Adjunctive Benefits of Subantimicrobial Dose Doxycycline in the Management of Severe, Generalized, Chronic Periodontitis

Novak, M. John; Johns, Lee P.; Miller, Renee C.; Bradshaw, Mark

doi:10.1902/jop.2002.73.7.762

Cited by 102 publications

(115 citation statements)

References 19 publications

(26 reference statements)

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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%

“…Systemic tetracycline/doxycycline treatment combined with mechanical treatment has been shown to improve clinical parameters, reduce probing depth, and gain clinical attachment in adult or refractory periodontitis patients (13,(41)(42)(43)(44)(45)(46). A recent study has shown that the supplementation of fullmouth subgingival d e b r i d e m e n t w i t h a h o s t -m o d u l a t i n g a g e n t , subantimicrobial dose doxycycline (SDD), provides clinically and statistically significant benefits in the reduction of deep pockets in patients with severe periodontitis (47). However, other studies have shown good results without the use of an adjunctive antibiotic (48,49).…”

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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“…Subantimicrobial 2.5 ± 1.9 (1.2-4.1) 6.9 ± 1.9 (5.2-7.9) Clinical loss of attachment (mm) 1.9 ± 0.5 (1.2-2.4) 5.5 ± 1.3 (3.5-6.9) Bleeding on probing (%) 5.32 ± 3.71 (3.78-8.56) 57.9 ± 14.6 (44.2-68.8) No. of teeth with periodontitis 4.12 ± 1.32 (3.24-6.89) 10.31 ± 1.32 (9.06-12.08) doses of doxycycline inhibit MMP-8 and reduce periodontal disease activity (Caton et al, 2001;Novak et al, 2002). Gingival crevicular MMP-8, -9 levels in periodontitis were higher than those in healthy subjects.…”

Section: Discussionmentioning

confidence: 98%

“…Increased production of a given cytokine is associated with carriage of a risk genotype. Previously, the risk of having periodontal disease has been related to carriage of rare alleles of single cytokine and receptor molecule genes such as IL-1, TNF-a, IL-6 and CD-14 (Caton et al, 2001;Novak et al, 2002;Miller et al, 2006;Rai et al, 2007). MMPs are derived predominantly from polymorphonuclear leukocytes during acute stages of periodontal diseases.…”

Section: Discussionmentioning

confidence: 99%

Levels of Gingival Crevicular Metalloproteinases-8 and -9 in Periodontitis

Rai¹

2008

Pesq Bras Odontoped Clin Integr

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Matrix metalloproteinases (MMPs), the key enzymes responsible for matrix degradation, are derived from polymorphonuclear leukocytes during the early stages of periodontitis. The aim of this study was planned to determine the levels of GCF (gingival crevicular fluid) matrix metalloproteinase-8 (MMP-8) and metalloproteinase-9 (MMP-9) patients with periodontitis and in healthy controls. Levels of crevicular MMP-8 and -9 were determined by ELISA in subjects with healthy without any periodontal disease (n = 10) and periodontitis (n = 10). Significantly higher crevicular MMP-8 and -9 were observed in cases of periodontitis compared to healthy adults. Crevicular MMP-8 and -9 may serve as biomarkers of periodontal disease and aid in early detection of periodontitis.

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“…MMP inhibitors such as low dose formulations of doxycycline have been used in combination with scaling and root planing or surgical therapy (Gapski, et al, 2004). In addition, high-risk patient populations such as diabetics or patients with recurrent periodontal disease have benefited from systemic MMP administration (Chang, et al, 1996, Golub, et al, 2001, Novak, et al, 2002. Encouraging results have been shown using soluble antagonists of TNF and IL-1 delivered locally to periodontal tissues in nonhuman primates .…”

Section: Future Host Modulatory Approachesmentioning

confidence: 99%

Present and Future Non-Surgical Therapeutic Strategies for the Management of Periodontal Diseases

Leite¹,

Kirkwood²

2012

Periodontal Diseases - A Clinician's Guide

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Adjunctive Benefits of Subantimicrobial Dose Doxycycline in the Management of Severe, Generalized, Chronic Periodontitis

Cited by 102 publications

References 19 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

Levels of Gingival Crevicular Metalloproteinases-8 and -9 in Periodontitis

Present and Future Non-Surgical Therapeutic Strategies for the Management of Periodontal Diseases

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