Ocimum sanctum L (Tulsi) has various properties like antibacterial, anti-inflammatory and anti-oxidant. To compare the effect of the local-drug delivery system containing 2% Ocimum sanctum L (Tulsi) as an adjunct to scaling and root planing (SRP).The main aim of the study was to evaluate the efficacy of Ocimum sanctum L (Tulsi) gel with Tetracycline fibers (Actisite) for the treatment of periodontitis patients. 40 subjects with periodontitis (pocket depth of 5 mm) were selected and divided into 2 groups Group I: Ocimum sanctum L (Tulsi) gel (n= 20) and Group II: Tetracycline fibers (Actisite) (n = 20). Clinical parameters assessed were Gingival Index , Plaque Index , Probing Depth and Clinical Attachment Loss were assessed at baseline, 1 month, 3 months, 6 months, 8 months. Our results showed that Gingival index and Plaque index for for GROUP I: Ocimum sanctum L (Tulsi) and GROUP II: Tetracycline fibers (Actisite)are not statistically significant p>0.05 for baseline, at 1 month, 3 months, 6 months, 8 months. Probing depth and Clinical attachment are not significant p>0.05 for baseline, at 1 month, 3 months, 6 months, and statistically significant difference seen at 8 months p<0.05. 2% Ocimum sanctum L (Tulsi) gel can be effectively used as an adjunct to scaling and root planing. When used as an adjunct to scaling and root planing, it helps in reduction of pocket depth and gain of clinical attachment. Ocimum sanctum L (Tulsi) showed promising results when compared to Tetracycline fibers (Actisite).

Increased prevalence of oral diseases such as gingivitis, periodontitis and dental caries has become major health issue worldwide. Such growing incidence of periodontitis has directly affected the development of drug delivery systems and growth of the market. Since the infections are limited to periodontal pockets or oral cavity, localized intrapocket drug delivery will be more beneficial than conventional systemic administration. Advances in intrapocket technology and innovations in the field of periodontal drug delivery led to increased patent applications. Newer trends like use of mucoadhesive polymers, in situ forming gels, viscosity modifiers, plasticizers etc which can enhance intrapocket retention of drugs have gained considerable attention among researchers and industrialists. Current market is flooded with products such as Periostat, Periochip(®), Atridox(®), Arestin(®), Actisite(®), Dentomycin(®), and Elyzol(®) and generics such as metronidazole, levofloxacin, tetracycline, doxycyline and minocycline for intrapocket delivery. There is a need of novel drugs and delivery systems with better efficacy profiles than the existing compounds. Inclusion of novel technologies like films, fibers, in situ forming implants, microparticles, nanoparticles, and liposomes as intrapocket drug delivery has great potential. Development of antibiotic free drug delivery such as antiseptics, host modulators, biofilms inhibitors and antibodies has promising role in the improvement of pathogenesis of periodontitis. Further, this review deals with various innovations in drug delivery and patents related to localized intrapocket administration of medicaments in the implications of periodontitis.

The purpose of the present study was to evaluate the effects of tetracycline fibres (TCF) as an adjunct to scaling in the treatment of generalised aggressive periodontitis and to compare the effects with mechanical treatment only. Ten patients, 24-39 years old referred for treatment to the Department of Preventive Dentistry, Periodontology and Implant Biology, Aristotle University of Thessaloniki took part in the study. A split-mouth experimental design was used. Measurements referring to bleeding on probing (BOP), pocket depth (PD) and clinical attachment level (CAL) were performed at 12 sites randomly selected. Clinical recordings were made at baseline, 2 and 6 months, after treatment. Subgingival plaque samples were taken for microbiological analysis using the 'checkerboard' DNA-DNA hybridisation technique at baseline, immediately after treatment and at 2 and 6 months. Full-mouth scaling and root planing were performed, with the exception of 2 pre-selected sites, which served as controls. Tetracycline fibres were applied in 5 pockets located in the same half mouth. Analysis of clinical findings showed that mechanical instrumentation in combination with TCF application led to a greater improvement in clinical parameters than scaling and root planing only. Microbial analysis showed a statistically significant greater reduction in the percentages of detection for B. forsythus, P. nigrescens and A. naeslundii genospecies II in pockets where tetracycline fibres were applied. In conclusion, the clinical and microbiological data of the present study suggest that the adjunctive use of TCF improves the clinical response of scaling and root planing in aggressive periodontitis patients.

Antimicrobial agents, systemic and/or local, are thought by some to be effective agents for treating periodontal infections. Here the authors determine the costs and benefits of local delivery agents for treating periodontal disease. Applying this cost-benefit analysis to patient care, however, will depend upon a clinician's expertise and a patient's value system.

The management of periodontal diseases has included both non-surgical and surgical treatment options. Non-surgical treatment traditionally has referred to the role of mechanical instrumentation of the root surface with either scalers or curettes. However, the introduction of locally delivered anti-microbial medications, which can be placed directly into a periodontal pocket, has provided the practitioner with another treatment option. This article looks at the different locally delivered anti-microbial medications being used in the non-surgical management of periodontal diseases.

Electrospun fiber mats are explored as drug delivery vehicles using tetracycline hydrochloride as a model drug. The mats were made either from poly(lactic acid) (PLA), poly(ethylene-co-vinyl acetate) (PEVA), or from a 50:50 blend of the two. The fibers were electrospun from chloroform solutions containing a small amount of methanol to solubilize the drug. The release of the tetracycline hydrochloride from these new drug delivery systems was followed by UV-VIS spectroscopy. Release profiles from the electrospun mats were compared to a commercially available drug delivery system, Actisite (Alza Corporation, Palo Alto, CA), as well as to cast films of the various formulations.

This article discusses the principles, products, and techniques currently available for local delivery of antimicrobials in the treatment of adult periodontitis. Four principles provide the scientific basis for the treatment of periodontitis: it is caused by bacteria; it cannot be cured, but it can be controlled; clinicians cannot remove all the plaque and calculus; and periodontitis reinfects. This article stresses how the local delivery of antimicrobials can help the clinician achieve the goals of arresting the disease and maintaining the disease in the arrested or controlled state. Rationales for reevaluating the treated patient and treatment options are presented. Local-delivery systems are reviewed, stressing those available in the United States. Pharmacokinetics, multicenter randomized trials, and techniques are presented.

In situ release kinetics of 25% tetracycline-loaded fibers (Actisite) were evaluated in this study. 1 cm precut tetracycline fibers were removed from periodontal pockets (>5 mm) of 24 patients. Fibers were maintained at their site for 1, 3, 7, 10 and 12 days. Remaining biologically active tetracycline on the fibers was determined by agar diffusion inhibition assay. Inhibition zones induced by fibers on P. gingivalis (256) seeded BHI agar were measured after 48 hours of anaerobic incubation. Data were evaluated by one-way analysis of variance with Post-hoc Duncan analysis. Results of this study show there is a considerable decrease in the amount of tetracycline remaining in the fibers removed between 1-3 and 10-12 days. The amount of active drug remaining in the fibers at days 3 and 7 was comparable and indicates no significant deposition between these two days.

To longitudinally determine if early therapeutic intervention, based on a positive neutral protease activity (NPA) assay score could effectively arrest the progress of periodontal disease destruction.

Periodontal therapy has the primary aim of halting periodontal disease progression. Clinical trials over the years have indicated that meticulous scaling and root planing in conjunction with a patient's proper plaque control can arrest periodontitis, but this therapy is not always completely effective and thus adjunctive therapies need to be considered. Local delivery of antibacterial agents into periodontal pockets has been extensively developed and investigated since the late 1970s and many systems have been designed to maintain high levels of antimicrobial agents in the crevicular fluid with minimal systemic uptake. More recently subgingival antimicrobial delivery systems have become available to the practising periodontist for clinical use. These systems, employ different antimicrobial agents but also different delivery systems which influence the concentration of available drug over time. The dental profession is confused by the wide variety of available slow release subgingival antimicrobial devices on the market and clearly comparative independent assessment of these therapies is needed. This review will summarise the findings of a comparative study on three commonly available periodontal local delivery antimicrobial systems on sites with previously unsuccessful mechanical therapy. The slow release devices studied adjunctively with root planing were: Actisite, Dentomycin and Elyzol, compared to root planing alone. Substantivity of an antimicrobial system is the ability of the system to maintain an effective concentration of drug over time which may be the most significant difference between the three delivery systems rather than the type of antimicrobial drug used. Although all three locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regime of scaling and root planing plus tetracycline fibre placement gave the greatest reduction in probing pocket depth over the six months after treatment.