Subgingival doxycycline as effective as scaling and root planing in reducing the clinical signs of adult periodontitis

Abstract

Objective To test the safety and effectiveness of doxycycline hyclate delivered subgingivally to human periodontal pockets in a biodegradable controlled-release delivery system. Design Multi-centre, randomised single-blind study Intervention Patients with generalised moderate to severe periodontitis (two quadrants with more than four pockets ⩾5mm which bled on probing at least two sites must be ⩾7mm) were randomised to receive one of the following treatments; subgingival doxycycline hyclate (DH), subgingival placebo (VC), oral hygiene (OH) or scaling and root planing (SRP). Patients were excluded if they were receiving a contraindicated medication, or had received SRP within 2 months. DH and VC patients also had periodontal dressings, which were removed at 7 days together with test material. Blind evaluation of treatment was carried out. Outcome measures Clinical attachment gain, probing depth reduction, plaque score and adverse events Results Mean and frequency data for clinical attachment and probing depth changes over the 9-month period are given, as are plaque scores. Adverse events (mild to moderate gingival soreness) were also noted with 38 in DH group, 51 in VC, 10 in OH and 35 in SRP. Numbers needed to treat (NNT) and harm (NNH) were calculated from data presented in study. Conclusion Subgingival doxycycline hyclate is equally effective as scaling and root planing and superior to placebo and oral hygiene in reducing the clinical signs of adult periodontitis over 9 months. Garrett S, Johnson L, Drisko CH, Adams DF, Bandt C, Beiswanger B, Bogle G, Donly K, Hallmon WW, Hancock EB, Hanes P, Hawley CE, Kiger R, Killoy W, Mellonigg JT, Polson A, Raab FJ, Ryder M, Stoller NH, Horn-Lay Wang, Wolinsky LE, Evans GH, Harrold CQ, Arnold RM, Atack DF, Fitzgerald B, Hill M, Issacs RL, Nasi HF, Newell DH, MacNeil RL, MacNeill S, Spolsky VW, Duke SP, Polson A, Southard GL. Two Multi-Centre Studies evaluating locally delivered doxycycline hyclate, placebo control, oral hygiene and scaling and root planing in the treatment of periodontitis. J Periodontol 1999; 70: 490–503