Tetracycline-loaded fibers as adjunctive treatment in periodontal disease
This paper reports the results from one clinical practice that participated in an open-label evaluation on the effectiveness of the tetracycline fibers and an adjunctive treatment to scaling and root planing in patients with refractory sites. Researchers took 66 adults, mean age of 52.8 years, who had at least 4 mm pockets that bled on probing and had received active, nonsurgical, or surgical treatment. Each of the patients received S/Rp prior to fiber placement. The TCN fibers were then inserted in the pockets until the pocket was full. Cyanoacrylate adhesive was used to maintain the fiber in place. The fibers were removed after 7 to 12 days. Clinical parameters, pocket depth, and BOP were assessed at baseline, 1, 3, and 6 months after treatment. Their results showed an overall mean pocket depth reduction from 8.2 mm to 2.8 mm from baseline to 6 months. Deep sites exhibited more reduction, 3 mm, and moderated sites had 1.5 mm. Molar depth was reduced by 5.5 mm and incisor decreased by 4.4 mm. Multirooted teeth improved to the same extent as single-rooted teeth. Bleeding on probing also improved from 92% at baseline to 24% after one month and 37% after six months. Researchers also noted some adverse effects such as swelling redness, and itching on the face, and sensitivity in the mouth. The symptoms subsided when the fiber was removed. Fiber length and insertion were longest for molars (11.5 min.) and shortest for incisors (7.2 min.). Because the study did not involve a control group, its results can only serve as a clinical endorsement of adjunctive fiber therapy in arresting refractory disease. [M.C.R.]
Kerry, G., JADA, 125:1199,1994