Initial antimicrobial effect of controlled-release doxycycline in subgingival sites.
OBJECTIVE
To determine the ability of a 10% doxycycline hyclate controlled-release polymer (Atridox) to suppress periodontopathic bacteria when placed subgingivally following scaling and root planing (Sc/Rp).


METHODS
Eight males and seven females, mean age 48 years, with moderate to advanced periodontitis participated in the study. In each patient, bilateral periodontal pockets probing 6-7 mm were randomly assigned to treatment by Sc/Rp + doxycycline polymer or by Sc/Rp alone. Subgingival placement of doxycycline polymer was carried out according to the manufacturer's instructions. Sc/Rp was performed with hand instruments for at least 10 min in each study tooth. Subgingival samples were collected by paper-points at baseline, at 2 weeks and at 4 weeks post-treatment. Culture methodology was used to isolate and identify putative periodontal pathogens, including Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Dialister pneumosintes, Tannerella forsythia, Prevotella intermedia/Prevotella nigrescens, Campylobacter species, Eubacterium species, Fusobacterium species, Peptostreptococcus micros, Eikenella corrodens, Staphylococcus species, enteric gram-negative rods, beta-hemolytic streptococci and yeasts. The microbiologic examination was carried out blindly. Microbiological data were analyzed using a General Linear Model Analysis of Variance for within and between group effects.


RESULTS
Sites receiving Sc/Rp + doxycycline polymer and sites receiving Sc/Rp alone exhibited similar levels of periodontal pathogens at baseline and did not differ significantly in total viable counts and proportional recovery of periodontopathic bacteria post-treatment.


CONCLUSIONS
Controlled-release doxycycline placed in moderate to deep periodontal pockets caused no significant additional reduction in the subgingival pathogenic microbiota compared to thorough Sc/Rp alone. Since controlled-release doxycycline may not significantly suppress several subgingival pathogenic microorganisms and seems to possess no distinct advantage over broad-spectra, safe and inexpensive antiseptics, the rationale for its employment in periodontal therapy remains unclear.
University of Southern California School of Dentistry, Los Angeles, California 90089-0641, USA. jorgensm@usc.edu
M G
MG
Jorgensen
A
A
Safarian
N
N
Daneshmand
R J
RJ
Keim
J
J
Slots
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001421:Bacteria, Anaerobic / Q000187:drug effects*; D015169:Colony Count, Microbial; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D012534:Dental Scaling; D004318:Doxycycline / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010514:Periodontal Pocket / Q000188:drug therapy* / Q000382:microbiology
D000891:Anti-Infective Agents, Local; D003692:Delayed-Action Preparations; D004318:Doxycycline