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Subgingival topical doxycycline versus mechanical debridement for supportive periodontal therapy: a single blind
Peter Eickholz1, Ti-Sun Kim, Beate Schacher
1Poliklinik für Parodontologie, Zentrum für Zahn-, Mund- und Kieferheilkunde, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany. eickholz@med.uni-frankfurt.de
Purpose:
To evaluate the clinical effects of topical subgingival application of a doxycycline gel compared to conventional mechanical debridement in supportive periodontal therapy.
Methods:
37 patients with residual or recurring periodontitis after systematic periodontal treatment at two centers (Heidelberg, Frankfurt) participated in this study. They had to exhibit at least one single-rooted tooth with either a probing depth (PPD) = 5 mm and bleeding-on-probing (BOP) or with PPD > or = 6 mm. The patients were randomly assigned to one of the two different treatment regimes: DOXY (exclusively subgingival application of a 14% doxycycline gel) or SRP (scaling and root planing with a sonic scaler). Clinical examinations (plaque index [P1I], PPD, vertical relative attachment level [RAL-V], gingival index [GI]) were performed before, 3, and 6 months after therapy.
Results:
In 37 patients (19 female), aged 30-76 years with a total of 168 teeth were treated (DOXY: 79; SRP: 89). Six months after therapy, both groups exhibited statistically significant (P< 0.001) reductions of PPD (DOXY: -1.43 +/- 0.22 mm; SRP: -1.14 +/- 0.18 mm) and gains of RAL-V (DOXY: 0.79 +/- 0.22 mm; SRP: 0.72 +/- 0.19 mm). Multilevel regression analyses, considering the therapy of different numbers of teeth in different patients, failed to show statistically significant differences concerning PPD reduction and RAL-V gain between both therapies (DOXY/SRP). For both therapies, PPD reduction was significantly better in deeper pockets (PPD > or = 7 mm) than in shallow pockets (PPD: 5-6 mm).