Abstract
BackgroundThe purpose of periodontal treatments is to reduce inflammation, restore gingival health and clinical attachment level gain by controlling microbial plaque formation and other etiological factors. One of the drugs that has been tested in many areas and shown good anti-inflammatory properties is erythropoietin (EPO). We evaluated the effect of this drug on the improvement of periodontitis after the phase I treatment.MethodsThis study was conducted on 30 patients with stage III periodontitis who had at least two bilateral teeth with CAL of ≥ 5 mm and PPD ≥ 6 mm at ≥ 2 non‐adjacent teeth and bleeding on probing. After oral hygiene instruction and scaling and root planning (SRP), EPO gel containing a solution of 4000 units was applied deeply in the test group and placebo gel was deeply administered in the control pockets (5 times, every other day). The clinical parameters of the plaque index (PI), gingival index (GI), clinical attachment level (CAL), probing depth (PD) and bleeding index (BI) were measured at baseline and after three months of follow up. The P-value was set at 0.05.ResultsAll clinical variables improved after treatment in both groups. The BI and GI scores (which reflects the degree of gingival inflammation) showed statistically more reduction in test group. The CAL decreased from 5.1 ± 4.1 to 3.40 ± 2.71 mm; and 5.67 ± 4.32 to 4.33 ± 3.19 mm in test and control group, respectively (P < 0.00). After the treatment, there was a significant greater reduction in CAL and also PD values in test group (P < 0.01).ConclusionLocal application of EPO gel in adjunct to SRP can improve clinical inflammation and CAL gain in periodontitis.Trial registration: This study was registered at 2017-11-06 in IRCT. All procedures performed in this study were approved with ID number of IR.TUMS.DENTISTRY.REC.1396.3139 in Tehran University of medical science.
Highlights
The purpose of periodontal treatments is to reduce inflammation, restore gingival health and clinical attachment level gain by controlling microbial plaque formation and other etiological factors
We considered the bleeding index (BI) and gingival index (GI) as primary outcomes and clinical attachment level (CAL), probing depth (PD) and plaque index (PI) as secondary outcomes
This study was aimed to investigate the efficacy of a topical erythropoietin for treatment of Stage III grade B/C periodontitis
Summary
The purpose of periodontal treatments is to reduce inflammation, restore gingival health and clinical attachment level gain by controlling microbial plaque formation and other etiological factors. One of the drugs that has been tested in many areas and shown good anti-inflammatory properties is erythropoietin (EPO). We evaluated the effect of this drug on the improvement of periodontitis after the phase I treatment. Local administration of anti-infective agents (e.g. Doxycycline), directly into the periodontal pocket, has the potential to provide greater concentrations of drug into the infected area and to reduce possible systemic side effects [9, 10]. In a study on mice with heat damage, treatment with EPO was associated with improved and accelerated wound healing by increasing vascular proliferation, extracellular matrix maturation, angiogenesis and vascular density [20]. Recent studies have shown the effects of EPO on the recovery of damaged nerves by increasing vascular proliferation [21]. Human clinical studies are ongoing to confirm the safety of systemic application of EPO
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