Summary Review/Periodontal Disease
Evidence-Based Dentistry (2007) 8, 5–6. doi:10.1038/sj.ebd.6400488
No evidence to support the use of low-dose doxycycline as an adjunct to nonsurgical therapy in smokers
Does low-dose doxycycline improve clinical outcomes when smokers have periodontal therapy?
Address for correspondence: Ian Needleman, Department of Periodontology and International Centre for Evidence-based Oral Health, UCL Eastman Dental Institute, 256 Gray's Inn Road, London WC1X 8LD, UK. E-mail: i.needleman@eastman.ucl.ac.uk
Richard Niederman1
1Forsyth Institute and Boston University Goldman School of Dental Medicine, Boston, Massachusetts, USA
Needleman I, Suvan J, Gilthorpe MS, et al. A randomized-controlled trial of low-dose doxycycline for periodontitis in smokers. J Clin Periodontol 2007; vol:34 325–333
Abstract
Design
This was a randomised, placebo-controlled trial with 6 months of follow-up.
Intervention
Patients received nonsurgical periodontal therapy and 3 months of the test treatment (low-dose doxycycline; LDD) or control (inactive identical placebo).
Outcome measure
The primary outcome was the change in the clinical attachment level (CAL) recorded from the cemento-enamel junction to the base of the probing pocket using a graduated UNC-15 probe (Hu Friedy, Chicago, Illinois, USA). Secondary outcomes included pocket depth, gingival recession and bleeding on probing recorded at six sites per tooth with the manual probe and ICTP (terminal carboxytelopeptide of type 1 collagen).
Results
The velocity of change was statistically significantly greater for the test group for CAL [-0.19 mm/ month; 95% confidence interval (CI), -0.34– -0.04; P 0.012] and probing depth (0.30 mm/ month; 95% CI, -0.42– -0.17; P 0.001). No differences were observed, however, for absolute change in clinical or biochemical markers at 6 months.
Conclusions
Nonsurgical periodontal therapy in smokers can produce a substantial improvement in periodontal health but there is no evidence to support the use of LDD as an adjunct to their nonsurgical therapy. Quitting tobacco use continues to be of fundamental importance in improving the periodontal health of these individuals.
