Clinical Case 1 – Ms. S – Arestin

Case #1: Arestin Placement

Patient: Ms. S

85 Year Old Caucasian Woman.
ASA Classification: II

Case Value: Light       Perio: Stage II/B      Caries Risk: High (due to multiple caries related restoriations and tooth loss due to decay, as well as active/recurrent and suspicious areas seen clinically.

Med Hx: Patient has a history of high blood pressure and high cholesterol. Patient takes Toprol 50mg and Norvasc 5mg for HTN, and Lipitor 20mg for high cholesterol. Patient also takes OTC Calcium supplements, 630mg and Vitamin D 1000mg daily.

During my 3rd semester in the program, I was able to place Arestin in 4 sites on a clinic patient. Ms. S came in for her RECARE visit on 10/07/2021. After all assessments were completed, and cleaning was completed, it was determined that the patient would be a good candidate for Arestin placement. She had Arestin placed before in other sites, and she reacted well and did not have any adverse reactions. This was an indication to me that she did not have any allergies to minocycline, and if  I was able to find 4 acceptable sites to place the Arestin which did not receive the treatment before. Post dental prophylaxis, the patient returned to clinic on November 4th, after adequate tissue healing to have the Arestin placed into the 4 new sites. The patient came back to the clinic on December 16th to have her post placement evaluation. 3 out of the 4 sites were successful and showed a reduction in pocket depth of 1-2mm. I never used Arestin before, so I didn’t know what to expect but that was an awesome experience. What really amazed me was her tissue response and how tight and firm her gingiva looked in the areas where she was treated with Arestin, in addition to the pocket depth reduction.  Of course, the success of the Arestin placement not only goes partially to me for proper placement of the medication, but mostly goes to my patient who has great home care.

Arestin Placement Sites

Tooth # and Pocket Site PD before Arestin placement PD after Arestin Placement Result
#3 Mesio-lingual 5mm 5mm No change
#4 disto-lingual 5mm 3mm 2mm PD reduction
#30 disto-lingual 6mm 4mm 2mm PD reduction
#31 mesio-lingual 5mm 4mm 1mm PD reduction