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Rivista di Odontostomatologia e Chirurgia Maxillo-Facciale
Minerva Stomatologica 2014 Jan 14
Periodontal maintenance following scaling and root planing. A randomized single-center study comparing minocycline treatment and daily oral irrigation with water
Genovesi A. M. 1, Lorenzi C. 2, Lyle D. M. 3, Marconcini S. 4, Barone A. 5, Pardo A. 6, Rigoni G. 7, Gelpi F. 8, Covani U. 9 ✉
1 Assistant Prof. School of Dental Hygiene, University of Genoa, Italy;
2 Consultant Istituto Stomatologico Toscano;
3 Director of Professional and Clinical Affairs at Water Pik Inc., Fort Collins, CO, USA;
4 Assistant Professor, Istituto Stomatologico Toscano, Versilia General Hospital, Italy;
5 Research Fellow Department of Prosthodontics School of Dental Medicine, University of Pisa, Pisa, Italy, and Istituto Stomatologico Toscano Camaiore, Italy;
6 Dental Hygienist, Section of Dentistry and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy;
7 Section of Dentistry and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy;
8 Centro Odontostomatologico Ospedale Sacro Cuore , Don Calabria, Verona, Italy;
9 Full Professor, School of Dentistry, University of Pisa, and Istituto Stomatologico Toscano Versilia General Hospital, Italy
Objective: Trying to limit the use of antimicrobial drugs in periodontitis is a general trend. Thus, the aim of the present study was to assess the efficacy of daily water irrigation in comparison with subgingival minocycline in periodontal maintenance, in subjects with moderate to severe periodontitis. This was done by evaluating probing pocket depth (the primary outcome), other clinical parameters such as clinical attachment level, plaque index and bleeding on probing, and bacterial flora changes inside periodontal pockets.
Materials and Methods: In this single-center, parallel, single blind, randomized clinical study, thirty subjects (12 men, mean age 56 ± 2.2 years) with moderate to severe periodontitis were randomized 1:1 into a minocycline-treated group (M-group, n=15) and a water-treated group (W-group, n=15). Clinical and microbiological parameters were measured at baseline. Scaling and root planing were carried out on all subjects, then to M-group patients minocycline was administered inside the pockets. W-group subjects had instead to daily apply oral irrigation with water. Clinical and microbiological measurements were repeated after 30 days.
Results: Both water irrigation and minocycline treatment led to a significant reduction of all the clinical parameters tested at t=30 days with respect to baseline. Moreover, both procedures appeared to be able to maintain a low bacterial load inside periodontal pockets, for most of the microorganisms tested. No statistically significant differences were observed between M-group and W-group at t=30 days, concerning both clinical and microbiological parameters. However, further studies are needed to assess the long-term effect.
Conclusion: Daily oral irrigation with water showed comparable efficacy to a single administration of minocycline in periodontal maintenance subjects.