Effect of subantimicrobial dose doxycycline as an effective adjunct to scaling and root planing

초록

Background: This study evaluated the efficacy and safety of a subantimicrobial dose of doxycycline (SDD) in conjunction with scaling and root planing (SRP). Methods: The study was a 9-month, double masked, randomized, placebo-controlled, parallel-group trial. A total of 41 patients with moderate chronic periodontitis who received SRP were randomly allocated to receive either a doxycycline hyclate or a placebo 2 weeks after SRP. Clinical attachment level (CAL), the probing depth (PD), gingival crevicular fluid (GCF) levels, and matrix metalloproteinase (MMP)-8 and -13 levels were measured throughout the study. The effect of SDD in conjunction with SRP on the dynamics of the periodontal microflora was also assessed using dark-field microscopic and culture analysis. Information on adverse events was collected throughout the study. Results: During the treatment period, per-patient reductions in PD and CAL were demonstrated for both treatment groups, with a significantly greater reduction for the SDD group. The mean value of per-patient change in the GCF was much greater for the SDD group. Microbial analysis showed there were a general tendency for cocci, non-motile rods, and aerobes to increase with increasing treatment duration and a general decreasing tendency for spirochetes, motile rods, and anaerobes and black pigmented bacteria in both treatment groups, but no significant difference between the groups. The MMP-8 and - 13 levels of the SDD group gradually reduced with time, and the mean per-patient average was significantly higher than in the placebo group. The adverse events in the SDD group were similar to those in the placebo group. Conclusion: This study suggests that a submicrobial dose of doxycycline as an adjunct therapy with SRP might be safe and effective in the long-term management of chronic periodontitis.

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