Eckles T A, Reinhardt R A, Dyer J K, Tussing G J, Szydlowski W M, DuBous L M
Department of Periodontics, University of Nebraska Medical Center, College of Dentistry, Lincoln.
J Clin Periodontol. 1990 Aug;17(7 Pt 1):454-62. doi: 10.1111/j.1600-051x.1990.tb02344.x.
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.
我们实验室的体外试验表明，白色凡士林载体中的40%盐酸四环素（TTC-WP）有作为缓释、自动消散系统的潜力。本研究在体内通过注射器测试了TTC-WP的龈下放置。将9例中度/重度牙周炎患者的象限（每个象限有2个患病部位）随机分配接受以下治疗：（1）TTC-WP；（2）仅凡士林；（3）龈下刮治和根面平整；（4）未治疗的对照。使用琼脂扩散生物测定法测量随时间（基线、1、8、24、72和168小时）TTC向龈沟液（GCF）中的释放。还随时间（基线、2、4、8、12周）评估了临床参数和龈下细菌形态类型（暗视野分析）。结果表明，TTC-WP易于放入牙周袋，生物活性TTC释放到GCF中至少3天（3天时平均浓度 = 115.8 +/- 43.1微克/毫升）。相对于治疗后8 - 12周的基线测量，TTC-WP减少了探诊袋深度和探诊出血，并在2 - 8周内减少了活动杆菌和螺旋体的百分比，同时球菌增加。在龈下刮治和根面平整部位也观察到类似效果，但持续时间更长。2周后TTC-WP和凡士林在临床上消散，未观察到不良组织反应。从这些发现来看，龈下TTC-WP不能替代龈下刮治和根面平整治疗，但具有有助于龈下菌斑控制的特性。
