title: Subantimicrobial dose doxycycline as an adjunct to scaling and root planing: post-treatment effects.
abstract: OBJECTIVE
  Subantimicrobial dose doxycycline (SDD 20 mg bid) plus scaling and root planing (SRP) significantly improved clinical attachment level (CAL) and reduced probing depth (PD) compared with placebo plus SRP in a double-blind, placebo-controlled, multicenter study of patients with adult periodontitis (AP). In a study conducted as a follow-up, the post-treatment effects of SDD were assessed in patients who completed the SRP study.
  
  
  METHODS
  The SRP study was a 9-month, active-treatment study and the follow-up was a 3-month, no-treatment study. In the SRP study, tooth sites in qualifying quadrants were scaled and root planed and patients were randomized to receive twice daily SDD 20 mg or placebo. In the follow-up, patients received no study drug; investigators and patients remained blinded to the previous treatment group assignments. Efficacy measures included the change in CAL and PD from baseline values determined at the start of the SRP study in tooth sites stratified by baseline PD (i.e., 0-3 mm, 4-6 mm, > or =7 mm). Safety was evaluated using adverse event data and the results of clinical laboratory tests, oral pathology examinations, and microbiological assessments.
  
  
  RESULTS
  Within each disease stratum, the incremental improvements in PD and CAL demonstrated in the SDD group over 9 months of active treatment were maintained through 3 additional months of no treatment. Treatment cessation did not result in an accelerated regression of periodontal health. No differences in the incidence of adverse events (including those related to infection) or laboratory or microbiological parameters were noted between the SDD group and the placebo group.
  
  
  CONCLUSIONS
  The administration of SDD 20 mg bid for a period of up to 9 months is not associated with rebound effects or delayed or negative after-effects for a 3-month period after cessation of therapy.
authors.affiliation: University of Rochester, Eastman Dental Center, 625 Elmwood Avenue, Rochester, NY 14620, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Caton
authors.forename: S G
authors.initials: SG
authors.lastname: Ciancio
authors.forename: T M
authors.initials: TM
authors.lastname: Blieden
authors.forename: M
authors.initials: M
authors.lastname: Bradshaw
authors.forename: R J
authors.initials: RJ
authors.lastname: Crout
authors.forename: A F
authors.initials: AF
authors.lastname: Hefti
authors.forename: J M
authors.initials: JM
authors.lastname: Massaro
authors.forename: A M
authors.initials: AM
authors.lastname: Polson
authors.forename: J
authors.initials: J
authors.lastname: Thomas
authors.forename: C
authors.initials: C
authors.lastname: Walker
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012534:Dental Scaling / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004318:Doxycycline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020782:Matrix Metalloproteinases / Q000187:drug effects; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000188:drug therapy / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D016745:Root Planing / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D020782:Matrix Metalloproteinases; D004318:Doxycycline