 265 micrograms/ml, from 6-mm lengths, after an 18-hour incubation.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Delayed-Action Preparations; Female; Gingival Crevicular Fluid; Humans; In Vitro Techniques; Male; Microbial Collagenase; Middle Aged; Minocycline; Periodontal Diseases; Periodontal Pocket; Tetracycline; Tetracyclines

Topics: Aggressive Periodontitis; Chlorhexidine; Dental Plaque; Dental Scaling; Female; Humans; Minocycline; Periodontal Diseases; Tetracyclines

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