Periodoncia.Eley.6a.Ed

Uso de antisépticos, enzimas y oxigenantes como auxiliares en el control de la placa supragingival 239
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liberación lenta demostraron también reducciones significativas en las cifras
de anaerobios de pigmento negro, lo que no se produjo ni con la irrigación de
agua (control negativo) ni con el raspado y alisado radicular. Además, a diferencia
de con el raspado y alisado radicular, muy pocos pacientes manifestaron
molestias con las aplicaciones de azul de metileno.
Estos resultados indican que, al elevar el potencial redox, el azul de metileno
es capaz de alterar la microflora en la bolsa periodontal a una más compatible
con la salud periodontal. En la mayoría de los aspectos, estos cambios
son comparables a los logrados con el raspado y alisado radicular pero en
algunos aspectos son mejores. No tiene ninguno de los inconvenientes asociados
con el uso de antibióticos, ya sea por administración local o sistémica
como la aparición de cepas bacterianas resistentes y el desarrollo de hipersensibilidad.
Por consiguiente, el azul de metileno tiene el potencial de ser
una sustancia terapéutica en el tratamiento de la periodontitis crónica.
No se conoce con precisión qué dosis de azul de metileno es necesaria en
la bolsa periodontal para lograr el efecto óptimo del potencial redox. Sin
embargo, los estudios in vitro han demostrado que P. gingivalis es destruido
por el cambio en el potencial redox producido por el azul de metileno a la
concentración de 1,0 mg/ml (Fletcher y Wilson, 1993).
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