ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Adjunctive use of minocycline with traditional non-surgical periodontal therapy in patients with chronic periodontitis produces increased attachment
Clinical Question Does scaling/root planing plus locally delivered minocycline gel provide a greater increase in attachment level compared to scaling/root planing alone in patients with Chronic Periodontitis?
Clinical Bottom Line Locally delivered minocycline gel in addition to scaling/root planing provides a greater reduction in attachment loss and probing depth than scaling/root planing alone. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15613075Lu/200515 patients with chronic periodontitis, age 33-62 (mean 43 years); 78 periodontal pockets with a mean probing depth of 5 mmRandomized Controlled Trial
Key resultsCompared to the control sites, sites receiving minocycline showed significant reduction in probing depth and gingival index (p < 0.05) and reduced interleukin 1B levels (p < 0.01) at 10, 14, and 18 weeks, and a more significant attachment gain (p < 0.05) at 14 and 18 weeks.
Evidence Search "Root Planing"[Mesh] AND "Minocycline"[Mesh] AND Clinical Trial[ptyp]
Comments on
The Evidence
A split-mouth technique was used in this study. In sites receiving treatment, the minocycline gel was applied to the bottom of the pocket and withdrawn in a zigzag motion until the gel flowed over the gingival margin. The study authors concluded that “gingival crevicular fluid is relatively isolated from saliva,” and thus the antibiotic effect was not carried over from the minocycline treated half of the mouth to the untreated part of the mouth.
Applicability Adult patients with chronic periodontitis and pocket depths of at least 5 mm. Minocycline is not currently available in the U.S. in a gel form; however, minocycline is available in sustained release microspheres for subgingival use.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Chronic Periodontitis, Minocycline, Scaling and Root Planing, Attachment Loss
ID# 512
Date of submission: 01/13/2010spacer
E-mail kartaltepe@uthscsa.edu
Author Christen Kartaltepe
Co-author(s) Gregory C. Millar
Co-author(s) e-mail
Faculty mentor/Co-author
Faculty mentor/Co-author e-mail
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Amar Patel (San Antonio, Texas) on 05/07/2012
After conducting a search on PubMed regarding this topic on April 2012, I found a more recent publication: PubMed ID 16460239. There were 26 individuals who took part in this RCT and produced the same results which adds further documentation for this CAT.
by Shannan Johnson (San Antonio, TX) on 07/13/2011
After conducting a new MeSH search using the terms “Root Planing”[MeSH] AND “Minocycline”[MeSG] and limiting to clinical trial/meta-analysis/RCT, only one new study was available specifically concerning locally applied minocycline gel (additional studies available regarding minocycline microspheres). New study was a randomized clinical trial involved 40 patients who had already completed the active phase of periodontal therapy. Minocycline gel was applied to sites with persisting probing depths > or = 5mm in patients randomly assigned to test group, along with continued ScRP. Control group patients received ScRP only. Following the follow-up period, probing depths, plaque index, and bleeding scores were decreased in all patients, with no difference noted between control group and patients that received adjunctive minocycline gel. (McColl E, Patel K et al. Supportive periodontal therapy using mechanical instrumentation or 2% minocycline gel: a 12 month randomized, controlled, single masked pilot study. J Clin Periodontol 200g Feb;33(2):141-150).
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