Treatment of periodontitis by local administration of minocycline microspheres: a controlled trial.
BACKGROUND
Periodontitis is an inflammatory condition of tooth-supporting tissues that is usually treated by mechanical removal of plaque and microorganisms that adhere to teeth. This treatment, known as scaling and root planing, is not optimally effective. Adjunctive therapy with locally delivered antimicrobials has resulted in improved clinical outcomes such as probing depth reduction. This article reports on the efficacy and safety of locally administered microencapsulated minocycline.


METHODS
Seven hundred forty-eight (748) patients with moderate to advanced periodontitis were enrolled in a multi-center trial and randomized to 1 of 3 treatment arms: 1) scaling and root planing (SRP) alone; 2) SRP plus vehicle; or 3) SRP plus minocycline microspheres. The primary outcome measure was probing depth reduction at 9 months. Clinical assessments were performed at baseline and 1, 3, 6, and 9 months.


RESULTS
Minocycline microspheres plus scaling and root planing provided substantially more probing depth reduction than either SRP alone or SRP plus vehicle. The difference reached statistical significance after the first month and was maintained throughout the trial. The improved outcome was observed to be independent of patients' smoking status, age, gender, or baseline disease level. There was no difference in the incidence of adverse effects among treatment groups.


CONCLUSIONS
Scaling and root planing plus minocycline microspheres is more effective than scaling and root planing alone in reducing probing depths in periodontitis patients.
Williams
R C
RC
Department of Periodontology, University of North Carolina, School of Dentistry, Chapel Hill 27599-7450, USA. ray_williams@dentistry.unc.edu
Paquette
D W
DW
Offenbacher
S
S
Adams
D F
DF
Armitage
G C
GC
Bray
K
K
Caton
J
J
Cochran
D L
DL
Drisko
C H
CH
Fiorellini
J P
JP
Giannobile
W V
WV
Grossi
S
S
Guerrero
D M
DM
Johnson
G K
GK
Lamster
I B
IB
Magnusson
I
I
Oringer
R J
RJ
Persson
G R
GR
Van Dyke
T E
TE
Wolff
L F
LF
Santucci
E A
EA
Rodda
B E
BE
Lessem
J
J
D000287:Administration, Topical; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002214:Capsules; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D012534:Dental Scaling; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016017:Odds Ratio; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D010518:Periodontitis / Q000188:drug therapy* / Q000628:therapy; D014677:Pharmaceutical Vehicles; D012449:Safety; D012737:Sex Factors; D012907:Smoking; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002214:Capsules; D014677:Pharmaceutical Vehicles; D008911:Minocycline