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Treatment with subantimicrobial dose doxycycline improves the efficacy of scaling and root planing in patients with adult periodontitis.

AbstractBACKGROUND:
In a previous study, subantimicrobial dose doxycycline (SDD) significantly improved clinical parameters associated with periodontal health in patients with adult periodontitis (AP) when used as an adjunct to a maintenance schedule of supragingival scaling and dental prophylaxis. In this double-blind, placebo-controlled, parallel-group, multicenter study, the efficacy and safety of SDD were evaluated in conjunction with scaling and root planing (SRP) in patients with AP.
METHODS:
Patients (n = 190) received SRP at the baseline visit and were randomized to receive either SDD 20 mg bid or placebo bid for 9 months. Efficacy parameters included the per-patient mean changes in clinical attachment level (CAL) and probing depth (PD) from baseline, the per-patient percentages of tooth sites with attachment loss (AL) > or = 2 mm and > or = 3 mm from baseline, and the per-patient percentage of tooth sites with bleeding on probing. Prior to analysis, tooth sites were stratified by the degree of disease severity evident at baseline
RESULTS:
In tooth sites with mild to moderate disease and severe disease (n = 183, intent-to-treat population), improvements in CAL and PD were significantly greater with adjunctive SDD than with adjunctive placebo at 3, 6, and 9 months (all P <0.05). In tooth sites with severe disease, the per-patient percentage of sites with AL > or = 2 mm from baseline to month 9 was significantly lower with adjunctive SDD than with adjunctive placebo (P<0.05). Improvements in clinical outcomes occurred without detrimental shifts in the normal periodontal flora or the acquisition of doxycycline resistance or multiantibiotic resistance. SDD was well tolerated, with a low incidence of discontinuations due to adverse events.
CONCLUSIONS:
The adjunctive use of SDD with SRP is more effective than SRP alone and may represent a new approach in the long-term management of AP.
AuthorsJ G Caton, S G Ciancio, T M Blieden, M Bradshaw, R J Crout, A F Hefti, J M Massaro, A M Polson, J Thomas, C Walker
JournalJournal of periodontology (J Periodontol) Vol. 71 Issue 4 Pg. 521-32 (Apr 2000) ISSN: 0022-3492 [Print] United States
PMID10807113 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
  • Placebos
  • Doxycycline
Topics
  • Adult
  • Aged
  • Anti-Bacterial Agents (administration & dosage, adverse effects, therapeutic use)
  • Bacteria (drug effects)
  • Dental Plaque (microbiology)
  • Dental Prophylaxis
  • Dental Scaling
  • Double-Blind Method
  • Doxycycline (administration & dosage, adverse effects, therapeutic use)
  • Female
  • Gingival Hemorrhage (classification, drug therapy, prevention & control)
  • Humans
  • Male
  • Middle Aged
  • Periodontal Attachment Loss (classification, drug therapy, prevention & control)
  • Periodontal Pocket (classification, drug therapy, prevention & control)
  • Periodontitis (classification, drug therapy, prevention & control)
  • Placebos
  • Root Planing
  • Safety
  • Statistics as Topic
  • Tetracycline Resistance
  • Treatment Outcome

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