Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
권호 표지
DOI QR코드

DOI QR Code

Comparing the clinical effects of local administration of minocycline ointment and doxycycline solution in the treatment of acute periodontal abscesses: a retrospective clinical study

  • DongYeol Jung (Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Jae-Kook Cha (Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Young-Taek Kim (Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Chang-Sung Kim (Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry)
  • Received : 2023.01.29
  • Accepted : 2023.06.15
  • Published : 2024.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The objective of this retrospective clinical study was to provide evidence supporting the adjunctive local application of doxycycline solution or minocycline ointment, in conjunction with drainage, for the treatment of acute periodontal abscesses. Methods: The study included 63 patients who had received treatment for acute periodontal abscesses through drainage supplemented with 1 of 3 types of adjunctive medications during their initial visit (visit 1; baseline): 1) saline irrigation (the control group), 2) 2% minocycline ointment (the TM group), or 3) 300 mg/mL doxycycline irrigation (the TD group). The same adjunctive medication was administered at visit 2, which took place 1 week after visit 1. Probing depth (PD), bleeding on probing (BOP), plaque index, gingival recession, clinical attachment level, and tooth mobility were clinically evaluated at visits 1, 2, and a third visit (visit 3; 4 weeks after visit 1). Statistical significance was considered to be indicated by P values <0.05. Results: By visit 3, all clinical indices and tooth mobility had significantly decreased in each group. At this visit, PD and BOP on the abscess side were significantly lower in the TM and TD groups compared to the control group. The TD group showed a significantly greater improvement than the TM group, with mean PD reductions of 1.09 mm in the control group, 1.88 mm in the TM group, and 2.88 mm in the TD group. Similarly, mean BOP reductions were 45% in the control group, 73.02% in the TM group, and 95.45% in the TD group. Conclusions: Local and adjunctive administration of doxycycline and minocycline in combination with drainage exhibited clinical advantages over drainage alone in improving PD and BOP. Notably, a doxycycline solution of 300 mg/mL was more effective than a 2% minocycline ointment.

Keywords

Acknowledgement

This work was supported by a grant from the National Research Foundation of Korea (NRF) funded by the Korean government (MSIT) (grant No. 2020R1A2C2008053).

References

  1. Herrera D, Roldan S, Sanz M. The periodontal abscess: a review. J Clin Periodontol 2000;27:377-86. https://doi.org/10.1034/j.1600-051x.2000.027006377.x
  2. Corbet EF. Diagnosis of acute periodontal lesions. Periodontol 2000 2004;34:204-16. https://doi.org/10.1046/j.0906-6713.2003.003432.x
  3. Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Clin Periodontol 2018;45 Suppl 20:S78-94. https://doi.org/10.1111/jcpe.12941
  4. Olsen I, van Winkelhoff AJ. Acute focal infections of dental origin. Periodontol 2000 2014;65:178-89.  https://doi.org/10.1111/prd.12018
  5. Herrera D, Alonso B, de Arriba L, Santa Cruz I, Serrano C, Sanz M. Acute periodontal lesions. Periodontol 2000 2014;65:149-77. https://doi.org/10.1111/prd.12022
  6. Eguchi T, Koshy G, Umeda M, Iwanami T, Suga J, Nomura Y, et al. Microbial changes in patients with acute periodontal abscess after treatment detected by PadoTest. Oral Dis 2008;14:180-4. https://doi.org/10.1111/j.1601-0825.2007.01370.x
  7. Lewis MA, McGowan DA, MacFarlane TW. Short-course high-dosage amoxycillin in the treatment of acute dento-alveolar abscess. Br Dent J 1986;161:299-302. https://doi.org/10.1038/sj.bdj.4805959
  8. Wilder RS. A new option for local delivery. Antimicrobials, such as minocycline microspheres, can enhance the effectiveness of mechanical therapy in treating chronic periodontitis. Tex Dent J 2003;120:984-7.
  9. Lee SB, Lee BA, Choi SH, Kim YT. Long-term outcomes after peri-implantitis treatment and their influencing factors: a retrospective study. J Periodontal Implant Sci 2022;52:194-205. https://doi.org/10.5051/jpis.2103020151
  10. Chadha VS, Bhat KM. The evaluation of doxycycline controlled release gel versus doxycycline controlled release implant in the management of periodontitis. J Indian Soc Periodontol 2012;16:200-6. https://doi.org/10.4103/0972-124X.99262
  11. Jung DY, Park JC, Kim YT, Yon JY, Im GI, Kim BS, et al. The clinical effect of locally delivered minocycline in association with flap surgery for the treatment of chronic severe periodontitis: a split-mouth design. J Clin Periodontol 2012;39:753-9. https://doi.org/10.1111/j.1600-051X.2012.01908.x
  12. Jain R, Mohamed F, Hemalatha M. Minocycline containing local drug delivery system in the management of chronic periodontitis: a randomized controlled trial. J Indian Soc Periodontol 2012;16:179-83. https://doi.org/10.4103/0972-124X.99259
  13. Ranch KM, Maulvi FA, Koli AR, Desai DT, Parikh RK, Shah DO. Tailored doxycycline hyclate loaded in situ gel for the treatment of periodontitis: optimization, in vitro characterization, and antimicrobial studies. AAPS PharmSciTech 2021;22:77.
  14. Kalsi R, Vandana KL, Prakash S. Effect of local drug delivery in chronic periodontitis patients: a meta-analysis. J Indian Soc Periodontol 2011;15:304-9. https://doi.org/10.4103/0972-124X.92559
  15. Abraham A, Raghavan R, Joseph A, Devi MP, Varghese M, Sreedevi PV. Evaluation of different local drug delivery systems in the management of chronic periodontitis: a comparative study. J Contemp Dent Pract 2020;21:280-4. https://doi.org/10.5005/jp-journals-10024-2779
  16. Matesanz-Perez P, Garcia-Gargallo M, Figuero E, Bascones-Martinez A, Sanz M, Herrera D. A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis. J Clin Periodontol 2013;40:227-41. https://doi.org/10.1111/jcpe.12026
  17. Stabholz A, Nicholas AA, Zimmerman GJ, Wikesjo UM. Clinical and antimicrobial effects of a single episode of subgingival irrigation with tetracycline HCl or chlorhexidine in deep periodontal pockets. J Clin Periodontol 1998;25:794-800. https://doi.org/10.1111/j.1600-051X.1998.tb02372.x
  18. Christersson LA, Norderyd OM, Puchalsky CS. Topical application of tetracycline-HCl in human periodontitis. J Clin Periodontol 1993;20:88-95. https://doi.org/10.1111/j.1600-051X.1993.tb00335.x
  19. Parameter on acute periodontal diseases. American Academy of Periodontology. J Periodontol 2000;71:863-6. https://doi.org/10.1902/jop.2000.71.5-S.863
  20. Heijl L, Dahlen G, Sundin Y, Wenander A, Goodson JM. A 4-quadrant comparative study of periodontal treatment using tetracycline-containing drug delivery fibers and scaling. J Clin Periodontol 1991;18:111-6. https://doi.org/10.1111/j.1600-051X.1991.tb01699.x
  21. Ozcan G, Taner IL, Doganay T, Iscanoglu M, Taplamacioglu B, Gultekin SE, et al. Use of membranes containing 20% chlorhexidine and 40% doxycycline for treatment of chronic periodontal pockets. J Nihon Univ Sch Dent 1994;36:191-8. https://doi.org/10.2334/josnusd1959.36.191
  22. Ahl DR, Hilgeman JL, Snyder JD. Periodontal emergencies. Dent Clin North Am 1986;30:459-72. https://doi.org/10.1016/S0011-8532(22)00449-9
  23. Meitner SW, Zander HA, Iker HP, Polson AM. Identification of inflamed gingival surfaces. J Clin Periodontol 1979;6:93-7. https://doi.org/10.1111/j.1600-051X.1979.tb02187.x
  24. Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38:610-6. https://doi.org/10.1902/jop.1967.38.6.610
  25. Nabers JM. Treatment of the symptomatic periodontal lesions. Dent Clin North Am 1969;13:169-80. https://doi.org/10.1016/S0011-8532(22)02953-6
  26. Paquette D, Oringer R, Lessem J, Offenbacher S, Genco R, Persson GR, et al. Locally delivered minocycline microspheres for the treatment of periodontitis in smokers. J Clin Periodontol 2003;30:787-94. https://doi.org/10.1034/j.1600-051X.2003.00375.x
  27. Goodson JM, Gunsolley JC, Grossi SG, Bland PS, Otomo-Corgel J, Doherty F, et al. Minocycline HCl microspheres reduce red-complex bacteria in periodontal disease therapy. J Periodontol 2007;78:1568-79. https://doi.org/10.1902/jop.2007.060488
  28. Madison JG 3rd, Hokett SD. The effects of different tetracyclines on the dentin root surface of instrumented, periodontally involved human teeth: a comparative scanning electron microscope study. J Periodontol 1997;68:739-45. https://doi.org/10.1902/jop.1997.68.8.739
  29. Drisko CL, Cobb CM, Killoy WJ, Michalowicz BS, Pihlstrom BL, Lowenguth RA, et al. Evaluation of periodontal treatments using controlled-release tetracycline fibers: clinical response. J Periodontol 1995;66:692-9. https://doi.org/10.1902/jop.1995.66.8.692
  30. van Steenberghe D, Rosling B, Soder PO, Landry RG, van der Velden U, Timmerman MF, et al. A 15-month evaluation of the effects of repeated subgingival minocycline in chronic adult periodontitis. J Periodontol 1999;70:657-67. https://doi.org/10.1902/jop.1999.70.6.657
  31. McColl E, Patel K, Dahlen G, Tonetti M, Graziani F, Suvan J, et al. Supportive periodontal therapy using mechanical instrumentation or 2% minocycline gel: a 12 month randomized, controlled, single masked pilot study. J Clin Periodontol 2006;33:141-50. https://doi.org/10.1111/j.1600-051X.2005.00879.x
  32. Bonito AJ, Lux L, Lohr KN. Impact of local adjuncts to scaling and root planing in periodontal disease therapy: a systematic review. J Periodontol 2005;76:1227-36. https://doi.org/10.1902/jop.2005.76.8.1227
  33. Isik AG, Tarim B, Hafez AA, Yalcin FS, Onan U, Cox CF. A comparative scanning electron microscopic study on the characteristics of demineralized dentin root surface using different tetracycline HCl concentrations and application times. J Periodontol 2000;71:219-25. https://doi.org/10.1902/jop.2000.71.2.219
  34. Sterrett JD, Simmons J, Whitford G, Russell CM. Tetracycline demineralization of dentin: the effects of concentration and application time. J Clin Periodontol 1997;24:457-63. https://doi.org/10.1111/j.1600-051X.1997.tb00212.x
  35. Stoller NH, Johnson LR, Trapnell S, Harrold CQ, Garrett S. The pharmacokinetic profile of a biodegradable controlled-release delivery system containing doxycycline compared to systemically delivered doxycycline in gingival crevicular fluid, saliva, and serum. J Periodontol 1998;69:1085-91. https://doi.org/10.1902/jop.1998.69.10.1085
  36. Kulik EM, Thurnheer T, Karygianni L, Walter C, Sculean A, Eick S. Antibiotic susceptibility patterns of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis strains from different decades. Antibiotics (Basel) 2019;8:253.
  37. Cunha BA, Baron J, Cunha CB. Similarities and differences between doxycycline and minocycline: clinical and antimicrobial stewardship considerations. Eur J Clin Microbiol Infect Dis 2018;37:15-20. https://doi.org/10.1007/s10096-017-3081-x
  38. Maze GI, Reinhardt RA, Payne JB, Maze C, Baker RA, Bouwsma OJ, et al. Gingival fluid tetracycline release from bioerodible gels. J Clin Periodontol 1996;23:1133-6. https://doi.org/10.1111/j.1600-051X.1996.tb01815.x
  39. Anderegg CR, Metzler DG. Tooth mobility revisited. J Periodontol 2001;72:963-7. https://doi.org/10.1902/jop.2001.72.7.963
  40. Kerry GJ, Morrison EC, Ramfjord SP, Hill RW, Caffesse RG, Nissle RR, et al. Effect of periodontal treatment on tooth mobility. J Periodontol 1982;53:635-8. https://doi.org/10.1902/jop.1982.53.10.635