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Randomized controlled trial of doxycycline in prevention of recurrent periodontitis in high‐risk patients: antimicrobial activity and collagenase inhibition
Author(s) -
McCulloch C. A. G.,
Birek P.,
Overall C.,
Aitken S.,
Lee W.,
Kulkarni G.
Publication year - 1990
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/j.1600-051x.1990.tb01682.x
Subject(s) - doxycycline , medicine , placebo , periodontitis , gastroenterology , randomized controlled trial , antimicrobial , collagenase , clinical trial , antibiotics , dentistry , microbiology and biotechnology , pathology , biology , biochemistry , enzyme , alternative medicine
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 ≥ 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 < 0.05) for Doxycycline compared to placebo. Minimal inhibitory concentrations of Doxycycline for subgingival plaque samples from active sites ranged between 25–100 μg/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 μg/ml Doxycycline. These data indicate that Doxycycline provides significant risk reduction of recurrent periodontitis in patients with active disease.