Treatment With Subantimicrobial Dose Doxycycline Improves the Efficacy of Scaling and Root Planing in Patients With Adult Periodontitis

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 G.; Walker, Clay

doi:10.1902/jop.2000.71.4.521

Cited by 218 publications

(258 citation statements)

References 31 publications

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“…In several studies, the inhibitor effects of doxycycline on matrix degrading MMP activities have been demonstrated (7,8). The results have indicated that this host-modulating antibiotic as an adjunct to SRP has also provided more successful clinical healing results than SRP alone (47,55). Recently, one of these studies has shown that improvements in PD and CAL were significantly greater with adjunctive SDD than with adjunctive placebo and it was concluded that the adjunctive use of doxycycline with SRP is more effective than SRP alone, which is in contrast to our findings (55).…”

Section: Discussionmentioning

confidence: 99%

“…The results have indicated that this host-modulating antibiotic as an adjunct to SRP has also provided more successful clinical healing results than SRP alone (47,55). Recently, one of these studies has shown that improvements in PD and CAL were significantly greater with adjunctive SDD than with adjunctive placebo and it was concluded that the adjunctive use of doxycycline with SRP is more effective than SRP alone, which is in contrast to our findings (55). However, in those studies, low-dose doxycycline treatments were used for much longer time periods (6-9 months).…”

Section: Discussionmentioning

confidence: 99%

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A comparative evaluation of the clinical effects of systemic and local doxycycline in the treatment of chronic periodontitis

et al. 2004

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In this study, the clinical efficacies of systemic doxycycline (SD) and local doxycycline (LD) in the treatment of chronic periodontitis were compared. Forty-five patients were studied in 3 main groups with 5 treatments: SD alone, SD+scaling-root planing (SD+SRP), LD alone, LD+SRP and SRP alone. Antibiotic-treated patients were given doxycycline treatment alone in 1 quadrant of their upper jaws, and doxycycline+SRP was given in the contralateral quadrant. The areas included at least 4 teeth with ≥ 5 mm pockets. Probing depth (PD), clinical attachment level, gingival index, sulcular bleeding index and plaque index values were recorded at baseline and the 7 th week. The results were statistically analyzed. All of the clinical parameters were significantly reduced by all treatments (P ≤ 0.05). The SD and LD treatments alone provided significant clinical healings. The significant differences among the groups were only in PD at the 7th week. The LD treatment provided significantly higher PD reduction than the SD treatment (P ≤ 0.05). No significant difference was found between the SD+SRP and the LD+SRP treatments. There was no significant difference between SD+SRP and SRP alone treatment (P > 0.05). The SD group showed lower PD reduction than SRP group (P ≤ 0.05), while no significant difference was found between LD and SRP treatments. The LD alone treatment seemed more effective than SD alone treatment on PD reduction, but no significant difference was found between them when combined with the SRP. LD may be more preferable than SD as an adjunct to mechanical treatment since LD seems more effective than SD on PD reduction and does not have the side effects of SD. (J. Oral Sci. 46, [25][26][27][28][29][30][31][32][33][34][35] 2004) Key Words: tetracycline; systemic doxycycline; local doxycycline; periodontal treatment; local drug delivery; chronic periodontitis. IntroductionCurrently, periodontal disease is accepted as an infection of the periodontium since the primary etiologic factor is bacteria, which triggers the host immune response and the consequent tissue destruction. Because of its infectious nature, in a biological view, the main target for periodontal treatment must be the suppression of the effective bacteria (1,2). In light of this conceptual development, it recently has been considered that mechanical treatment alone is insufficient in the periodontal treatment strategy. Antimicrobial therapy, especially antibiotic treatment, is of special importance as an adjunct to mechanical periodontal treatment (1,3,4).To date, the most widely used antibiotics in the treatment of periodontal disease have been tetracyclines since they show the highest concentrations in gingival crevicular fluid (GCF) and are highly effective on Actinobacillus Actinomycetemcomitans (Aa) (5,6). Recently, some nonJournal of Oral Science, Vol. 46, No. 1, 25-35, 2004 7,8). In one of the studies, patients with moderate chronic periodontitis were administered doxycycline for 2 weeks prior to a full-thickness flap procedur...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A comparative evaluation of the clinical effects of systemic and local doxycycline in the treatment of chronic periodontitis

et al. 2004

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“…Doxycycline was discovered in the early 1960's as a semisynthetic long-acting tetracycline derivative useful as a bacterial ribosome inhibitor in a wide variety of microbes. In subantimicrobial doses it is also an effective primary treatment for rosacea, sterile corneal ulceration, and effective adjunctive treatment for adult periodontitis (84)(85)(86) . Doxycycline has been shown to effectively inhibit MMP-9 in a wide variety of mouse and human cells including prostate epithelium, epidermal keratinocytes, and the aortic endothelium (87)(88)(89)(90) .…”

Section: Tetracyclines and Their Derivativesmentioning

confidence: 99%

Rationale for anti-inflammatory therapy in dry eye syndrome

Paiva¹,

Pflugfelder²

2008

Arq. Bras. Oftalmol.

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“…[15][16][17] Therefore, the aim of this review was to compare the effects of adjunctive use of NSAIDs with nonsurgical periodontal treatment (NSPT) on periodontal disease based on the available literature. Following focused question was addressed: "In patients with periodontal disease, is there an additional benefit of the oral administration of NSAIDs adjunctive with NSPT compared to control in terms of the clinical attachment level (CAL), probing depth (PD), and adverse outcomes in randomized controlled trials?…”

Section: Introductionmentioning

confidence: 99%

Effects of host modulation by nonsteroidal anti-inflammatory drugs on periodontal disease: a systematic review and meta-analysis

Kang

Cho

Shin

et al. 2017

J Dent Rehabil Appl Sci

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Purpose: Nonsteroidal anti-inflammatory drugs that prohibit biosynthesis of arachidonic acid metabolites have been considered potent host modulation agents. The aim of this review was to determine the effect of nonsteroidal anti-inflammatory drugs adjunctive with nonsurgical periodontal treatment in patients with periodontal disease. Materials and Methods: Three electronic databases were searched to identify relevant studies. The methodological quality and mean differences of the change in clinical attachment level and probing depth were analyzed according to Cochrane review methods. Results: Twelve studies were included in the methodological assessment and nine studies were suitable for inclusion in the meta-analysis. The mean difference in the clinical attachment level gain did not differ significantly between the nonsteroidal anti-inflammatory drugs and control groups at any observation time. The highest mean difference in clinical attachment level gain was 0.30 mm at 4 weeks (95% confidence interval = -0.37 to 0.97). There was a significant mean difference in the probing depth reduction, of 0.34 mm (95% confidence interval = 0.29 to 0.40) at 6 weeks. Conclusion: Therefore, nonsteroidal anti-inflammatory drugs have additional therapeutic effect when administrated with nonsurgical periodontal treatment.

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Treatment With Subantimicrobial Dose Doxycycline Improves the Efficacy of Scaling and Root Planing in Patients With Adult Periodontitis

Abstract: 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.

Cited by 218 publications

References 31 publications

A comparative evaluation of the clinical effects of systemic and local doxycycline in the treatment of chronic periodontitis

A comparative evaluation of the clinical effects of systemic and local doxycycline in the treatment of chronic periodontitis

Rationale for anti-inflammatory therapy in dry eye syndrome

Effects of host modulation by nonsteroidal anti-inflammatory drugs on periodontal disease: a systematic review and meta-analysis

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