W7-Local Antimicrobials.pdf

14.11.2023 Locally Delivered, Controlled Release Antimicrobials Assisst. Prof. Ece RAKUNT TOPTAŞ School of Dental Medicine Department of Periodontology Istanbul [email protected] 1 Resources Newman and Carranza`s Clinical Periodontology Newman Takei Klokkevold Carranza Chapter 53 2 1...

14.11.2023 Locally Delivered, Controlled Release Antimicrobials Assisst. Prof. Ece RAKUNT TOPTAŞ School of Dental Medicine Department of Periodontology Istanbul [email protected] 1 Resources Newman and Carranza`s Clinical Periodontology Newman Takei Klokkevold Carranza Chapter 53 2 1 14.11.2023 Locally Delivered, Controlled Release Antimicrobials ØThe aim of controlled-release delivery systems is to deposit antimicrobials directly into the periodontal pocket ØMaintain effective concentrations of drug for an extended period ØThey are used adjunct therapy to SRP to make it more effective 3 4 2 14.11.2023 Chlorhexidine Chip The chlorhexidine chip contains 2.5 mg of the active ingredient chlorhexidine gluconate in a resorbable, biodegradable matrix of hydrolyzed gelatin 5 Chlorhexidine Chip ØAfter placement in the pocket, chip releases chlorhexidine into the GCF over 7 to 10 days ØThe chip is biodegradable and does not require removal ØBut dental floss should be avoided for 10 days to avoid dislodging Biodegradable means things that can be disintegrated by bacteria 6 3 14.11.2023 Doxycyline Gel Doxycyline gel is two syringe mixing system, after mixing the gel cannula is attached for injection Mixed product is a viscous liquid of 500 mg, which contains 50 mg of doxycycline hyclate 7 Doxycyline Gel ØThe gel releases doxycycline in the GCF over 7 days ØIt is biodegradable and does not require removal ØThe pockets are then covered with periodontal dressing 8 4 14.11.2023 Minocycline Microspheres Minocycline microspheres are packaged into unit-dose cartidges. Each cartridge delivers minocycline hydrochloride equals to 1 mg of minocycline free base 9 Minocycline Microspheres Ø Patients should avoid hard or sticky food for 1 week and interproximal cleaning for 10 days Ø It is biodegradable and does not require removal Ø They are used by injecting the contents of a unit-dose catridge into the pocket Ø Periodontal dressing is not necessary 10 5 14.11.2023 Non-US Locally Delivered Antimicrobials Chlorhexidine Based Products Tetracycline Based Products Doxycycline Based Products PerioCol-CG PerioCol-TC Ligosan Slow Release Chlo Site Periodontal Plus AB 11 Benefits of Locally Delivered Antimicrobials Adverse Effects and Cautions for Use ØDecreased systemic, side effects Ø Hypersensitivity reactions ØDecreased risk for promoting microbial resistance Ø Overgrowth of opportunistic microorganisms ØHigher concentrations of active antimicrobials can be achieved Ø Pregnancy Ø Discoloration during tooth development (tetracycline) Ø Use in an acute abscess Ø Use of oral hygiene procedures (interdental cleaning) for 7-10 days 12 6 14.11.2023 Thank you for listening 13 7