Locally delivered doxycycline as an adjunctive therapy to scaling and root planing in the treatment of smokers: a clinical study.
BACKGROUND
The aim of this clinical study was to evaluate the association of locally delivered doxycycline (10%) with scaling and root planing in the periodontal treatment of smokers.


METHODS
Forty-three patients with chronic periodontitis and a minimum of four pockets (> or = 5 mm) on anterior teeth that bled on probing were selected. Patients were randomly assigned to scaling and root planing (SRP) or scaling and root planing followed by local application of doxycycline (SRP-D). Plaque, bleeding on probing, gingival recession, relative attachment level (RAL), and probing depth (PD) were recorded at baseline, 45 days, and 3 and 6 months. Differences between baseline and each period were considered for analysis.


RESULTS
At 6 months, no difference was found between groups regarding plaque, bleeding reduction, gingival recession or PD (P > 0.05). However, RAL gain was greater for SRP-D (1.63 +/- 0.93 mm) than for SRP (1.04 +/- 0.71 mm) (P = 0.025). In addition, deep pockets (> or = 7 mm) showed a significant reduction (3.78 +/- 1.41 versus 2.60 +/- 1.28 mm, P = 0.039) and RAL gain (2.54 +/- 1.27 mm versus 1.29 +/- 0.95 mm, P = 0.01) when doxycycline was applied. The proportion of sites showing RAL gain of 1 to 2 mm was 36.8% versus 21.7% for SRP-D and SRP, respectively (P = 0.01).


CONCLUSIONS
The use of locally delivered doxycycline may constitute an important adjunct for the treatment of severe periodontal disease in smokers.
Machion
Luciana
L
Department of Periodontics and Prosthodontics, Division of Periodontics, School of Dentistry at Piracicaba, University of Campinas, Piracicaba, São Paulo, Brazil.
Andia
Denise Carleto
DC
Benatti
Bruno Braga
BB
Carvalho
Marcelo Diniz
MD
Nogueira-Filho
Getúlio R
GR
Casati
Márcio Zafallon
MZ
Nociti
Francisco H
FH
Sallum
Enilson Antonio
EA
D000287:Administration, Topical; D000328:Adult; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D003774:Dental Plaque Index; D012534:Dental Scaling; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000628:therapy; D005889:Gingival Recession / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D008297:Male; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D010518:Periodontitis / Q000188:drug therapy / Q000628:therapy*; D011446:Prospective Studies; D016745:Root Planing; D016037:Single-Blind Method; D012907:Smoking
D000900:Anti-Bacterial Agents; D004318:Doxycycline