Supportive periodontal therapy of furcation sites: non-surgical instrumentation with or without topical doxycycline.
OBJECTIVE
Evaluation of the clinical effect of topical subgingival application of doxycycline gel adjunctively to scaling and root planing (SRP) at furcation sites during supportive periodontal therapy (SPT).


METHODS
In 39 SPT patients exhibiting at least four pockets > or m with bleeding on probing, SRP was rendered in all pockets > or m. Additionally, 14% doxycycline gel was applied subgingivally in 20 patients after random assignment (SRP&DOXY). Clinical parameters were assessed at baseline, 3, 6, and 12 months after therapy. Additional benefit of topical doxycycline was evaluated as a short-term (3 months) improvement of furcation involvement and influence on the frequency of re-instrumentation up to 12 months.


RESULTS
A total of 323 furcation sites (class 0: 160; class I: 101; class II: 18; and class III: 44) were treated (SRP: 165, SRP&DOXY: 158). SRP&DOXY resulted in better improvement of furcation involvement than SRP alone 3 months after treatment (p=0.041). However, SRP&DOXY failed to show a significant difference between both groups in the number of re-instrumentations.


CONCLUSIONS
Single subgingival application of doxycycline in addition to SRP had a short-term effect on furcation involvement. However, it failed to reduce the frequency of re-instrumentation up to 12 months at furcation sites.
Dannewitz
Bettina
B
Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.
Lippert
Katherine
K
Lang
Niklaus P
NP
Tonetti
Maurizio S
MS
Eickholz
Peter
P
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001641:Bicuspid / Q000473:pathology; D003131:Combined Modality Therapy; D003774:Dental Plaque Index; D012534:Dental Scaling; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000628:therapy*; D005782:Gels; D005881:Gingiva; D005884:Gingival Hemorrhage / Q000628:therapy; D005889:Gingival Recession / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000473:pathology; D017622:Periodontal Attachment Loss / Q000628:therapy; D010514:Periodontal Pocket / Q000628:therapy; D010518:Periodontitis / Q000628:therapy; D019233:Retreatment; D016745:Root Planing; D016037:Single-Blind Method; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005782:Gels; D004318:Doxycycline