Avaliação do uso de nanoesferas de Poly (I-Lactide-co-glycolide) contendo doxiciclina como adjunto ao tratamento da periodontite crônica: estudo clínico e enzimático

Resumo (EN)

Mechanical therapy with scaling and root planing it is established treatment for decontamination of the root surface of affected teeth by periodontal disease, but there are sites with unfavorable outcomes to conventional treatment and the use of systemic and local antibiotics with new technologies are possible supporting. The present study evaluated clinically and immunologically using nanospheres Poly (L-Lactide-Co-Glycolide) (PLGA) containing 2% of doxycycline in the treatment of subjects with severe chronic periodontitis. 43 subjects were selected (minimum of 10 sites / PD>5 mm and 2 sites with PD> 7 mm) were divided into 3 groups and treated: PLGA+Placebo (N=15) treated by Full Mouth Ultrassonic Debridement (FMUD) + PLGA nanospheres application placebo; PLGA+Doxy (N=13) treated by FMUD + PLGA nanospheres containing doxycycline 2% and Doxy Solution (N = 15) treated by FMUD+aplication of doxycycline 2% liquid. Clinical assessments were performed at baseline, 1, 3 and 6 months for the following clinical parameters: Bleeding on Probing (BOP), Probing Depth (PD), Clinical Attachment Level (CAL) and Gingival Margin Position (GMP). At baseline, 1, 3 and 6 months samples were taken from the peri-implant fluid for evaluation of IFN-y levels, IL1-β, IL-4, IL-6, IL-8, IL-17, IL-10, TNF-α, by Luminex/Magpix assay. To compare the clinical parameters were used the Kruskal-Wallis tests/Friedman or ANOVA/Tukey (α = 5%). PD in deep pockets, at 3 months follow up, PLGA+Doxy (3.5mm±1.0mm) had the best results with significant statistically differences between Doxi Solution (4.3mm±1.2mm) and PLGA+Placebo (4.3mm±1.3mm) therefore at the 6 months these differences did not occur. For CAL in 1 and 3 months of evaluation, PLGA+Doxy group showed statistically better results than the Doxi Solution and PLGA+Placebo groups, however at 6 months there was no difference between groups. It was observed an increased of anti inflammatories markers (IL-4; IL-10) in PLGA+Doxy group at 6 th month and a reduction in citokynes pro-inflammatories (IFNy; IL-1b) only at PLGA+Doxy group at 1st month and TNF-a concentration increased at 3rd month in PLGA+Placebo group. PLGA+Doxy nanospheres in short-term may be considered a potential adjunctive therapy in chronic periodontitis treatment offering advantages in clinical and immunological parameters, especially in deep pockets.