Clinical Efficacy of Subgingivally Delivered 0.5% Controlled Release Clarithromycin Gel in the Management of Chronic Periodontitis
Background: Main indication of adjunctive use of local antimicrobials lie around situations where the outcome of non-surgical mechanical treatment results in limited number of residual pockets. Purpose of this investigation was to evaluate clinical effect of subgingival application of 0.5% clarithromycin gel adjunctive to scaling and root planing (SRP) in management of localized chronic periodontitis.
Materials and method: Thirty sites in patients with chronic periodontitis were categorized randomly into two treatment groups: Scaling and Root Planing (SRP) plus 0.5% clarithromycin gel and SRP only. Clinical evaluation was undertaken using gingival index of Loe and Silness and plaque was assessed using the Turesky et al modification of Quigley Hein Index at baseline, 15 days and 1 month. Pocket probing depth and clinical attachment level were also measured using customized acrylic stents.
Result: Both therapies resulted in significant clinical improvements. Gingival index, probing depth and relative attachment level showed significantly better reduction in CLM group than in the control group. Plaque index also reduced in both the groups but the difference was not statistically significant between the groups.
Conclusion: Although both treatment strategies seem to benefit patients, the adjunctive use of 0.5% clarithromycin showed significant results with respect to clinical parameters.
Highfield J. Diagnosis and classification of periodontal disease. Aust Dent J. 2009;54:S11-S26.
Haffajee AD, Socransky SS. Microbial etiological agents of destructive periodontal disease. Periodontol 2000. 1994;5:78-111.
Moore JWEC, Moore LVH. The bacteria of periodontal diseases. Periodontol 2000. 1994;5:66-77.
Baehni PC. Supportive care of the periodontal patient. Curr Opin Periodontol. 1997:151e157.
Ximenez-Fyvie LA, Haffajee AD, Socransky SS. Comparison of the microbiota of supragingival and sub-gingival plaque in health and periodontitis. J Clin Periodontol. 2000;27:648-657.
Drisko CH. Non-surgical periodontal therapy. Periodontol 2000. 2001;25:77-88.
Haffajee AD, Socransky SS, Gunsolley JC. Systemic antiinfective perio therapy. Ann Periodontal. 2003;8:115-181.
Goodson JM, Haffajee A, Socransky SS. Periodontal therapy by local delivery of tetracycline. J Clin Periodontol. 1979;6:83-92.
Garrett IR, Gutierrez G, Mundy GR. Statins and bone formation. Curr Pharm Des. 2001;7:715-736.
Greenstein G. Clinical significance of bacterial resistance to tetracyclines in the treatment of periodontal diseases. J Periodontol. 1995;66:925-932.
Moore PA. Dental therapeutic indications for the newer longacting macrolide antibiotics. J Am Dent Assoc. 1999;130:1341-1343.
Jain R, Danziger LH. The macrolide antibiotics: a pharmacokinetic and pharmacodynamic overview. Curr Pharm Des. 2004;10:3045-3053.
Pradeep AR, Kathariya R. Clarithromycin, as an adjunct to non surgical periodontal therapy for chronic periodontitis: a double blinded, placebo controlled, randomized clinical trial. Arch Oral Biol. 2011 Oct;56:1112-1119.
Shah NH, Railkar AS, Chen FC, Tarantino R, Kumar S, Murjani M. A biodegradable injectable implant for delivering micro and macromolecules using poly (lactic-co-glycolic) acid (PLGA) copolymers. J Control Release. 1993;27:139-147.
Turesky S, Gilmore ND, Glickman I. Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol. 1970;41:41-43.
Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21:533-551.
Agarwal E, Pradeep AR, Bajaj P, Naik SB. Efficacy of local drug delivery of 0.5% clarithromycin gel as an adjunct to nonsurgical periodontal therapy in the treatment of current smokers with chronic periodontitis: a randomized controlled clinical trial. J Periodontol. 2012 Sep;83:1155-1163.
Chou CH, Walters JD. Clarithromycin transport by gingival fibroblasts and epithelial cells. J Dent Res. 2008;87:777-781.
Burrell RC, Walters JD. Distribution of systemic clarithromycin to gingiva. J Periodontol. 2008;79:1712-1718.
Bajaj P, Pradeep AR, Agarwal E, Kumari M, Naik SB. Locally delivered 0.5% clarithromycin, as an adjunct to nonsurgical treatment in chronic periodontitis with well-controlled type 2 diabetes: a randomized controlled clinical trial. J Investig Clin Dent. 2012 Nov;3:276-283.
Kathariya R, Pradeep AR, Raghavendra NM, Gaikwad R. Evaluation of subgingivally delivered 0.5% clarithromycin as an adjunct to nonsurgical mechanotherapy in the management of chronic periodontitis: a short-term double blinded randomized control trial. J Investig Clin Dent. 2014 Feb;5:23-31.
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