82 patients with a recent history of
periodontal abscesses and/or loss of gingival attachment (GAL) despite active periodontal
therapy were enrolled in a double-blind, randomized, placebo-controlled trial. Clinical measurements and
subgingival scaling were performed every 2 months. If any site exhibited greater than or equal to 2 mm loss of GAL or a
periodontal abscess, patients were administered either 100 mg
Doxycycline per day for 3 weeks or placebo. During 12 months of monitoring, 55 patients exhibited recurrent active disease and were then randomly assigned to either the
Doxycycline or placebo groups. Clinical measurements of GAL and microbiological culture of subgingival bacteria were made at intervals between 1 week and 7 months after completion of the
drug regime. Within 7 months, 15 out of 19 patients on placebo exhibited recurrent disease compared to 13 out of 29 patients on
Doxycycline, a relative risk reduction of 43% (p less than 0.05) for
Doxycycline compared to placebo. Minimal inhibitory concentrations of
Doxycycline for subgingival plaque samples from active sites ranged between 25-100 micrograms/ml, which are several fold higher than reported crevicular fluid concentrations for this
drug. However gingival crevicular fluid
collagenase was inhibited in vitro at concentrations of 5-10 micrograms/ml
Doxycycline. These data indicate that
Doxycycline provides significant risk reduction of recurrent
periodontitis in patients with active disease.