COMPARATIVE CLINICAL EVALUATION OF EFFICACY OF TETRACYCLINE AS ROOT CONDITIONING AGENT IN CONJUNCTION WITH PERIODONTAL FLAP SURGERY IN THE TREATMENT OF STAGE I/II GRADE A/B PERIODONTITIS
Main Article Content
Abstract
Introduction: Various organic and inorganic material with minute particle sizes is found which contain remnants of dental calculus, contaminated root cementum, and subgingival plaque after scaling and root planing. Various types of root biomodification agents have not only been used to remove the smear layer but also to enlarge dentinal tubules into which healing of connective tissue may be enhanced. Concentrated tetracycline solution plays a role in removing surface inorganic smear layer created on tooth surface during most dental treatment and also it may be used to expose underlying dentinal tubules.
Aim & Objective: To clinically evaluate the efficacy of tetracycline as root conditioning agent in conjunction with periodontal flap surgery in the treatment of stage I/II grade A/B periodontitis
Materials and Methods: A total of 20 systematically healthy patients diagnosed with Stage I/II Grade A/B periodontitis were randomly selected and divided into 2 groups. Group 1: 10 Patients received root conditioning agent Tetracycline as an adjunct to Periodontal flap surgery. Group 2:10 Patients were treated with periodontal flap surgery alone. Clinical parameters such as Plaque index, sulcular bleeding index, Probing pocket depth and Clinical attachment level were assessed at baseline and after 3 months of intervention.
Results: The result showed an improvement in all clinical parameters such as PI, GI, PPD and CAL in both test and control groups when measured at baseline and after 3 months. The intergroup comparison of mean changes in all parameters from baseline to 3 month reveals a significant reduction in the Group I (test group) as compared to Group II (control group).
Conclusion: It was established that root conditioning with tetracycline helped in removal of smear layer and exposure of dentinal tubules. Hence, it’s application as root conditioner has a significant role in periodontal wound healing and future new attachment.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Chandra RV, Jagetia GC, Bhat KM. The Attachment of V79 and Human Periodontal Ligament Fibroblasts on Periodontally Involved Root Surfaces Following Treatment with EDTA, Citric Acid, or Tetracycline HCL: An SEM in vitro Study. J Contemp Dent Pract 2006;7(1):044-059.
Theodoro, Haypek, Bachmann, Garcis, Sampaio et al. Effect of Er:YAG and diode laser irradiation on the root surface: Morphological and Thermal Analysis. J Periodontol 2003; 74:838-843.
Wen CR, Caffesse RG, Morrison EC, Nasjleti CE, Parikh UK. In vitro effects of citric acid application techniques on dentin surfaces. J Periodontol 1992; 63:883-889.
Blomlöf J, Blomöf LB, Lindskog SF. Smear removal and collagen exposure after non-surgical root planing followed by etching with an EDTA gel preparation. J Periodontol 1996; 67:841-845.
Lafferty TA, Gher ME, Gray JL. Comparative SEM study on the effect of acid etching with tetracycline HCL or citric acid on Instrumented periodontally involved human root surfaces. J Periodontol. 1993; 64:689–93.
Smith BA, Smith JS, Caffesse RG, Nasjteti CE, Lopatin DE, Kowalski CJ. Effect of citric acid and various concentrations of fibronectin on healing following periodontal flap surgery in dogs. J Periodontol. 1987; 58:667–73.
Blomlof J, Lindskog S. Periodontal tissue-vitality after different etching modalities. J Clin Periodontol. 1995; 22:464–8.
Madison JS, Hokett SD. The effect 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.
Sik AG, Tarim B, Hafez AA, Yalçin 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(2):219-25.
Alger FA, Solt CW, Vuddhakanok S, Miles K. The histologic evaluation of new attachment in periodontally diseased human roots treated with tetracycline hydrochloride and fibronectin. J Periodontol. 1990; 61:447-455.
Victor P. Terranova, Louis C. Franzetti, Susanne Hic, Roberta M. Diflorio, Raymond M. Lyall, Ulf M. E. Wikesjo, et al. A biochemical approach to periodontal regeneration: Tetracycline treatment of dentin promotes fibroblast adhesion and growth. Journal of Periodontal Research. 1986;21(4):330–337.
Shetty B, Dinesh A, Seshan H. Comparative effects of tetracyclines and citric acid on dentin root surface of periodontally involved human teeth: A scanning electron microscope study. J Indian Soc Periodontol. 2008;12(1):8-15.
Labahn, R, Fahrbach, WH, Clark, SM, Lie, T, Adams, TF. Root Dentin Morphology After Different Modes of Citric Acid and Tetracycline Hydrochloride Conditioning. J Periodontol 1992; 63:303-309.
Minabe, M, Takeuchi, K, Kumada, H, Umenoto, T. The effect of root conditioning with minocycline HCL in removing endotoxin from the roots of periodontally involved teeth. J Periodontol 1994; 65:387-392.
Scwach-Abdellaoui K, Vivien-Castioni N, Gurny R. Local delivery of antimicrobial agents for the treatment of periodontal diseases. Eur J Pharmaceut Biopharmaceut 2000;83-99
Trombelli L, Scabbia A, Scapoli C, Calura G. Clinical effect of tetracycline demineralization and fibrin-fibronectin sealing system application on healing response following flap debridement surgery. J Periodontol. 1996;67(7):688-93.
Sutamaya, Agus & Hendiani, Ina & Susanto, Agus. (2016). Clinical evaluation of adjunctive topical therapy HCl 25 mg in surgical periodontal flap. Padjadjaran Journal of Dentistry. 28. 10.24198/pjd.vol28no2.13724.