Single-dose Concentrations of Tinidazole in Gingival Crevicular Fluid,Serum,and Gingival Tissue in Adults with Periodontitis

Abstract

Previous studies have shown that metronidazole is effective in the treatment of subgingival microflora associated with destructive periodontitis. The aim of this study was to determine whether tinidazole, a close analogue of metronidazole, would reach sufficient concentrations in serum, gingival crevicular fluid, and gingival tissue, to inhibit putative periodontopathic bacteria.

Ten adult patients with moderate to advanced periodontitis took a single 2-g dose of tinidazole orally. Samples were assayed by high-performance liquid chromatography. The concentrations of tinidazole in serum and GCF were in a similar range (3.2-46.5 μg/mL). Tinidazole was not detected in the GCF in three of the patients. The drug was found in gingival tissue obtained at two h (0.17 ± 0.14 μg/mg) and six h (0.15 ± 0.18 μg/mg) after oral administration. The mean concentration of tinidazole in serum at 24 h (13 ± 3.0 μg/mL) is greater than the minimum inhibitory concentration for anaerobic bacteria as reported by others. The present data suggest that a single 2-g oral dose of tinidazole may lead to the presence of potentially bactericidal levels of tinidazole for up to 24 h in the periodontal pockets of some patients with periodontitis.

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References

Brill, N. (1962): The Gingival Pocket Fluid. Studies of its Occurrence , Composition and Effect, Acta Odontol Scand 20(Suppl. 32):1-115.

Britt, M.R. and Pohlod, D.J. (1986): Serum and Crevicular Concentrations after a Single Oral Dose of Metronidazole, J Periodontol 57:104-107.

Heimdahl, A. ; Von Konow, L. ; and Nord, C.E. (1982): Effect of Tinidazole on the Human Oral Microflora: A Comparison Between High Single and Low Repeated Doses, J Antimicrob Chemother 10(Suppl. A):157-164.

Kieser, J.B. (1974): An Approach to Periodontal Pocket Elimination , Br J Oral Surg 12:177-195.

Lindhe, J. ; Liljenberg, B. ; Adielsson, B. ; and Borges-Sen, I. (1983): Use of Metronidazole as a Probe in the Study of Human Periodontal Disease, J Clin Periodontol 10:590-601.

Loesche, W.J. ; Syed, S.A. ; Morrison, E.C. ; Laughton, B. ; and Grossman, N.S. (1981): Treatment of Periodontal Infections due to Anaerobic Bacteria with Short-term Treatment with Metronidazole, J Clin Periodontol 8:29-44.

Loesche, W.J. ; Syed, S.A. ; Morrison, E.C. ; Kerry, G.A. ; Higgins, T. ; and Stoll, J. (1984): Metronidazole in Periodontitis. I. Clinical and Bacteriological Results After 15 to 30 Weeks, J Periodontol 55:325-335.

Manor, A. ; Lebendiger, M. ; Shiffer, A. ; and Tovel, H. (1984): Bacterial Invasion of Periodontal Tissues in Human Gingival Tissues in Advanced Periodontitis in Humans, J Periodontol 55:567-573.

Nilsson-Ehle, I. ; Ursing, B. ; and Nilsson-Ehle, P. (1981): Liquid Chromatographic Assay for Metronidazole and Tinidazole: Pharmacokinetic and Metabolic Studies in Human Subjects, Antimicrob Agents Chemother 19:754-760.

10.

Pritchard, J.R. and Higgins, T.J. (1987): Tinidazole in Clinical Periodontics-The Effects upon the Subgingival Microflora, J Dent Res 66:821, Abst. No. 35.

11.

Saglie, R. ; Newman, M.G. ; Carranza, F.A. ; and Patti-Son, G.L. (1982): Bacterial Invasion of Gingiva in Advanced Periodontitis in Humans, J Periodontol 53:217-222.

12.

Shinn, D.L.S. (1962): Metronidazole in Acute Ulcerative Gingivitis, Lancet 1:1191.

13.

Slots, J. (1979): Subgingival Microflora and Periodontal Disease , J Clin Periodontol 6:351-382.

14.

Tanner, A.C.R. ; Haffer, C. ; Bratthall, G.T. ; Visconti, R.A. ; and Socransky, S.S. (1979): A Study of the Bacteria Associated with Advancing Periodontal Disease in Man, J Clin Periodontol 6:278-307.

15.

Van Oosten, M.A.C. ; Mikx, F.M.H. ; and Rengli, H.H. (1987): Microbial and Clinical Measurements of Periodontal Pockets During Sequential Periods of Nontreatment, Mechanical Debridement and Metronidazole Therapy, J Clin Periodontol 14:197-204.

16.

Van Palenstein Helderman, W.H. (1981): Microbial Etiology of Periodontal Disease, J Clin Periodontol 8:261-280.

17.

Von Konow, L. and Nord, C.E. (1982): Concentrations of Tinidazole and Metronidazole in Serum, Saliva and Alveolar Bone, J Antimicrob Chemother 10 (Suppl. A): 165-172.

18.

Wood, B.A. and Monro, A.M. (1975): Pharmacokinetics of Tinidazole and Metronidazole in Women After Single Large Oral Doses, Br J Vener Dis 51:51-53.

19.

Wust, J. (1977): Susceptibility of Anaerobic Bacteria to Metronidazole, Omidazole and Tinidazole and Routine Susceptibility Testing by Standardized Methods, Antimicrob Agents Chemother 11:631-637.