Periodontitis Clinical Trial
Official title:
Effects of Local Minocycline Adjunctive Application in Comparison to Instrumentation Alone, in Patients With Residual Pockets Under Supportive Periodontal Therapy: a Double-blinded Randomized Controlled Clinical Trial
The aims of the present study are to assess the significance of the adjunctive effect of the subgingival application of a 2% minocycline hydrochloride controlled-delivery system (MHS) in comparison to subgingival instrumentation with application of a placebo gel, 3 months after therapy in subjects with recurrent periodontitis undergoing supportive periodontal therapy (SPT) and to assess the substantivity of the gel attributable to the adjunctive delivery of the medication that is detected at 3 months during a 9-month period of regular SPT. Recurrent periodontitis will be defined as sites with residual periodontal probing depths and bleeding on probing after completion of initial periodontal therapy. This will include both persistent and recurrent periodontitis, where persistent means the residual periodontal site after initial periodontal therapy, and recurrent means the site which was improved by initial periodontal therapy, but disease recurred.
It has been reported that regular maintenance of subjects with treated periodontal disease is
the key consideration in the long-term periodontal prognosis of these subjects. Periodic
prophylaxis may prevent loss of clinical attachment over long periods of time even in
patients with less than optimal plaque control. However, there are limitations in routine
subgingival re-instrumentation especially in bleeding pockets, as only 50% of these sites
improve. Furthermore, the persistence of bleeding pockets increases the risk of disease
progression and tooth loss. Thus there is a need for adjuncts that may improve the outcome
especially in subjects with recurrent periodontitis during SPT. Some studies reported
significantly better results with subgingival administration of local minocycline in residual
pockets post initial periodontal therapy over a short period of time. There are few studies
assessing the efficacy of topical minocycline gel in subjects with recurrent periodontitis
while in SPT, and the long term effect.
The present study will examine the significance of the adjunctive effect of the subgingival
application of a 2% minocycline hydrochloride controlled-delivery system (MHS) in comparison
to subgingival instrumentation with application of a placebo gel, 3 months after therapy in
subjects with recurrent periodontitis undergoing supportive periodontal therapy (SPT) and to
assess the substantivity of the gel attributable to the adjunctive delivery of the medication
that will be detected at 3 months during a 9-month period of regular SPT.
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