Abstract
Periodontal pathogens and destructive host responses are involved in the initiation and progression of periodontitis. Therefore the successful management of this disease may require a treatment strategy that integrates therapies that address both etiologic components. Novel adjunctive therapies such as host modulation therapy (HMT) to enhance the efficacy of existing mechanical procedures can contribute favorably to an integrated approach for the long-term clinical management of periodontitis, particularly for susceptible, high-risk patients. Sub-antimicrobial–dose doxycycline (SDD) is the only systemically administered HMT currently approved and indicated as an adjunct to SRP for treating periodontitis. Clinical trials have demonstrated a clear treatment benefit when using SDD versus SRP alone. SDD should be used as part of a comprehensive treatment strategy that includes antibacterial treatments (SRP, plaque control, local antimicrobials, and periodontal surgery), host response modulation (SDD), and assessment and management of periodontal risk factors. The use of HMT to better manage chronic periodontal disease may have applications to other chronic systemic diseases such as arthritis, diabetes, osteoporosis, and cardiovascular disease.
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