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Lookup NU author(s): Professor Philip Preshaw
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Background: Previous studies showed that adjunctive subantimicrobial dose doxycycline (SDD; 20 mg, twice daily) provides significant clinical benefits to scaling and root planing (SRP). A modified-release SDD formulation containing 40 mg doxycycline (SDD-40) to be taken once daily has been developed. The aim of this study was to investigate the efficacy of SDD-40 when used as an adjunct to SRP for the treatment of periodontitis. Methods: A 9-month, double-masked, randomized, placebo-controlled, multicenter study was conducted to test the efficacy of adjunctive SDD-40 in 266 subjects with periodontitis. Subjects were treated by SRP and randomized to receive SDD-40 or placebo for 9 months with evaluations at 3, 6, and 9 months. Results: Adjunctive SDD-40 provided significantly greater clinical benefits than placebo at all time points. At month 9, at sites with baseline probing depths (PD) ≥6 mm, 72% to 76% of sites in the SDD-40 group demonstrated clinically significant PD reductions and clinical attachment level (CAL) gains ≥2 mm compared to 56% to 58% of sites in the placebo group (P<0.0001); 48% to 52% of sites in the SDD-40 group demonstrated PD reductions and CAL gains ≥3 mm compared to 32% of sites in the placebo group (P<0.0001). In moderate sites (baseline PD 4 to 6 mm), adjunctive SDD-40 provided significant clinical benefits compared to placebo for mean CAL (all time points: P<0.05), PD (3 months: P= 0.002; 6 and 9 months: P= 0.001), and bleeding on probing (BOP) (3 months: P<0.01; 6 months: P<0.02; 9 months: P<0.05). In deep sites (baseline PD ≥7 mm), SDD-40 provided significant benefits over control for mean CAL (3 months: P<0.05; 6 and 9 months: P<0.01), PD (all time points: P<0.001), and BOP (3 months: P<0.05; 6 months: not statistically significant; 9 months: P<0.05). Compliance with study medication was high (>92%) with no significant differences in adverse events between groups and no evidence of microbiologically significant changes or development of antibiotic resistance in the subgingival flora in either group. Conclusion: SDD-40 used as an adjunct to SRP resulted in significantly greater clinical benefits than SRP alone in the treatment of periodontitis.
Author(s): Preshaw PM, Novak MJ, Mellonig J, Magnusson I, Polson A, Giannobile WV, Rowland RW, Thomas J, Walker C, Dawson DR, Sharkey D, Bradshaw MH
Publication type: Article
Publication status: Published
Journal: Journal of Periodontology
Year: 2008
Volume: 79
Issue: 3
Pages: 440-452
ISSN (print): 0022-3492
ISSN (electronic): 1943-3670
Publisher: American Academy of Periodontology
URL: http://dx.doi.org/10.1902/jop.2008.070375
DOI: 10.1902/jop.2008.070375
PubMed id: 18315426
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