Abstract
Background: Local delivery agents (LDA) have the advantage of delivering the antibiotics at high concentrations to the targeted sites. However, the constant flow of gingival crevicular fluids and saliva may restrict their efficacy. Therefore, the drug sustainability and pharmacodynamic properties of any proposed LDA should be evaluated. Methods: Four dental implants were placed unilaterally in the edentulous mandible of six beagle dogs. Peri-implantitis were experimentally induced using silk-ligatures. Each implant was randomly allocated to receive one of the following four treatments: (i) MC (Chitosan-alginate (CA) minocycline), (ii) MP (CA-without minocycline), (iii) PG (Polyacrylate-glycerin minocycline), and (iv) Control (mechanical debridement only). Mechanical therapies and LDAs were administered into the gingival sulcus two times at a 4-week interval. Drug sustainability as well as clinical, radiographical, and immunohistochemical (IHC) analyses were conducted to evaluate the efficacies of treatments. Results: Reduced mean probing depth was observed in all of the test groups after the second delivery. A minimal marginal bone level change was observed during the treatment period (MP (−0.06 ± 0.53 mm) to PG (−0.25 ± 0.42 mm)). The distribution of IHC cell marker analysis of all targeted antibodies ranged from 6.34% to 11.33%. All treatment outcomes between the test groups were comparable. A prolonged retention of LDA was observed from CA microspheres (MC and MP) at both administrations (p < 0.017) and prolonged sustainability of bacteriostatic effect was observed from MC compared to PG after the second administration (p < 0.05). Conclusions: Prolonged retention of CA microspheres was observed and the longer bacteriostatic effect was observed from the MC group. Mechanical debridement with adjunct LDA therapy may impede peri-implantitis progression, however, prolonged drug action did not lead to improved treatment outcome.
Highlights
Peri-implantitis is an inflammatory peri-implant disease with the evidence of bleeding on probing, increased pocket probing depth, and progressive supporting bone loss [1]
Peri-implantitis is present in 20% of the population with dental implants and the prevalence rate is found to increase as the implants are retained for a longer period [2]
This study evaluated the sustainability of Local delivery agents (LDA) carrier and bacteriostatic effects, and their clinical, radiographical, and immunohistochemical efficacy on experimentally induced peri-implantitis model
Summary
Peri-implantitis is an inflammatory peri-implant disease with the evidence of bleeding on probing, increased pocket probing depth, and progressive supporting bone loss [1]. In areas where deep pockets are created, surgical approaches are suggested for the instrumental access to thoroughly remove inflammatory tissues and pathogenic contaminants [8]. Nowadays, various instruments such as different elements (e.g., plastic and titanium) of curettes and ultrasonic tips, air-powder abrasive, and laser devices are available to improve the efficiency of implant mechanical therapy [9,10,11]. Mechanical debridement with adjunct LDA therapy may impede peri-implantitis progression, prolonged drug action did not lead to improved treatment outcome
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