| 1538 Low-dose doxycycline for periodontitis in smokers | ||
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I. NEEDLEMAN1, G. ST GEORGE2, R. TUCKER2, M. TONETTI2, W. GIANNOBILE3, M. JARVIS4, and M. GILTHORPE5, 1Eastman Dental Institute, UCL, London, United Kingdom, 2Eastman Dental Institute, London, United Kingdom, 3University of Michigan, Ann Arbor, USA, 4University College London, United Kingdom, 5University of Leeds, United Kingdom Objectives: Smoking reduces the benefit of periodontal treatment (Labriola et al. 2005). Upregulation of inflammation and tissue destruction are implicated as key mechanisms. Low-dose tetracyclines have been demonstrated to inhibit excessive tissue destruction. The aim of this double blind randomised controlled trial was to investigate in smokers, the effect of low-dose doxycycline as an adjunct to conventional non-surgical treatment. Methods: 35 smokers with chronic periodontitis were randomised to 20mg doxycycline (Periostat) or identical-looking placebo (drug/placebo therapy 3 month duration). Randomisation was stratified by smoking status and disease severity. All participants were treated with non-surgical periodontal therapy (oral hygiene instruction, mechanical debridement under local anaesthesia up to 4 visits) and maintenance therapy at 1, 3 months. Clinical parameters, GCF markers and smoking exposure including PPD, CAL, BOP, PI, GCF ICTP, self-reported smoking status, salivary cotinine levels, and exhaled carbon monoxide, were assessed at 1, 3, 6 months post-therapy by a single calibrated masked examiner. Results: Both groups of smokers improved in their clinical outcomes throughout the study. Multilevel ANCOVA of full-mouth data demonstrated an improvement in PD from baseline of 0.56mm (95% CI 0.53, 0.59) for both groups (p<0.001) although this was not statistically significantly different between test and control groups (p=0.248). Whilst self-reported smoking status was balanced by randomisation at baseline in terms of cigarettes per day and years smoking, T: 17.2 (SD 6.1), 24.0 years (SD 8.1), C: 18.3 (SD5.5), 26.1 years (SD 6.4), differences existed between groups for salivary cotinine, T: 326.8ng/ml (SD 146.3), C: 379.6ng/ml (SD 192.9). Conclusions: Non-surgical periodontal therapy can produce clinical benefits in smokers. When measured by full-mouth PD, there was no additional effect of adjunctive low-dose doxycycline. Smoking status should be verified by biochemical measures to avoid baseline imbalances. This study was supported in part by Collagenex International and Eastman Periodontal Research Fund. | ||
| Seq #189 - Host Modulatory Agents and Systemic Influences of Periodontal Therapy 10:45 AM-12:45 PM, Friday, 11 March 2005 Baltimore Convention Center 327 | ||
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