Evaluation of Different Local Drug Delivery Systems in Treatment of Periodontitis: An Institutional Study

Abstract

Periodontal disease can be treated in both non-surgical and surgical therapy. There could be a possible reason why non-surgical therapy causes failure due to bacteria virulent factors and also the depth of periodontal pocket is greater than the instrumentation available, drug concentration is low in GCF as well as in saliva. To overcome this problem a treatment protocol that would include short-term usage of systemic and or local antimicrobial agents is being tried as an adjunct to mechanical therapy in treatment of periodontal diseases. A total of 540 sites, from 72 patients in different quadrants of the mouth received these treatment modalities in assigned quadrants such as scaling and root planning using both hand and ultrasonic instruments under local anesthesia (if required), combination therapy and local drug delivery alone. Patients with periodontal diseased sites were divided into five groups, based on the local drug delivery system, as Group I: Elyzol (25% Metronidazole), Group II: Dentomycin (2% Minocycline hydrochloride), Group III: Metrogene (5% Metronidazole), Group IV: Periochip (2.5mg of Chlorhexidine gluconate) and Group V: Atridox (10% Doxycycline hyclate). In the present study, the bleeding index score showed better reduction, for all LDD systems. The results showed that SRP alone, and LDD alone had shown no significance in overall reduction of pocket depth where clinical parameters (Plaque Index, Gingival Bleeding Index and Gingival Index). Although the combined treatment of scaling and root planing plus the local drug therapy reported to have a significant benefit over SRP alone in the treatment of periodontal lesions. Keywords: Anti-Bacterial Agents, Metronidazole, Minocycline, Doxycycline, Chlorhexidine, Local Drug Delivery Systems, Humans, Periodontitis, Periodontal Pocket, Root Planing