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The microbiological case for adjunctive therapy for periodontitis.

Roy C Page1

  • 1Regional Clinical Dental Research Center, Health Sciences Bldg., Rm. B-530, University of Washington, Seattle, WA 98195, USA. roypage@u.washington.edu

Journal of the International Academy of Periodontology
|November 13, 2004
PubMed
Summary

Locally delivered antimicrobial agents, such as doxycycline and chlorhexidine, significantly improve chronic periodontitis treatment outcomes. These therapies, when used alongside scaling and root planing, enhance clinical attachment and reduce pocket depth for more stable periodontal health.

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Area of Science:

  • Periodontology
  • Microbiology
  • Pharmacology

Background:

  • Chronic periodontitis is an infectious disease primarily caused by specific bacteria like Porphyromonas gingivalis.
  • Mechanical treatments (scaling, root planing, surgery) improve symptoms but may not prevent disease recurrence.
  • Persistent pathogenic bacteria in subgingival sites hinder long-term stability after mechanical therapy.

Purpose of the Study:

  • To evaluate the efficacy of locally delivered antimicrobial agents as an adjunct to mechanical periodontal therapy.
  • To determine if adjunctive antimicrobial therapy enhances clinical outcomes and long-term stability in chronic periodontitis patients.

Main Methods:

  • Review of randomized clinical trials on locally delivered antimicrobial devices (e.g., Atridox, Arestin, PerioChip).

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  • Comparison of outcomes between mechanical therapy alone and mechanical therapy combined with local antimicrobial delivery.
  • Assessment of key periodontal parameters including pocket depth reduction and clinical attachment level gain.

    • Main Results:

    • Adjunctive local antimicrobial therapy significantly enhances clinical outcomes compared to mechanical therapy alone.
    • These therapies lead to a greater reduction in periodontal pocket depth.
    • An average increase in clinical periodontal attachment level of approximately 0.8 mm was observed, with greater gains in deeper pockets.

    Conclusions:

    • Locally delivered antimicrobial therapy is an effective adjunctive treatment for chronic periodontitis.
    • This approach improves therapeutic outcomes by reducing pocket depth and increasing clinical attachment.
    • Enhancing mechanical therapy with local antimicrobials contributes to better long-term periodontal stability.