Controlled-release periodontal chemotherapy: the evolution of antimicrobial delivery systems

Bacterial plaque contributes to the development and progression of periodontal diseases. Therefore, therapeutics designed to stop or slow periodontal destruction must limit or eliminate the deleterious effects of plaque. Despite the recognized beneficial effects of in-office surgical and nonsurgical periodontal therapies and home mechanical plaque control, antimicrobials have been used locally, systematically, or in combination to limit plaque activity. This article discusses a new, localized antimicrobial delivery method. The technique discussed employs an ethylene/vinyl acetate copolymer, containing tetracycline hydrochloride. Description of this polymeric fiber, indications for its use, placement technique, patient education, the role of auxiliaries, and practice management aspects are reviewed. The future potential of sustained-release local pharmaceutical devices is addressed.