A randomized-controlled trial of low-dose doxycycline for periodontitis in smokers.
OBJECTIVE
Tobacco use reduces the effect of non-surgical periodontal therapy. Host-modulation with low-dose doxycycline (LDD) might favour repair and promote an improved treatment response. The aim of this study was to investigate the effect of LDD in smokers on non-surgical periodontal therapy.


METHODS
This was a parallel arm, randomized, identical placebo-controlled trial with masking of examiner, care-giver, participant and statistician and 6 months of follow-up. Patients received non-surgical therapy and 3 months of test or control drug. Statistical analysis used both conventional methods and multilevel modelling.


RESULTS
Eighteen control and 16 test patients completed the study. The velocity of change was statistically greater for the test group for clinical attachment level -0.19 mm/month (95% CI=-0.34, 0.04; p=0.012) and probing depth 0.30 mm/month (95% CI=-0.42, -0.17; p<0.001). However, no differences were observed for absolute change in clinical or biochemical markers at 6 months.


CONCLUSIONS
This study does not provide evidence of a benefit of using LDD as an adjunct to non-surgical periodontal therapy in smokers.
Needleman
Ian
I
Department of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK. i.needleman@eastman.ucl.ac.uk
Suvan
Jean
J
Gilthorpe
Mark S
MS
Tucker
Richard
R
St George
Geoff
G
Giannobile
William
W
Tonetti
Maurizio
M
Jarvis
Martin
M
D000328:Adult; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D024042:Collagen Type I; D012534:Dental Scaling; D004311:Double-Blind Method; D004318:Doxycycline / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010446:Peptide Fragments / Q000032:analysis; D010455:Peptides; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010518:Periodontitis / Q000188:drug therapy*; D011347:Procollagen / Q000032:analysis; D011446:Prospective Studies; D012907:Smoking; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; D004318:Doxycycline