[A biocompatibility study and the effects of slow-release antibiotic materials in the treatment of periodontal disease. I. The biocompatibility of cellulose acetate charged with 25% tetracycline hydrochloride. A clinical and scanning microscopic study of a case]. / Studio sulla biocompatibilità e gli effetti di alcuni materiali a lento rilascio di antibiotico nel trattamento della malattia parodontale. Nota I. Biocompatibilità dell'acetato di cellulosa caricato con il 25% di tetraciclina cloridrato. Studio clinico e al microscopio a scansione di un caso.

A clinical and microscopical (SEM) investigation has been carried out on the biocompatibility of cellulose acetate fiber tetracycline with 25% of tetracycline hydrochloride (Actisite R). A subject with advanced periodontal disease was selected and a pocket of 8 mm of PD was chosen. A segment of fiber was inserted into the pocket for 8 days. After removal, PD and GI clinical parameters were detected and the fiber removed was analyzed at the scanning electronic microscope. The results showed clinical signs of inflammation after removal of fiber. SEM analysis showed macrophagic reaction, a typical sign of inflammatory response to material. The study suggests the need of more biocompatible materials, easier to use as delivery system of antibiotics in the treatment of periodontal disease.

[A biocompatibility study and the effects of slow-release antibiotic materials in the treatment of periodontal disease. II. The biocompatibility and behavior of polyhydroxyethyl methacrylate (pHEMA) as a slow-release material for tetracycline of metronidazole. A study of 2 cases]. / Studio sulla biocompatibilità e gli effetti di alcuni materiali a lento rilascio di antibiotico nel trattamento della malattia parodontale. Nota II. Biocompatibilità e comportamento del poliidrossietilmetacrilato (pHEMA) come materiale a lento rilascio di tetraciclina o di metronidazolo. Studio su due casi.

The study analyses the possibility of using polyhydroxyethyl methacrylate as a material for the slow release of antibiotic in periodontal pockets. The antibiotics examined were tetracycline and metronidazole. The aim of the study was to evaluate the biocompatibility of the material with periodontal tissue and the efficacy of the 2 prepared systems. Two sites were selected in 2 periodontopathic patients who after non-surgical treatment presented pockets measuring 8 and 7 mm. A sheet of pHEMA containing tetracycline was inserted in one and in the other a sheet containing metronidazole: both were left for 8 days in the chosen pockets. At the start and end of treatment PD and GI clinical indices were measured and the DMDx microbiological test was performed to identify Aa of Pg and Pi. The tissue reaction to pHEMA was evaluated using SEM analysis of two samples collected after 8 days of treatment. The microscopic results showed the optimal biocompatibility of both samples. Differences were noted with regard to clinical and microbiological efficacy. It was observed that the sheet of pHEMA containing tetracycline resulted in the disappearance of bleeding and a reduced depth of survey. Moreover, microbiological results showed a significant reduction in Porphyromonas gingivalis. The sheet of pHEMA containing metronidazole showed a lower level of therapeutic efficacy. Although reduced depth was noted, gingival bleeding was persistent and the reduction of bacteria analysed was not significant. In conclusion, the authors confirm the optimal biocompatibility of the material and its easy application, although further research, especially for pHEMA with metronidazole, must be carried out to improve drug kinetics, trying to maintain an effective local concentration throughout treatment.

Effects of sodium polystyrene sulfonate on gingival plaque: microbiological investigation and clinical follow-up.

A new antiplaque agent was tested on nine subjects. The antiplaque agent, a 5% aqueous solution (p/v) of sodium polystyrene sulfonate, applied on the tooth surfaces by daily topical application for two weeks, caused a statistically significant 30% reduction of plaque index (PI), with corresponding reduction of total bacteria and qualitative modifications of plaque formation with reduction of Gram-negative bacteria.