Results of this trial demonstrate that treatment of periodontitis with subgingivally delivered doxycycline in a biodegradable polymer is equally effective as scaling and root planing and superior in effect to placebo control and oral hygiene in reducing the clinical signs of adult periodontitis over a 9-month period. This represents positive changes resulting from the use of subgingivally applied doxycycline as scaling and root planing was not limited regarding time of the procedure or use of local anesthesia.

Results show that a one-time MI session is insufficient for improving oral hygiene in long-standing maintenance patients.

The purpose of this study was to compare the in vivo osseous healing response of 4 commercially-available synthetic bone grafting materials; hydroxylapatite (HA), calcium sulfate (CaSO4) plus autogenous bone, or a bioactive glass ceramic: with particle size of 300-360 microm (BG1) or 90 to 710 microm (BG2). 4 osteotomy sites were prepared in each tibia of 10 adult male rabbits. One unfilled osteotomy site served as negative control (NC) and another site filled with autogenous bone was the positive control (PC). All animals received BG1 in 2 sites and BG2 in 2 sites. 5 animals received HA and five CaSO4 plus autogenous bone in the remaining 2 sites. Animals were sacrificed at 28 days post-surgery, histologic sections obtained and the % surface area of new bone formation for each material was determined by computerized image analysis. All graft sites showed evidence of bone formation, i.e., (NC) 41.95%; (PC) 50.41%; (BG1) 41.82%; (BG2) 40.36%; (HA) 41.83% and (CaSO4) 58.83%. Statistical analysis using an ANOVA with repeated measures on the materials common to all animals (excluding HA and CaSO4 groups) showed significant differences between materials in surface area of bone, with positive controls better than negative controls, and BG1 and BG2 not significantly different from the negative control. These results indicate that synthetic graft materials can support new bone formation in surgically prepared defects. The utility of a rabbit model for studying physiologic osseous turnover and healing is questioned for studies of slowly resorbing synthetic graft materials.

The results indicate that simplified subgingival instrumentation combined with local application of doxycycline in deep periodontal sites can be considered as a justified approach for non-surgical treatment of chronic periodontitis.

Intrapocket administration of lidocaine 25 mg/g plus prilocaine 25 mg/g and thermosetting agents may be effective for pain control for scaling and root planing and may offer an alternative to infiltration anesthesia.