Evaluation of Periostat for patient management

The cause of adult periodontitis involves complex bacteria-host interactions, with modifying influences exerted by genetic and environmental factors. Current thinking indicates that successful, long-term management of adult periodontitis requires a treatment approach that takes into account the various etiologic components of the disease. Recently, a formulation containing a subantimicrobial dose of doxycycline (Periostat) was approved for use as an adjunct to scaling and root planing (SRP) in the treatment of adult periodontitis. As an inhibitor of matrix metalloproteinases that have been implicated in the pathologic degradation of connective tissue collagen in periodontal support structures, Periostat in conjunction with SRP was shown to significantly improve clinical attachment and reduce probing depth compared with placebo in conjunction with SRP. This article reviews the clinical trial results leading to US Food and Drug Administration approved of Periostat and discusses the potential use of this host-modulatory agent as a complementary systemic pharmacotherapy in periodontal management programs.