Subantimicrobial dose doxycycline effects on alveolar bone loss in post-menopausal women.

Abstract

AIM:

Determine the efficacy of 2-year continuous subantimicrobial dose doxycycline (SDD; 20 mg bid) on alveolar bone in post-menopausal osteopenic, oestrogen-deficient women undergoing periodontal maintenance in a 2-year double-blind, placebo-controlled, randomized clinical trial.

MATERIAL AND METHODS:

One-hundred and twenty-eight subjects randomized to SDD or placebo (n=64 each). Posterior vertical bite wings taken at baseline, 1 and 2 years for alveolar bone density (ABD), using radiographic absorptiometry (RA) and computer-assisted densitometric image analysis (CADIA), and alveolar bone height (ABH). Statistical analyses utilized generalized estimating equations; primary analyses were intent to treat (ITT). Results are presented as SDD versus placebo.

RESULTS:

Under ITT, there was no statistically significant effect of SDD on ABD loss (RA: p=0.8; CADIA: p=0.2) or ABH loss (p=0.2). Most sites (81-95%) were inactive. For subgroup analyses, mean CADIA was higher with SDD for non-smokers (p=0.05) and baseline probing depths > or =5 mm (p=0.003). SDD was associated with 29% lower odds of more progressive ABH loss in women >5 years post-menopausal (p=0.05) and 36% lower among protocol-adherent subjects (p=0.03).

CONCLUSIONS:

In post-menopausal osteopenic women with periodontitis, SDD did not differ overall from placebo. Based on exploratory subgroup analyses, additional research is needed to determine the usefulness of SDD in non-smokers, subjects >5 years post-menopausal and in deeper pockets. Protocol registered at (ClinicalTrials.gov). Identifier: NCT00066027.

• Authors: Jeffrey B Payne, Julie A Stoner, Pirkka V Nummikoski, Richard A Reinhardt, Arthur D Goren, Mark S Wolff, Hsi-Ming Lee, James C Lynch, Robert Valente, Lorne M Golub
• Journal: Journal of clinical periodontology (J Clin Periodontol) Vol. 34 Issue 9 Pg. 776-87 (Sep 2007) ISSN: 0303-6979 [Print] United States
• PMID: 17716313 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Anti-Bacterial Agents
• Placebos
• Doxycycline

Topics

• Absorptiometry, Photon
• Aged
• Alveolar Bone Loss (prevention & control)
• Alveolar Process (drug effects)
• Anti-Bacterial Agents (administration & dosage)
• Bone Density
• Bone Diseases, Metabolic (complications)
• Double-Blind Method
• Doxycycline (administration & dosage)
• Female
• Follow-Up Studies
• Humans
• Image Processing, Computer-Assisted
• Middle Aged
• Osteoporosis, Postmenopausal (complications)
• Periodontal Pocket (prevention & control)
• Periodontitis (prevention & control)
• Placebos
• Postmenopause
• Radiography, Bitewing
• Smoking
• Treatment Outcome