title: Evaluation of subgingivally delivered 0.5% clarithromycin as an adjunct to nonsurgical mechanotherapy in the management of chronic periodontitis: a short-term double blinded randomized control trial.
abstract: OBJECTIVE
  As the risk involved with systemic antimicrobials (high doses, microbial resistance, adverse reactions, etc.) restricts their use and local delivery of antimicrobials into periodontal pockets improves periodontal health, this study was designed to investigate the effects of subgingivally delivered clarithromycin (CLM; 0.5%) as an adjunct to nonsurgical mechanotherapy in chronic periodontitis subjects.
  
  
  METHODS
  Ninety-eight patients were categorized into two treatment groups: scaling and root planing (SRP) plus 0.5% CLM (test; group 1) and SRP plus placebo (control; group 2). Clinical parameters included gingival index (GI), sulcus bleeding index (SBI), plaque index (PI), probing depth (PD), and periodontal attachment level (PAL), recorded at 4, 8 and 12 weeks. The concentration of 0.5% CLM in gingival fluid was estimated by reverse-phase high pressure liquid chromatography. anova, the chi-square test and the Scatterthwaite test were used for statistical analysis.
  
  
  RESULTS
  Patients treated with SRP + CLM showed enhanced reductions in GI, SBI, and PD, and gains in PAL (P < 0.001) over time, as compared with the placebo group. However, no statistically significant differences were noted for PI. The mean concentration of CLM was detected in gingival crevicular fluid for up to 7 weeks, fulfilling the conditions for a controlled-release device.
  
  
  CONCLUSIONS
  Adjunctive use of 0.5% CLM as a controlled drug delivery system enhanced the clinical outcome up to 3 months.
authors.affiliation: Department of Periodontology, Government Dental College and Research Institute, Bangalore, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Kathariya
authors.forename: A R
authors.initials: AR
authors.lastname: Pradeep
authors.forename: N M
authors.initials: NM
authors.lastname: Raghavendra
authors.forename: Rahul
authors.initials: R
authors.lastname: Gaikwad
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000032:analysis; D055113:Chronic Periodontitis / Q000628:therapy*; D017291:Clarithromycin / Q000008:administration & dosage* / Q000032:analysis; D003131:Combined Modality Therapy; D003692:Delayed-Action Preparations; D003774:Dental Plaque Index; D012534:Dental Scaling / Q000379:methods*; D004311:Double-Blind Method; D016503:Drug Delivery Systems; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000737:chemistry; D006801:Humans; D019344:Lactic Acid / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy; D010919:Placebos; D011100:Polyglycolic Acid / Q000737:chemistry; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D016745:Root Planing / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D003692:Delayed-Action Preparations; D010919:Placebos; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D017291:Clarithromycin
keywords: anti-infective agents; chronic periodontitis; clarithromycin; drug delivery systems; macrolides