chemical agents in plaque biofilm control Flashcards
(47 cards)
define systemic delivery
administering chemical agents such as antibiotic, in the form of tablet or capsule
define local delivery? example?
placing a chemical agent into the mouth or even into a perio pocket
example is toothpaste that contains a chemical agent that can kill bacteria such as stannous fluoride
what inhibits calculus formation
pyrophosphates
examples of chemical agents used in perio patients
- therapeutic mouth rinses
- therapeutic dentifrices
- subgingival irrigation
- controlled-release delivery devices
what could cause resistance of biofilm to delivery of chemical agents
- surface of plaque biofilm is covered by an extracellular slime layer
- slime layer acts as a natural barrier to protect organized bacterial colonies living in plaque biofilm
- slime layer prevents chemical from contacting and killing bacteria
what is a microbial reservoir
secure place that allows periodontal pathogens to live undisturbed during routine periodontal therapy and subsequently repopulate periodontal pockets quickly.
is there a chemical agent that can control perio?
no
examples of chemical agents
antibiotics, fluorides, metal salts, antimicrobial, phenolic compounds, and antiseptics
examples of antibiotics studied for use in perio care
- penicillin and amoxicillin
- tetracyclines
- clindamycin
- erythromycin
T/F: routine use of systemic antibiotics for plaque-induced gingivitis and chronic perio is recommended
false; not recommended
why is antibiotics not recommended
bacterial antibiotic resistance and good response to plaque-induced gingivitis and chronic perio can come from NSPT
how often would antibiotics need to be taken to control bactiera in mouth?
many many years
when is antibiotics indicated?
for patients with aggressive perio and other rarer forms of perio
what is microbiologic analysis used for?
used to identify the antibiotic that is effective against the bacterial pathogens present in patient’s biofilm
use of tetracyclines
- higher concentrations of the drug concentrate
- effective against A.A.
- inhibit action of collegenase
how is controlled-release delivery device used in the mouth
- an antibacterial chemical embedded in a carrier material
- device is placed directly into perio pockets
- material dissolves slowing producing a steady release of antimicrobial agent over a period of several days within the perio pocket
benefits of controlled-release delivery device
- result in a small increase in attachment level in perio pocket
- when used with perio instrumentation they can result in both an improvement in probing depth reduction and a clinical attachment gain
mechanisms of controlled-release delivery
- tetracyclin hydrochloride-containing fibers
- minocycline hydrochloride microspheres
- doxycycline hyclate gel
- chlorhexidine gluconate chip
features of tetracycline fibers
- no longer available in US
- gingival retraction cord impregnated with tetracyclin
- fiber laid back and forth all around tooth
minocyclin hydrochloride microspheres features
- cannula tip is used to expel microsphere into perio pocket
- within 5-7 days the microspheres dissolve so nothing to remove from pocket
reactions from minocyclin
- oral candidiasis
- allergic reaction
- don’t use in women who are pregnant or nursing
doxycycline gel features
- tetracycline derivate
- antibiotic is delivered in a gel to perio pocket with cannula
- gel solidifies into a waxlike substance
- gel dissolves
reactions from doxycycline
- oral candidiasis
- allergic reactions
- do not use in pregnant or nursing mothers
chlorhexidine gluconate chip features
- tiny gelatin chip containing the antiseptic chlorhexidine
- can be used in pockets with 5 mm or greater in depth
- chip dissolves
- no risk of antibiotic resistance with the use of gelatin chip
