Objectives: In the present randomized, double-blind, placebo-controlled, parallel arm study, effectiveness of low-dose doxcycline (LDD) in combination with nonsurgical periodontal therapy on gingival crevicular fluid (GCF) Ln-5 gamma2 chain fragment levels and clinical parameters in chronic periodontitis patients was examined over a 12 month period. Methods: Thirty chronic periodontitis patients were randomized either to LDD or to placebo groups. LDD group received doxycycline (20 mg, b.i.d) for 3 months plus scaling and root planing (SRP), while placebo group was given placebo capsules b.i.d for 3 months plus SRP. The patients were evaluated every three months during 12 months study period. GCF Ln-5 gamma2 chain fragment levels were determined by Western immunoblotting using specific antibody and quantitated by computerized image analysis. Friedman, Wilcoxon signed rank and Mann-Whitney test was used for statistical analysis. Results: Both groups revealed significant improvements in all clinical parameters over the 12-month period. LDD group showed a significantly greater reduction in mean probing depth scores at 9 and 12 months and in the mean gingival index scores at all time points than placebo group. In LDD group, GCF Ln-5 gamma2 chain fragment levels were significantly reduced at 3 months and then slightly increased during the entire study period. In placebo group GCF Ln-5 gamma2 chain fragments tended to decrease at 3 months compared to baseline, but this did not reach to significance. In this group these levels continued to increase throughout the study period. GCF Ln-5 gamma2 chain fragment levels in LDD group were significantly lower than that of placebo group during the study period. Conclusion: Since MMP-mediated fragmentation of laminin-5 can by stimulating epithelial cell migration contribute pocket formation, the reduction of Ln-5 gamma2 chain fragment levels could provide a new mechanism by which LDD, adjunctive to SRP, inhibits periodontal disease more effectively than SRP alone.

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