Periodontitis: A dynamic pathology

Periodontitis manifests at both the microbial and clinical levels1,2

Periodontitis is a chronic bacterial infection caused by microbial plaque, also called dental biofilm, that colonizes on the tooth's surface and below the gingival margin.2

When dental biofilm irritates the gingiva, it breaks down the tissue and bone supporting the dentition.3 Left untreated, periodontitis can increase periodontal pocket depth (PD) and bleeding on probing (BOP), and may lead to the spread of active infection to healthy sites.1-3

This epithelial cell-associated biofilm lining the epithelial surface of the pocket contains primarily spirochetes and gram-negative bacterial species.2 Three of the most prominent species are P. gingivalis, T. denticola, and T. forsythia, comprising the class known as red complex bacteria (RCB).2

RCB multiply rapidly, and re-colonization is a persistent threat.2 Scaling and root planing (SRP) alone may not be enough to achieve and sustain a healthier balance of bacteria.4

SRP alone may not be enough4

Periodontitis, being an active bacterial infection, can pose a range of risks and potential oral health consequences to your patients if not controlled.

SRP alone may not be enough to achieve and sustain a healthier balance of bacteria.4

With treatment by mechanical procedures alone, baseline levels of bacteria may return in just a few days.2 Since periodontitis manifests at both the microbial and clinical levels, a treatment plan that addresses both may be appropriate.1,2

Antibiotics can help reduce the prevalence and severity of periodontal disease.5 Orally administered antibiotics, such as tetracyclines, which are concentrated in the gingival crevicular fluid of the periodontal pockets, have been particularly useful as adjuncts in the treatment of some types of periodontitis.5

ARESTIN (minocycline HCl) Microspheres, 1 mg

is active against microorganisms associated with periodontal disease.5

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Like many other bacterial infections, consider an antibiotic as part of treatment.

REFERENCES: 1. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25:134-144. 2. Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontol 2000. 2002;28:12-55. 3. Page RC. Periodontal diseases: a new paradigm. J Dent Educ. 1998;62(10):812-821.  4. Goodson JM, Gunsolley JC, Grossi SG, et al. Minocycline HCl microspheres reduce red-complex bacteria in periodontal disease therapy. J Periodontol. 2007;78(8):1568-1579. 5. Williams RC. Medical progress: periodontal disease. N Engl J Med. 1990;322(6):373-382.


ARESTIN® (minocycline HCl) Microspheres, 1mg is indicated as an adjunct to scaling and root planing (SRP) procedures for reduction of pocket depth in patients with adult periodontitis. ARESTIN® may be used as part of a periodontal maintenance program, which includes good oral hygiene and SRP.


  • ARESTIN is contraindicated in any patient who has a known sensitivity to minocycline or tetracyclines. Hypersensitivity reactions and hypersensitivity syndrome that included, but were not limited to anaphylaxis, anaphylactoid reaction, angioneurotic edema, urticaria, rash, eosinophilia, and one or more of the following: hepatitis, pneumonitis, nephritis, myocarditis, and pericarditis may be present. Swelling of the face, pruritus, fever and lymphadenopathy have been reported with the use of ARESTIN. Some of these reactions were serious. Post-marketing cases of anaphylaxis and serious skin reactions such as Stevens Johnson syndrome and erythema multiforme have been reported with oral minocycline, as well as acute photosensitivity reactions.
  • Tetracyclines, including oral minocycline, have been associated with development of autoimmune syndromes including a lupus-like syndrome manifested by arthralgia, myalgia, rash, and swelling. Sporadic cases of serum sickness-like reaction have presented shortly after oral minocycline use, manifested by fever, rash, arthralgia, lymphadenopathy and malaise. In symptomatic patients, diagnostic tests should be performed and ARESTIN treatment discontinued.
  • The use of ARESTIN in an acutely abscessed periodontal pocket or for use in the regeneration of alveolar bone has not been studied.
  • The safety and effectiveness of ARESTIN has not been established in immunocompromised patients or in those with coexistent oral candidiasis. Use with caution if there is a predisposition to oral candidiasis.
  • In clinical trials, the most frequently reported nondental treatment-emergent adverse events were headache, infection, flu syndrome, and pain.

To report SUSPECTED ADVERSE REACTIONS, contact Valeant Pharmaceuticals North America LLC at 1-800-321-4576 or FDA at 1-800-FDA-1088 or

Click here for full Prescribing Information.

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