It had been tried to combine substances that, after a single application in the periodontal pocket, release antimicrobial substance gradually and in a prolonged manner. This may enhance the success of root planing and curettage.
After a pretreatment with clindamycin (Antirobe ®, Cleorobe®), Pharmacia) a professional tooth cleaning including removal of plaque and tooth scale, polishing and curettage of the periodontal pockets was performed. After assessment of the gingivitis index and the amount of gingival crevicular fluid, probing depth and attachment loss were determined by means of a pressure-calibrated (15 g), electronic periodontal probe which had a reading-accuracy of 0.2 mm. Then, the periodontal pockets of the teeth 204, 208, 304 and 309 were filled with the doxycycline-containing perioceutic Doxirobe® (Pharmacia).
Compared to the base value, the gingivitis index of the side treated additionally with Doxirobe® was reduced by 49 % (p= 0.17) and the amount of gingival crevicular fluid was reduced by 37 % (p= 0.001), pocket depth was reduced by 35 % (p= 0.001) and attachment loss was reduced by 38 % (p= 0.001). Shallow pockets (< 2 mm) were reduced after 12 weeks by 13 % (p= 0.04), medium-sized pockets (2 - 4 mm) were reduced by 32 % and deep pockets (> 4 mm) were reduced by 53 % (p= 0.001). After 12 weeks, the amount of subgingivally harvested bacteria which was statistically highly significantly lower compared to the control side, was 25565.00 +/- 9867.18 CFU (p= 0.001) for aerobes and 38800.83 +/- 14931.06 CFU (p= 0.001) for anaerobes.
In addition to curettage, a local application of the biodegradable polymer Doxirobe® to periodontal pockets can significantly increase treatment success with regard to pocket depth reduction, attachment loss and amount of subgingival plaque.