yp \/ \/ N AVAVAVAVA, VON NANA O00 ” a] i= We) Nome | one oe oy oe:ELSEVIER © 2015 Elsevier. All rights reserved, except Chapters 11,12, 14 and 1.6 Royal College of Surgeons of England, No part of this publication may be reproduced or transmitied in any form or by any means, electronic ‘or mechanical, including photocopying, recording, or any information storage and retrieval system, ‘without permission in writing from the publisher. Deals on how to seek permission, Further information about the Publishes permissions polices and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be founed at our website ‘eorwelsevier com permissions This book and the individual contibutions contained in i ae protected under copyright by Publisher (other than as may be noted herein). ISBN 9780702013574 Notices Knowledge and best practice in this feld are constantly changing. As new research and experience broaden our understanding, changes in research methods, profesional practices, or medical treatment may become necessary Practitioners and researchers must always sey on their awn experience and knowledge in evalu nd using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of theit oven safety and the safery of athers, including panties for whom they have a professional responsibil ‘With respect to any drug or pharmaceutical products identified, readers are advised to check the most ‘current information provided (i) on procedures featured or (it) by the manufacturer of each product to he administered, to verify the recommended dose or formula, the method and duration administration, and contraindications. It isthe responsibility of practitioners, relying on their wn ‘experience and knowledge of their patients, to make diagnoses, to determine dosages and the best tweatment foreach individual patient, and to take all appropriate safety preeautions ‘To the fllest extent ofthe law; neither the Publisher nor the authors, contibutors, or editors assume any liability for any injury and/or damage wo persons or property as a matter of products lability, negligence or otherwise, or from any use of operation of any methods, products, insructions, oF ideas contained in the material herein, BE ee’ Inthe health sclences ‘wonwelsevierhealth.com 7 Working together F to grow libraries in amt] fReEAB developing countries Printed For Elsevier Content Strategist: Alison Taylor Content Development Specialists: Barbara Simmons and Carole McMurray Project Manager: Julie Taylor Designer/Design Direction: Christian Bilbow Mlustration Manager: Emily Constantino Mlustrator: Antbits LidCH 300 dari 370 Antibiotics in the Management of Periodonta: viseases. oes Commonly used single therapies ‘Combination therapies Metronidazole ‘Amoxicilin and metronidazole Tetracyciine group Penicilin group Azithromycin 287 Figure 5.3.1 2% minocycline gel. Local delivery systems include a range of different drugs and vehicles. Gel systems, appli by syringe, include 25% metronidazole and 2% minocycline, These are quickly and & applied to pockets, and can readily be used at multiple sites. However, t less assured as they are washed out of the pocket by crevicular fluid. As a consequence, the protocols recommend that the dosage is repeated Con several occasions, Chlorhexidine (2.5 mg) can be applied in a degradable gelatin chip, 25% tetracycline hydrochloride in a non-tesorbable fibre, and doxycycline hyclate in a gel/sol cartier. Examples of local delivery devices are shown in Figures 5.3.1-5.3.4, EVALUATING STUDIES WHICH USE ANTIBIOTICS AS ADJUNCTS TO RSD As resistant strains of bacteria emerge, and new antibiotics are produced, itis impossible to provide specific protocols and regimens for clinical practice. Research into both local and systemic antibiotics is constantly published (more than 2000 papers on the subject) and this information is often distributed to the dental profession by manufacturers aiming to support a particular product. It is therefore important for any professional to be able to critically appraise the literature so that they can provide the most clinically effective, and the most cost-effective, treatment for their patients.301 dari 370 Practical Periodontics Figure 5.3.2 25% tetracycline hydrochloride. Figure 5.3.3 CChilothexicine chip. Figure 5.34 25% metronidazole gel