ABSTRACT
AIM: The aim of this study was to investigate a rapid spectrophotometric assay for its potential to measure tetracycline levels in gingival crevicular fluid (GCF). MATERIALS AND METHODS: The technique involves complexation of tetracycline with molybdenum in order to shift the absorbance spectrum away from that region where interference with plasma proteins is a problem. The sensitivity of the assay and reproducibility of elution were examined together with an assessment of the effect of plasma proteins. The assay was also tested in a small pilot clinical project, measuring tetracycline levels in GCF following placement of a test gel formulation in 25 periodontal pockets in 5 patients. RESULTS: The in vitro results showed good sensitivity of the assay over the concentration range tested (0.5-200 microg tetracycline) and with little effect of plasma proteins. Elution from the paper strips was reproducible with a good linear correlation between direct and filter absorbed assays (r=0.9989, p<0.01). The pilot clinical study indicated a mean half-time of tetracycline in GCF of 28 min with confidence intervals of 21 to 34 min, although wide variation between the drug levels of individual periodontal pockets was seen. CONCLUSIONS: The results indicate good sensitivity for this assay to measure tetracycline hydrochloride in vivo. The potential for rapidly processing large numbers of samples contrasts with the assay time and limited sample throughput of other methods such as high pressure liquid chromatography (HPLC) and suggests that the technique may be a useful addition to current techniques for measuring tetracycline hydrochloride in vivo.
Subject(s)
Anti-Bacterial Agents/analysis , Gingival Crevicular Fluid/chemistry , Spectrophotometry/methods , Tetracycline/analysis , Blood Proteins/chemistry , Calibration , Humans , Linear Models , Molybdenum/chemistry , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Since last reviewing the field, controlled release products have made the jump from research to clinical practice. The potential to extend the efficacy of periodontal therapy with such products is exciting, but also needs careful evaluation. This review will look at recent developments and also will examine the eventual place for these products in periodontics.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Drug Delivery Systems , Periodontitis/drug therapy , Anti-Bacterial Agents/therapeutic use , Delayed-Action Preparations , Gels , Humans , Metronidazole/therapeutic use , Minocycline/therapeutic use , Patient Care Planning , Patient Selection , Periodontal Pocket/drug therapy , Polyvinyls/therapeutic use , Root Planing , Tetracycline/therapeutic useABSTRACT
Controlled release devices containing tetracyclines or metronidazole are now commercially available for use in periodontal pockets. This review, in two parts, evaluates the evidence for and against using antibiotics in the treatment of periodontitis and considers the role for systemic and local delivery. Guidelines for antibiotic usage and recommended regimes are proposed.
