Madi Marwa, Pavlic Verica, Samy Wael, Alagl Adel
a Department of Preventive Dental Sciences , University of Dammam , Dammam , Saudi Arabia.
b Department of Periodontology and Oral Medicine, Department of Dentistry , Medical Faculty University of Banja Luka , Banja Luka , Bosnia and Herzegovina.
Acta Odontol Scand. 2018 Jan;76(1):71-76. doi: 10.1080/00016357.2017.1385096. Epub 2017 Sep 29.
To date, various drugs as host modulating agents had been suggested as adjunctive treatment modality in the therapy of chronic periodontal disease. In this study, the anti-inflammatory effect of subgingivally delivered nanostructured doxycycline gel (nDOX) was evaluated and compared to conventional doxycycline gel (DOX) used as adjunct to scaling and root planning (SRP) in the treatment of moderate chronic periodontitis to reduce probing pocket depth.
Nanostructured doxycycline gel (nDOX) was prepared using spray-drying technique with chitosan (CH) as a matrix polymer, followed by dispersion in polyvinyl alcohol (PVA). The deepest periodontal pocket in 45 patients suffering from moderate chronic periodontitis was selected. The patients were divided into three groups following scaling and root planning (SRP); group I: SRP + nDOX, group II: SRP + DOX and group III: SRP + placeboCH. Plaque Index (PI), Gingival Index (GI), pocket depth (PD) and clinical attachment level(CAL), as well as ginigival crevicular fluid levels of (GCF) IL-6 and TNF-α were assessed at baseline, 1 and 3 months following local drug application.
Group I showed significant reduction in probing depth and attachment gain compared with group II and III at one and three months period. The inflammatory mediators levels were significantly reduced in all treatment groups at one-month period. Except for group I, the reduced values were observed at three-month period.
The results suggest that treatment with nDOX gel as an adjunct to SRP had anti-inflammatory effect by improving both clinical parameters and inflammatory markers up to three months period.
迄今为止,多种药物作为宿主调节剂已被建议作为慢性牙周炎治疗的辅助治疗方式。在本研究中,评估了龈下递送的纳米结构强力霉素凝胶(nDOX)的抗炎作用,并与用于中度慢性牙周炎治疗中作为龈上洁治和根面平整(SRP)辅助手段的传统强力霉素凝胶(DOX)进行比较,以减少探诊深度。
采用喷雾干燥技术,以壳聚糖(CH)为基质聚合物制备纳米结构强力霉素凝胶(nDOX),然后分散于聚乙烯醇(PVA)中。选取45例中度慢性牙周炎患者最深的牙周袋。患者在龈上洁治和根面平整(SRP)后分为三组;第一组:SRP + nDOX,第二组:SRP + DOX,第三组:SRP + 安慰剂CH。在基线、局部用药后1个月和3个月时评估菌斑指数(PI)、牙龈指数(GI)、牙周袋深度(PD)和临床附着水平(CAL),以及龈沟液中白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的水平。
在1个月和3个月时,第一组与第二组和第三组相比,探诊深度显著降低,附着增加。在1个月时,所有治疗组的炎症介质水平均显著降低。除第一组外,在3个月时观察到数值降低。
结果表明,nDOX凝胶作为SRP的辅助治疗,通过改善临床参数和炎症标志物,在长达3个月的时间内具有抗炎作用。