Short-term effects of intensive non-surgical periodontal therapy and low-dose doxycycline on serum levels of IL-6, TNF-α and lipid profile in advanced periodontitis

Abstract

Adjunctive use of sub-antimicrobial dose doxycycline (SDD) is a mode of host modulation therapy for periodontitis. However, the potential of SDD for moderating serum inflammatory mediators has not been investigated extensively. This study evaluated the effects of intensive scaling and root planning (ITSRP) ± SDD on the serum levels of tumor necrosis factor-alpha (TNF-, interleukin-6 (IL-6) and lipid profile in advanced periodontitis. Forty systemically healthy patients were randomly assigned into two groups to take either a placebo or an SDD adjunctive to ITSRP in a double-blind controlled clinical trial. At baseline and after 4 weeks, we collected blood samples and recorded clinical indices. Statistically significant changes in TNF- and IL-6 serum levels did not occur in either group compared to baseline. A significant increase in high-density lipoprotein (HDL) cholesterol levels and a decrease in white blood cell counts were observed in the SDD group. Between groups, significantly greater improvements in pocket depth, clinical attachment level, mean number of pockets ≥ 7 mm and IL-6 alteration occurred in the SDD group. This study demonstrated the effectiveness of combining ITSRP with SDD in gaining periodontal attachment, IL-6 alteration and HDL cholesterol levels over ITSRP alone. Adjunctive use of SDD is likely to have a protective role against vascular events by mediating patient HDL levels. Further investigation among a high-risk population is recommended. Key words: Double-blind method, doxycycline, inflammatory mediators, cholesterol high-density lipoprotein (HDL), periodontitis, root planning, serum.