Feracrylum –A Haemostatic Becomes a Boon for Treating Chronic Periodontitis In Patients Under Anti-Coagulant Therapy
Keywords:
Feracrylum, anti-coagulant therapy, chronic periodontitis, nonsurgical therapy, red complex bacteria, BANA testAbstract
Background:Chronic periodontitis is an inflammatory disease of many origins that compromises tooth-supporting structures.(1,2) Patients with bleeding tendencies usually have compromised periodontal health.(1,2,3,4) While scaling and root planing (SRP) remains the main stay of non-surgical management, adjunctive drug delivery agents can enhance therapeutic outcomes. Patients with compromised bleeding and coagulation pathways are usually unable to receive optimum dental treatment often. Feracrylum, a lesser-explored topical hemostatic with antimicrobial properties, may be an ideal agent which can be utilized in such patients to provide supportive periodontal therapy.(3,4)
Aim:To determine the efficacy of Feracrylum in the management of chronic periodontitis, in patients under anti-coagulant therapy.
Materials and Methods:A total of 30 patients, undergoing anti-coagulant therapy, with associated chronic periodontitis were randomized into two groups, after acquiring informed consent and cardiologist consultation. Taking into account the dropouts in the study, the final count of patients in each group were as follows: Feracrylum (n=13) and Control (SRP + saline, n=12). Intervention was as follows, Feracrylum group, received oral prophylaxis and subingival irrigation of 1% Feracrylum, while the control group received saline irrigation. Both groups were advised regarding chemical plaque control with 1% feracrylum mouthwash and saline mouth rinse respectively. Clinical parameters including probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and modified sulcus bleeding index (MSBI) were recorded at baseline and one month post-treatment respectively. Subgingival plaque samples were tested for the presence of red complex organisms with BANA enzymatic test.
Results:The Feracrylum group exhibited a significant mean PPD reduction (1.4 mm), CAL gain (1 mm), and MSBI scores. BANA Test, scores were co-relative with the clinical findings indicating that feracrylum group clearly outperformed the placebo group (<0.05)
Conclusion: The results clearly indicate the significance of Feracrylum, in non-surgical Periodontal therapy, in patients undergoing anti-coagulant therapy for miscellaneous cardiovascular disorders
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Burt B. Position paper: Epidemiology of periodontal diseases. J Periodontol. 2005;76:1406–1409. doi: 10.1902/jop.2005.76.8.1406. [DOI] [PubMed] [Google Scholar]
Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol. 2007;78:1387–1399. doi: 10.1902/jop.2007.060264. [DOI] [PubMed] [Google Scholar]
Hill RW, Ramfjord SP, Morrison EC, et al. Four types of periodontal treatment compared over two years. J Periodontol. 1981;52:655–662. doi: 10.1902/jop.1981.52.11.655. [DOI] [PubMed] [Google Scholar]
Isidor F, Karring T. Long-term effect of surgical and non-surgical periodontal treatment. A 5-year clinical study. J Periodontal Res. 1986;21:462–472. doi: 10.1111/j.1600-0765.1986.tb01482.x. [DOI] [PubMed] [Google Scholar]
Kaldahl WB, Kalkwarf KL, Patil KD, Molvar MP, Dyer JK. Long-term evaluation of periodontal therapy: I. Response to 4 therapeutic modalities. J Periodontol. 1996;67:93–102. doi: 10.1902/jop.1996.67.2.93. [DOI] [PubMed] [Google Scholar]
Kaldahl WB, Kalkwarf KL, Patil KD, Molvar MP, Dyer JK. Long-term evaluation of periodontal therapy: II. Incidence of sites breaking down. J Periodontol. 1996;67:103–108. doi: 10.1902/jop.1996.67.2.103. [DOI] [PubMed] [Google Scholar]
Brunsvold MA, Nair P, Oates TW., Jr Chief complaints of patients seeking treatment for periodontitis. J Am Dent Assoc. 1999;130:359–364. doi: 10.14219/jada.archive.1999.0205. [DOI] [PubMed] [Google Scholar]
Romney G, Glick M. An updated concept of coagulation with clinical implications. J Am Dent Assoc. 2009;140:567–74. doi: 10.14219/jada.archive.2009.0227. [DOI] [PubMed] [Google Scholar]
2.Jover-Cervero A, Poveda-Roda R, Bagan JV, Jimenez-Soriano Y. Dental treatment of patients with coagulation factor alterations: An update. Med Oral Patol Oral Cir Bucal. 2007;12:302–9. [PubMed] [Google Scholar]
3.Quintero Parada E, Sabater Recolons MM, Chimenos Klistner E, López López J. Hemostasia y tratamiento odontológico. Av. Odontoestomatol. 2004;5:247–61. [Google Scholar]
4.Partridge CG, Campbell JH, Alvarado F. The effect of platelet-altering medications on bleeding from minor oral surgery procedures. J Oral Maxillofac Surg. 2008;66:93–7. doi: 10.1016/j.joms.2005.11.055. [DOI] [PubMed] [Google Scholar]
5.Cañigral A, Silvestre FJ, Cañigral G, Alós M, Garcia-Herraiz A, Plaza A. Evaluation of bleeding risk and measurement methods in dental patients. Med Oral Patol Oral Cir Bucal. 2010;15:e863–8. doi: 10.4317/medoral.15.e863. [DOI] [PubMed] [Google Scholar]
6.Jiménez Y, Poveda R, Gavaldá C, Margaix M, Sarrión G. An update on the management of anticoagulated patients programmed for dental extractions and surgery. Med Oral Patol Oral Cir Bucal. 2008;13:E176–9. [PubMed] [Google Scholar]
7.Devani P, Lavery KM, Howell CJ. Dental extractions in patients on warfarin: is alteration of anticoagulant regime necessary? Br J Oral Maxillofac Surg. 1998;36:107–11. doi: 10.1016/s0266-4356(98)90177-2. [DOI] [PubMed] [Google Scholar]
8.Russo G, Corso LD, Biasnolo A, Berengo M, Pengo V. Simple and safe method to prepare patients with prosthetic heart valves for surgical dental procedures. Clin Appl Thromb Hemost. 2000;6:90–3. doi: 10.1177/107602960000600208. [DOI] [PubMed] [Google Scholar]
9.Ferrieri GB, Castiglioni S, Carmagnola D, Cargnel M, Strohmenger L, Abati S. Oral Surgery in Patients on Anticoagulant Treatment Without Therapy Interruption. J Oral Maxillofac Surg. 2007;65:1149–54. doi: 10.1016/j.joms.2006.11.015. [DOI] [PubMed] [Google Scholar]
10.Sacco R, Sacco M, Carpenedo M, Mannucci PM. Oral surgery in patients on oral anticoagulant therapy: a randomized comparison of different intensity targets. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:e18–e21. doi: 10.1016/j.tripleo.2006.12.035. [DOI] [PubMed] [Google Scholar]
11.Bajkin BV, Popovic SL, Selakovic SD. Randomized, Prospective Trial Comparing Bridging Therapy Using Low-Molecular-Weight Heparin With Maintenance of Oral Anticoagulation During Extraction of Teeth. J Oral Maxillofac Surg. 2009;67:990–5. doi: 10.1016/j.joms.2008.12.027. [DOI] [PubMed] [Google Scholar]
12.Bacci C, Maglione M, Favero L, Perini L, Di Lenarda R, Berengo M. Management of dental extraction in patients undergoing anticoagulant treatment. Thromb Haemost. 2010;104:972–5. doi: 10.1160/TH10-02-0139. [DOI] [PubMed] [Google Scholar]
13.Morimoto Y, Niwa H. On the use of prothrombin complex concentrate in patients with coagulopathy requiring tooth extraction. Oral Med Oral Pathol Oral Radiol Endod. 2010;110:e7–e10. doi: 10.1016/j.tripleo.2010.08.014. [DOI] [PubMed] [Google Scholar]
14.Pereira CM, Gasparetto PF, Carneiro DS, Corrêa ME, Souza CA. Tooth extraction in patients on oral anticoagulants: prospective study conducted in 108 brazilian patients. ISRN Dent. 2011;2011:203619. doi: 10.5402/2011/203619. [DOI] [PMC free article] [PubMed] [Google Scholar]
15.Nematullah A, Alabousi A, Blanas N, Douketis JD, Sutherland SE. Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis. J Can Dent Assoc. 2009;75:41. [PubMed] [Google Scholar]
16.Madrid C, Sanz M. What influence do anticoagulants have on oral implant therapy? A systematic review. Clin Oral Implants Res. 2009;20:96–106. doi: 10.1111/j.1600-0501.2009.01770.x. [DOI] [PubMed] [Google Scholar]
17.Firriolo FJ, Hupp WS. Beyond warfarin: the new generation of oral anticoagulants and their implications for the management of dental patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:431–41. doi: 10.1016/j.oooo.2011.10.005. [DOI] [PubMed] [Google Scholar]
Herrera D., Sanz M., Kebschull M., Jepsen S., Sculean A., Berglundh T., Papapanou P.N., Chapple I., Tonetti M.S. Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline. J. Clin. Periodontol. 2022;49((Suppl. 24)):4–71. doi: 10.1111/jcpe.13639. [DOI] [PubMed] [Google Scholar]
Panwar M., Gupta S.H. Local Drug Delivery with Tetracycline Fiber: An Alternative to Surgical Periodontal Therapy. Med. J. Armed Forces India. 2009;65:244–246. doi: 10.1016/S0377-1237(09)80014-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
4.Vijayalashmi R., Ravindranath S.M., Jayakumar N.D., Padmalatha, Vargheese S.H., Kumaraswamy K.L. Kinetics of drug release from a biodegradable local drug delivery system and its effect on Porphyromonas gingivalis isolates: An in vitro study. J. Indian Soc. Periodontol. 2013;17:429–434. doi: 10.4103/0972-124X.118311. [DOI] [PMC free article] [PubMed] [Google Scholar]
5.He Z., Liu S., Li Z., Xu J., Liu Y., Luo E. Coaxial TP/APR electrospun nanofibers for programmed controlling inflammation and promoting bone regeneration in periodontitis-related alveolar bone defect models. Mater. Today Bio. 2022;16:100438. doi: 10.1016/j.mtbio.2022.100438. [DOI] [PMC free article] [PubMed] [Google Scholar]
6.Deasy P.B., Collins A.E., MacCarthy D.J., Russell R.J. Use of strips containing tetracycline hydrochloride or metronidazole for the treatment of advanced periodontal disease. J. Pharm. Pharmacol. 1989;41:694–699. doi: 10.1111/j.2042-7158.1989.tb06343.x. [DOI] [PubMed] [Google Scholar]
7.Steinberg D., Friedman M., Soskolne A., Sela M.N. A new degradable controlled release device for treatment of periodontal disease: In vitro release study. J. Periodontol. 1990;61:393–398. doi: 10.1902/jop.1990.61.7.393. [DOI] [PubMed] [Google Scholar]
8.Wu L., Chen W., Li F., Morrow B.R., Garcia-Godoy F., Hong L. Sustained Release of Minocycline from Minocycline-Calcium-Dextran Sulfate Complex Microparticles for Periodontitis Treatment. J. Pharm. Sci. 2018;107:3134–3142. doi: 10.1016/j.xphs.2018.08.023. [DOI] [PubMed] [Google Scholar]
9.Pichayakorn W., Boonme P. Evaluation of cross-linked chitosan microparticles containing metronidazole for periodontitis treatment. Mater. Sci. Eng. C Mater. Biol. Appl. 2013;33:1197–1202. doi: 10.1016/j.msec.2012.12.010. [DOI] [PubMed] [Google Scholar]
10.Xu S., Zhou Q., Jiang Z., Wang Y., Yang K., Qiu X., Ji Q. The effect of doxycycline-containing chitosan/carboxymethyl chitosan nanoparticles on NLRP3 inflammasome in periodontal disease. Carbohydr. Polym. 2020;237:116163. doi: 10.1016/j.carbpol.2020.116163. [DOI] [PubMed] [Google Scholar]
11.Mou J., Liu Z., Liu J., Lu J., Zhu W., Pei D. Hydrogel containing minocycline and zinc oxide-loaded serum albumin nanopartical for periodontitis application: Preparation, characterization and evaluation. Drug Deliv. 2019;26:179–187. doi: 10.1080/10717544.2019.1571121. [DOI] [PMC free article] [PubMed] [Google Scholar
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