CLINICAL-RESPONSE TO LOCAL-DELIVERY OF TETRACYCLINE IN RELATION TO OVERALL AND LOCAL PERIODONTAL CONDITIONS

The purpose of this study was to determine the clinical response to lo cal delivery of tetracycline in relation to clinical and microbiologic al conditions of the other teeth. 4 deep pockets were monitored in 19 subjects with multiple deep periodontal lesions and high counts of P. gingivalis. In 9 patients (LT) only 2 of the selected lesions were tre ated by placement of tetracycline fibers (Actisite(R)), while the rest of the dentition was left untreated. In the other 10 patients, all te eth were supragingivally scaled and then treated by application of pol ymeric tetracycline HCl containing fibers, the whole dentition was sub ject to full mouth scaling and root planing, and the patients rinsed w ith 0.2% chlorhexidine (FT). A significant reduction in mean PPD was o bserved in all treated sites after two months. This reduction was main tained over the following 4 months. The magnitude of the effect was si gnificantly greater in the FT group (1.74 mm) than in the LT group (0. 88 mm). The mean attachment level changes were similar after 2 months in locally and fully treated subjects. A tendency of relapse was noted for treated sites in LT patients from month 2 to 6. A level of statis tical significance was not reached for this effect. Data from measurem ents recorded at 6 sites around all teeth in the full mouth treated pa tients were analyzed using multiple linear regression. This analysis s howed local changes in PPD and AL were significantly and strongly corr elated with the baseline value of the respective parameter at the same site. In addition, more pocket depth reduction was noted if a site wa s not bleeding on probing at 6 months, if the location of a site was n ot approximal and if the tooth was not a second molar. Sites located o n second molars showed also less AL gain than sites located on other t eeth. Smokers showed significantly less reduction in PPD and significa ntly less AL gain. Furthermore, if subjects had a high % of pockets de eper than 4 mm at baseline they showed significantly less attachment g ain.