Effects of smoking on local delivery of controlled-release doxycycline as compared to scaling and root planing.
This paper examines the effects of smoking on the treatment outcomes of two nonsurgical therapies: (1) scaling and root planing alone (SRP) or (2) controlled-release of subgingivally delivered doxycycline hyclate in a polylactic acid based polymer gel. Subjects from 2 9-month multicenter studies were classified as nonsmokers (never smoked: 100 subjects), former smokers (137 subjects), and current smokers (> or = 10 cigarettes/day: 121 subjects). Clinical parameters were analyzed for treated sites with baseline probing depths > or = 5 mm and for a subset of treated sites with baseline probing depths of > or = 7 mm. Clinical parameters (plaque levels, clinical attachment levels, pocket depths, and bleeding on probing) were analyzed at baseline, 4, 6, and 9 months. In the doxycycline treated group in general, there were neither marked significant differences in clinical attachment gain nor differences in probing depth reduction among the 3 smoking groups. On the other hand, in the scaling and root planing treated group in general, there were significant differences in clinical attachment gain and pocket depth reduction, with non-smokers responding better than former smokers and current smokers at 6 and 9 months. These differences in clinical response between scaling and root planing alone versus controlled-release of locally-delivered doxycycline hyclate among these 3 smoking groups are discussed in relation to treatment implications for smokers.
Ryder
M I
MI
University of California San Francisco/School of Dentistry, USA. mirper@itsa.ucsf.edu
Pons
B
B
Adams
D
D
Beiswanger
B
B
Blanco
V
V
Bogle
G
G
Donly
K
K
Hallmon
W
W
Hancock
E B
EB
Hanes
P
P
Hawley
C
C
Johnson
L
L
Wang
H L
HL
Wolinsky
L
L
Yukna
R
R
Polson
A
A
Carron
G
G
Garrett
S
S
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D003774:Dental Plaque Index; D012534:Dental Scaling; D004318:Doxycycline / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D019344:Lactic Acid; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010510:Periodontal Diseases / Q000188:drug therapy / Q000628:therapy*; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D011091:Polyesters; D011108:Polymers; D016745:Root Planing; D016037:Single-Blind Method; D012907:Smoking / Q000503:physiopathology*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D003692:Delayed-Action Preparations; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide); D004318:Doxycycline