Microbiologic changes following administration of locally delivered doxycycline in smokers: a 15-month follow-up.
BACKGROUND
Additional clinical benefits have been reported with the use of locally delivered antimicrobials in the treatment of smokers; however, long-term changes in the subgingival microbiota following the use of these drugs in smokers have not been documented. The aim of this study was to evaluate long-term microbiologic changes following locally delivered doxycycline in the treatment of smokers.


METHODS
Sixteen smokers with chronic periodontitis presenting a minimum of four pockets (probing depth>or=5 mm) were selected. Patients were assigned randomly to receive scaling and root planing (SRP) or SRP and local doxycycline (SRP-D). Patients were treated at baseline and 12 months. Subgingival plaque samples were collected at baseline; 3, 6, and 12 months; and 45 and 90 days following retreatment. Polymerase chain reaction and DNA-DNA hybridization analyses were performed to detect the presence of selected periodontal pathogens.


RESULTS
The reduction in the number of sites positive for Porphyromonas gingivalis and Tannerella forsythia (previously T. forsythensis) was statistically significant for SRP-D at 3 months (68% and 41.3%, respectively) and for SRP at 6 months (75% and 52%, respectively) following treatment. The SRP group showed a greater frequency of P. gingivalis than the SRP-D group at 3 months (58% and 25%, respectively). There also was a greater reduction in the frequency of P. gingivalis at 3 months following retreatment with SRP-D compared to SRP (47% and 8%, respectively).


CONCLUSIONS
In smokers, adjunctive local doxycycline resulted in a greater reduction in the frequency of P. gingivalis following initial and supportive therapy compared to conventional treatment.
M Shaddox
Luciana
L
Department of Periodontology, School of Dentistry, University of Florida, Gainesville, FL 32610, USA. lmachion@dental.ufl.edu
Andia
Denise Carleto
DC
Casati
Marcio Zaffalon
MZ
Nociti
Francisco Humberto
FH
Sallum
Enilson Antonio
EA
Gollwitzer
Jennifer
J
Walker
Clay B
CB
D000190:Actinomyces / Q000187:drug effects / Q000302:isolation & purification; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D015342:DNA Probes; D003773:Dental Plaque / Q000188:drug therapy* / Q000382:microbiology; D012534:Dental Scaling; D004318:Doxycycline / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010518:Periodontitis / Q000188:drug therapy*; D016966:Porphyromonas gingivalis / Q000187:drug effects / Q000302:isolation & purification; D016745:Root Planing; D012907:Smoking; D018709:Statistics, Nonparametric
D000900:Anti-Bacterial Agents; D015342:DNA Probes; D004318:Doxycycline