Subantimicrobial dose doxycycline effects on alveolar bone loss in post-menopausal women.
OBJECTIVE
Determine the efficacy of 2-year continuous subantimicrobial dose doxycycline (SDD; 20 mg bid) on alveolar bone in post-menopausal osteopenic, oestrogen-deficient women undergoing periodontal maintenance in a 2-year double-blind, placebo-controlled, randomized clinical trial.


METHODS
One-hundred and twenty-eight subjects randomized to SDD or placebo (n=64 each). Posterior vertical bite wings taken at baseline, 1 and 2 years for alveolar bone density (ABD), using radiographic absorptiometry (RA) and computer-assisted densitometric image analysis (CADIA), and alveolar bone height (ABH). Statistical analyses utilized generalized estimating equations; primary analyses were intent to treat (ITT). Results are presented as SDD versus placebo.


RESULTS
Under ITT, there was no statistically significant effect of SDD on ABD loss (RA: p=0.8; CADIA: p=0.2) or ABH loss (p=0.2). Most sites (81-95%) were inactive. For subgroup analyses, mean CADIA was higher with SDD for non-smokers (p=0.05) and baseline probing depths > or =5 mm (p=0.003). SDD was associated with 29% lower odds of more progressive ABH loss in women >5 years post-menopausal (p=0.05) and 36% lower among protocol-adherent subjects (p=0.03).


CONCLUSIONS
In post-menopausal osteopenic women with periodontitis, SDD did not differ overall from placebo. Based on exploratory subgroup analyses, additional research is needed to determine the usefulness of SDD in non-smokers, subjects >5 years post-menopausal and in deeper pockets. Protocol registered at (ClinicalTrials.gov). Identifier: NCT00066027.
Payne
Jeffrey B
JB
Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, NE 68583-0740, USA. jbpayne@unmc.edu
Stoner
Julie A
JA
Nummikoski
Pirkka V
PV
Reinhardt
Richard A
RA
Goren
Arthur D
AD
Wolff
Mark S
MS
Lee
Hsi-Ming
HM
Lynch
James C
JC
Valente
Robert
R
Golub
Lorne M
LM
D015502:Absorptiometry, Photon; D000368:Aged; D016301:Alveolar Bone Loss / Q000517:prevention & control*; D000539:Alveolar Process / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications; D004311:Double-Blind Method; D004318:Doxycycline / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D010514:Periodontal Pocket / Q000517:prevention & control; D010518:Periodontitis / Q000517:prevention & control; D010919:Placebos; D017698:Postmenopause; D016300:Radiography, Bitewing; D012907:Smoking; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D010919:Placebos; D004318:Doxycycline
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