Effects of smoking on local delivery of controlled-release doxycycline as compared to scaling and root planing

J Clin Periodontol. 1999 Oct;26(10):683-91. doi: 10.1034/j.1600-051x.1999.261008.x.


This paper examines the effects of smoking on the treatment outcomes of two nonsurgical therapies: (1) scaling and root planing alone (SRP) or (2) controlled-release of subgingivally delivered doxycycline hyclate in a polylactic acid based polymer gel. Subjects from 2 9-month multicenter studies were classified as nonsmokers (never smoked: 100 subjects), former smokers (137 subjects), and current smokers (> or = 10 cigarettes/day: 121 subjects). Clinical parameters were analyzed for treated sites with baseline probing depths > or = 5 mm and for a subset of treated sites with baseline probing depths of > or = 7 mm. Clinical parameters (plaque levels, clinical attachment levels, pocket depths, and bleeding on probing) were analyzed at baseline, 4, 6, and 9 months. In the doxycycline treated group in general, there were neither marked significant differences in clinical attachment gain nor differences in probing depth reduction among the 3 smoking groups. On the other hand, in the scaling and root planing treated group in general, there were significant differences in clinical attachment gain and pocket depth reduction, with non-smokers responding better than former smokers and current smokers at 6 and 9 months. These differences in clinical response between scaling and root planing alone versus controlled-release of locally-delivered doxycycline hyclate among these 3 smoking groups are discussed in relation to treatment implications for smokers.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase III
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Delayed-Action Preparations
  • Dental Plaque Index
  • Dental Scaling*
  • Doxycycline / administration & dosage
  • Doxycycline / analogs & derivatives*
  • Doxycycline / therapeutic use
  • Follow-Up Studies
  • Gingival Hemorrhage / drug therapy
  • Gingival Hemorrhage / therapy
  • Humans
  • Lactic Acid
  • Middle Aged
  • Periodontal Attachment Loss / drug therapy
  • Periodontal Attachment Loss / therapy
  • Periodontal Diseases / drug therapy
  • Periodontal Diseases / therapy*
  • Periodontal Pocket / drug therapy
  • Periodontal Pocket / therapy
  • Polyesters
  • Polymers
  • Root Planing*
  • Single-Blind Method
  • Smoking / physiopathology*
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Delayed-Action Preparations
  • Polyesters
  • Polymers
  • Lactic Acid
  • poly(lactide)
  • Doxycycline