A comparative scanning electron microscopic study on the characteristics of demineralized dentin root surface using different tetracycline HCl concentrations and application times.

BACKGROUND: The use of demineralizing agents has been reported to enhance the degree of connective tissue attachment to denuded roots. Of the agents used, tetracycline HCI has received the most attention. METHODS: The purpose of this study was to evaluate and compare the SEM surface morphology of human root dentin following various concentrations and application times of tetracycline HCl. The surface characteristics were compared and the width of dentin tubule orifices were measured and analyzed. Twelve human teeth were collected and stored in distilled water after soft tissue removal using hand instruments. The apical third of each root was removed and remaining mid-root region was sectioned longitudinally through the root canal following removal of its cementum with a fine diamond bur. A total of 48 dentin specimens were randomly divided into 8 groups for conditioning at different tetracycline HCl concentrations, at 0, 10, 25, 50, 75, 100, 125, and 150 mg/ml. Application times for each group were 1, 3, and 5 minutes. Immediately following treatment procedures, the specimens were rinsed, fixed in GTA-PBF, dehydrated, and prepared for SEM. Each specimen was examined at 2 magnification values, representative fields photographed, and data tested by one-way ANOVA and paired t test statistical analysis. RESULTS: Our results indicate that the use of tetracycline HCl solution between 50 mg/ml and 150 mg/ml showed a statistically significant opening of dentin tubules. All tetracycline HCl groups at 1, 3, and 5 minutes show smear layer removal from the dentin surface. CONCLUSIONS: Dentin demineralization is not time dependent at all concentrations of tetracycline HCI.

Release kinetics of 25% tetracycline hydrochloride-loaded ethylene vinyl acetate fibers.

In situ release kinetics of 25% tetracycline-loaded fibers (Actisite) were evaluated in this study. 1 cm precut tetracycline fibers were removed from periodontal pockets (>5 mm) of 24 patients. Fibers were maintained at their site for 1, 3, 7, 10 and 12 days. Remaining biologically active tetracycline on the fibers was determined by agar diffusion inhibition assay. Inhibition zones induced by fibers on P. gingivalis (256) seeded BHI agar were measured after 48 hours of anaerobic incubation. Data were evaluated by one-way analysis of variance with Post-hoc Duncan analysis. Results of this study show there is a considerable decrease in the amount of tetracycline remaining in the fibers removed between 1-3 and 10-12 days. The amount of active drug remaining in the fibers at days 3 and 7 was comparable and indicates no significant deposition between these two days.

Evaluation of adjunctive tetracycline fiber therapy with scaling and root planing: short-term clinical results.

The purpose of this single-blind, randomized study was to evaluate the clinical efficacy of slow-release tetracycline fibers as an adjunct to initial periodontal therapy in moderate to advanced periodontitis patients who had no periodontal treatment before. A group of 17 patients with at least two sites in each quadrant with probing pocket depths > 5 mm that bled on probing were included in the study. After scaling and root planing, each selected site was randomly assigned to one of two treatment groups: tetracycline fiber therapy and control group. Plaque index, gingival index, bleeding on probing, probing pocket depth, and clinical attachment level were measured at baseline and at 1, 3, and 7 weeks. The change from the baseline of each measurement was studied using analysis of variance with subject and treatment effects and a baseline covariate. Results of this investigation demonstrated that tetracycline fiber treatment as adjunct to scaling and root planing is effective in regard to probing pocket depth reduction and bleeding on probing. On the other hand, fiber application seems to have no beneficial effect on gain of clinical attachment level within limits of this study.

Comparative SEM study on the effect of different demineralization methods with tetracycline HCl on healthy root surfaces.

Periodontal regeneration through the use of root demineralization received a lot of interest in periodontology. Topical application of acid to dentin surfaces produced a zone of demineralization, exposing dentin collagen fibrils and opening dentin tubules. In this study, the in vitro effects of different tetracycline HCl application techniques were investigated. According to the results of this SEM study, it may be desirable to apply tetracycline HCl using burnishing technique to expose maximum intertubular fibrils and for the tubular openings. However, this technique should be studied when placed in an in vivo system.

Human papillomavirus in a patient with severe gingival overgrowth associated with cyclosporine therapy. A case report.

Cyclosporin a is an endecapeptide that has been used clinically since 1978 as an immunosuppressant agent. Although cyclosporine appears to be uniformly beneficial in the treatment of a wide variety of disorders, its use may result in a number of side effects. One of the most important adverse effects is gingival overgrowth. This report relates a case of severe gingival overgrowth in a 31-year-old female who had received cyclosporine therapy in conjunction with a kidney transplant. Because of the severe gingival overgrowth, we analyzed a biopsy, which was positive for human papillomavirus. The case was treated and followed for 18 months.

The relationship between clinical attachment loss and the duration of insulin-dependent diabetes mellitus (IDDM) in children and adolescents.

The periodontal status of 77 diabetic children and adolescents, and 77 paired, systemically-healthy, sex- and age-matched control subjects, was clinical examined. Fasting blood glucose, fructosamine and glycosylated haemoglobin (HbA1) values were determined. The mean periodontal pocket depths, clinical attachment levels and the parameters to assess diabetes mellitus from the diabetic group were significantly higher than those of the controls. We found a positive correlation between the duration of diabetes and clinical attachment loss, but not with periodontal probing depth, plaque index and gingival index in the diabetic group. A positive correlation was also assessed between the present serum fructosamine and gingival index in the diabetic group, but not in controls.

Infantile genetic agranulocytosis (Kostmann type). A case report.

Severe periodontitis in a patient with infantile genetic agranulocytosis (Kostmann syndrome) is presented. This rare syndrome is inherited as an autosomal recessive pattern and characterized by severe neutropenia. The periodontal status and treatment of the patient is described. It is concluded that periodontal therapy including scaling, root planning, soft tissue curettage, and the use of selected antimicrobial agents can be successful in this particular syndrome.

Antioxidative activities of some chemotherapeutics. A possible mechanism in reducing gingival inflammation.

Inflammatory periodontal diseases are related to dental plaque formation. Increase in the perfusion of the inflamed tissue results in increased oxygen supply. Although oxygen has healing effects, it is bound to be a mediator of peroxidation in biological membranes. Chemotherapeutic agents such as chlorhexidine, listerine, sanguinarine, and cetylpridinium chloride and oral antibiotics such as tetracycline HCl and doxycyline were tested for their antioxidative activities. While doxycycline has the highest antioxidant activity in lower volumes (0.1 ml), sanguinarine, listerine and a pace after them, tetracycline HCl, had similar effects in higher volumes (0.3 and 0.4 ml). The results showed that in addition to their antiseptic or antimicrobial effects, these preparations have an antioxidative activity against spontaneous oxidation.

Serum fructosamine correlates with gingival index in children with insulin-dependent diabetes mellitus (IDDM).

Fructosamine assay, which is used in diagnosing and monitoring diabetic patients, is compared with the hemoglobin and plasma glucose assays in children and adolescent insulin-dependent diabetes mellitus patients. We demonstrated that the gingival index scores were correlated with fructosamine values in insulin-dependent diabetes mellitus patients but not in non-diabetic controls. We also found that there was no correlation between gingivitis scores and fasting plasma glucose and HbA1c values. Periodontitis was found to be rare in diabetic children and adolescents.