Chemical Adjuncts to Periodontal therapy Flashcards
types of antimicrobial agents?
antiseptics
antibiotics
chemical antimicrobials may cause?
sensitivity
resistance
super infections - MRSA/candida
an alternative to an antibiotic could be an?
antiseptic
drugs excreted by kidney?
amoxicillin
erythromycin
acyclovir
drugs metabolised by liver?
clindamycin
metronidazole
enzymes used for?
- to interfere with bacterial attachment
- potentitation of host defences to inhibit bacteria
what type of antiseptics posses anti plaque activity?
Bisbigaunide
e.g - Chlorhexidine gluconate
how does chlorhexidine work?
broad spec of killing
damage bacterial wall
example of a quaternrary ammonium compound, what do they do?
cetylpyridinium chloride
mod plaque inhibitory activity - not retained for long
what is a phenolic antiseptics?
used in high concs and decrease plaque accumulation
e.g Listerine - mod plaque inhibitory effects/anti gingivitis
poor oral retention
what is Triclosan?
used in TP/MW
mod plaque inhibitory effecr
little substantivity
anti inflamm
what metal ions have plaque inhibitory effects?
zinc,copper,tin - copper/tin cause extrinsic staining
zinc retained by plaque and inhibits regrowth
natural products have any effect?
Sanguinarine chloride
mod reductions in plaque and gingivitis
antiseptic mouthwashes replace mechanical brushing when?
after oral/perio surgery
during acute gingival conditions
mentally/physically handicapped
all effective anti plaque mouthwashes cause?
staining
what is Perio - Chip?
slow release decide - deliver theraputic agent directly to perio site
used as an adjunct in sites not responding to tx
what does perio chip contain?
2.5mg Chx - prolonged exposure,
biodegradable
gelatine and water impregnanted with chx
what type of release does perio chip have?
bisphasic release over 7 days
initially 40% released - 1000ppm GCF, then 60% over 7 days
how is perio chip used?
placed in pocket after RSD and arrest of haemorrhage
chip swells in moisture and is retained
eliminates pathogenic bac - levels decreased for up to 100 days
perio chip supposed to promote?
decreased probing depths
decreased BOP
poss reattachement
use 3/12 as no.of bac decreaased for up to 100 days
what are the antibiotics most commonly used to treat periodontitis?
tetracyclines
metronidazole
= both are broad spec
what is a course of tetracycline given along side of?
a course of non surgaical treatment in aggressive periodontitis to eliminate actinobacillus actinomycetemcomitans
modes of action of antibiotics?
bacteriocidal - kill sensitive - penicillin and metronidazole
bacteriostatic - inhibit multiplication of sensitive bacteria - tetracycline and metronidazole
advantages of local administration of antibiotics?
- local admin = much higher conc in the pocket
- much lower total dose of antibiotic
- very low systemic spill over - decreasing risk of hypersensitivity and resistance
short term use of systemic or topical tetracycline and metronidazole produces a marked reduction in?
marked reduction in gram negative anaerobes and spirochetes and improvement in clinical condition
- decrease in probing depth
- decrease in BOP
what is dentomycin?
semi synthetic tetracylcine 2% minocycline for pockets over 5mm as an adjunct to scaling/RSD decrease in probing pocket depth and bop
how to use dentomycin?
applied 2-3x weekly with 2 weeks between administration
what is elyzol?
25% metronidazole - kills A.a injected into pocket and becomes semi- solid active for 24 hours pockets over 5 decreased ppd/bop adjunct only - careful in first 24 hours
what is actisite?
25% tetracycline
active for 10 days
into pocket with flat plastic
fibre left in situ for 10 days then removed with scaler
what is periostat and what is it used for?
subantimicrobial dose of doxycycline
collagenase inhibitor,
