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Date: Fri 23-Apr-1999

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Date: Fri 23-Apr-1999

Publication: Hea

Author: DONNAG

Quick Words:

antibiotics-periodontal

Full Text:

HEALTH MONITOR: Can Antibiotics Inhibit Peridontal Disease?

FARMINGTON -- A researcher at the University of Connecticut School of Dental

Medicine is investigating whether two different applications of antibiotics

may help patients with periodontal disease.

The researcher, John W. Dean III, DDS, PhD, is an associate professor in the

UConn dental school Department of Periodontology. His investigations are part

of a pair of national studies.

Peridontal disease is a progressive disease affecting the gums and the

jawbone. If left untreated, periodontal disease will eventually cause the

teeth to be lost. Treatment involves deep cleaning or root planing by a

professional, and regular flossing and brushing of the teeth and gums

thereafter. The first of Dr Dean's investigations is helping to determine if a

small dose of antibiotics may inhibit the production of an enzyme that

contributes to periodontal disease. Bacteria in the mouth promote the body's

production of collagenase, an enzyme that breaks down collagen -- an insoluble

fibrous protein found in connective tissue. Collagen allows the gums and jaw

bone to hold the teeth.

Low doses of the antibiotic doxycycline -- marketed commercially as Periostat

-- prevent the bacteria from promoting the production of collagenase, even as

the dose is too low to adversely affect the body's good bacterial flora.

"The idea isn't to replace deep cleaning or periodontal surgery with

Periostat," Dr Dean said, "but to use it as an adjunct to traditional

treatments." Thirty-five patients are involved in Dr Dean's investigation with

Periostat, which will run for nine months. Early indications are that the

treatment may be effective. There are about three months left in the trial.

Dr Dean's second investigation involves the effect of local antibiotics on

periodontal disease. The idea behind the investigation is to apply a high dose

of antibiotic -- in this case Minocycline -- after the teeth and gums have

been deep cleaned, to keep the bacteria that contributes to periodontal

disease from repopulating the area.

Applying the drug locally minimizes the systemic effect of the antibiotics. Dr

Dean said some antibiotic will enter the bloodstream, but the amount is too

low to have any undesirable side affects.

Like the use of Periostat, this therapy too, is seen as an adjunct to the

standard therapy of deep cleaning and root scaling. But it does hold out to

periodontists the prospect of yet another tool with which to fight periodontal

disease. Dr Dean added both therapies being investigated could be important

for people with periodontal disease who have bleeding disorders, or

compromised or suppressed immune systems and who might not be good candidates

for regular therapy.

The Minocycline investigation started in December and involves 25 volunteers.

The UConn dental school is one of six participating in the Periostat study.

The other include Pittsburgh, Minnesota, New York University, Boston

University and Ohio State.

UConn dental school is one of four participating in the Minocycline study. The

others are: Maryland, Wake Forest and Nebraska.

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