Initial antimicrobial effect of controlled-release doxycycline in subgingival sites.

Jorgensen MG, Safarian A, Daneshmand N, Keim RJ, Slots J. Initial antimicrobial effect of controlled-release doxycycline in subgingival sites. J Periodont Res 2004; doi: 10.1111/j.1600-0765.2004.00742.x© Blackwell Munksgaard 2004 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). 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, β-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. 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. 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. [ABSTRACT FROM AUTHOR]