New Local Drug Delivery with Antibiotic in the Nonsurgical Treatment of Periodontitis—Pilot Study

Abstract

Combination of the classical subgingival instrumentation (scaling and root planing procedure, SRP) with an antibiotic administered to periodontal pockets in a suitable medium is a promising alternative protocol of nonsurgical periodontal treatment. It enables obtaining the long-term minimum drug concentration inhibiting the development of periopathogens. Objectives: Clinical and microbiological evaluation of periodontal pockets two months after single application of a gel containing piperacillin and tazobactam (Gelcide)® in relation to the nonsurgical treatment procedure (SRP). Materials and methods: Ten patients aged 24–56 years (mean 39.5) with chronic periodontitis, nonsmokers with acceptable oral hygiene and no classical exclusion criteria were qualified for treatment. In the maxilla area, SRP was performed and the assessed gel was inserted to two randomly selected adjacent periodontal pockets. Clinical evaluation included the assessment of bleeding on probing (BoP), pocket depth (PD), and clinical attachment loss (CAL) at six measurement points. A microbiological examination with the use of PET deluxe diagnostic kit in the drug-administered pockets and symmetrically in two pockets on the other side of the dental arch was performed. The examination was conducted before the treatment and two months later. Results: Two months after the treatment, a significant improvement in all analyzed clinical parameters was observed. However, the extent of this improvement did not differ significantly between the compared treatment methods. No statistically significant differences were found in the number of bacteria before and after the treatment, except for a significant decrease in the number of Micromonas micros (2957 vs. 589, p = 0.028) and a higher number of the green complex bacteria Capnocytophaga gingivalis (5439 vs. 2050, p = 0.041) after antibiotic had been used. Conclusion: No significant clinical and microbiological differences were found after additional administration of gel with piperacillin and tazobactam in relation to SRP in the preliminary study.