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Treatment With Subantimicrobial Dose Doxycycline Improves the Efficacy of Scaling and Root Planing in Patients With Adult Periodontitis
Author(s) -
Caton Jack G.,
Ciancio Sebastian G.,
Blieden Timothy M.,
Bradshaw Mark,
Crout Richard J.,
Hefti Arthur F.,
Massaro Joseph M.,
Polson Alan M.,
Thomas John,
Walker Clay
Publication year - 2000
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2000.71.4.521
Subject(s) - medicine , scaling and root planing , placebo , periodontitis , adjunctive treatment , dentistry , doxycycline , bleeding on probing , randomized controlled trial , chronic periodontitis , antibiotics , alternative medicine , pathology , microbiology and biotechnology , biology
Background: 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) ≥2 mm and ≥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 ≥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. J Periodontol 2000;71:521‐532.