Clinical efficacy of subgingivally delivered 0.5% controlled release azithromycin gel in the management of chronic periodontitis.

Background: Recent developments suggest that the local delivery of antimicrobials into periodontal pockets can improve periodontal health. Azithromycin (AZM) has a wide antimicrobial spectrum of action toward anaerobic bacteria as well as Gram-negative bacilli. It is effective against periodontal pathogens such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Therefore, this study was undertaken to investigate the clinical effectiveness of AZM at 0.5% concentration in an indigenously prepared bioabsorbable controlled release gel as an adjunct to non-surgical mechanical therapy in the treatment of chronic periodontitis. Materials and Methods: Thirty sites in patients with chronic periodontitis and probing depth (PD) 4-6 mm were categorized randomly into two treatment groups: Scaling and root planing (SRP) plus 0.5% AZM gel (group 1) and SRP only (group 2). Clinical evaluation was undertaken using the Gingival Index (GI) of Loe and Silness and plaque was assessed using the Turesky et al. modification of Quigley Hein Index at baseline and 21 days. Pocket PD and clinical attachment level (CAL) were also measured. Statistical Analysis: Results were expressed as mean ± standard deviation and percentages and the data were analyzed using Statistical Package for Social Sciences (SPSS version 16.0, SPSS, Chicago, IL) software. Result: Both therapies resulted in significant improvements. Mean reduction in GI from baseline to 21 days was 1.20 ± 0.41 and 0.73 ± 0.45 in group 1 and group 2, respectively. Plaque Index also improved through the study period in both groups, i.e., 0.86 ± 0.51 in group 1 and 1.6 ± 0.97 in group 2. Mean PD reduced significantly with SRP plus AZM gel application in group 1, i.e., 2.1 ± 0.91 mm as compared to 1.0 ± 1.06 mm achieved with SRP alone. A significant gain in mean CAL gain was observed in the test group (1.8 ± 0.63 mm) as compared to control group (1.0 ± 1.06 mm). Conclusion: Although both treatment strategies seem to benefit patients, the adjunctive use of 0.5% of AZM showed significant results.

Healing of periodontal flaps when closed with silk sutures and N-butyl cyanoacrylate: a clinical and histological study.

BACKGROUND: The closure of the periodontal flaps post-surgery is a necessity for attainment of a primary union between the flap margins and the establishment of a healthy dentogingival junction. N-butyl cyanoacrylate is a tissue adhesive, which can be used for the closure of the incised wounds to overcome the problems associated with conventional suture materials like silk. OBJECTIVE: The present study was carried out to assess the healing of the periodontal flaps when closed with the conventional silk sutures and N-butyl cyanoacrylate. MATERIALS AND METHODS: The study was carried out on 24 patients who needed flap surgical procedure for pocket therapy. RESULTS: It was found that healing with the cyanoacrylate is associated with less amount of inflammation during the first week when compared with silk. However, over a period of 21 days to 6 weeks, the sites treated with both the materials showed similar healing patterns. CONCLUSION: It can be concluded that cyanoacrylate aids in early initial healing.