Treatment with subantimicrobial dose doxycycline improves the efficacy of scaling and root planing in patients with adult periodontitis

J Periodontol. 2000 Apr;71(4):521-32. doi: 10.1902/jop.2000.71.4.521.


Background: In a previous study, subantimicrobial dose doxycycline (SDD) significantly improved clinical parameters associated with periodontal health in patients with adult periodontitis (AP) when used as an adjunct to a maintenance schedule of supragingival scaling and dental prophylaxis. In this double-blind, placebo-controlled, parallel-group, multicenter study, the efficacy and safety of SDD were evaluated in conjunction with scaling and root planing (SRP) in patients with AP.

Methods: Patients (n = 190) received SRP at the baseline visit and were randomized to receive either SDD 20 mg bid or placebo bid for 9 months. Efficacy parameters included the per-patient mean changes in clinical attachment level (CAL) and probing depth (PD) from baseline, the per-patient percentages of tooth sites with attachment loss (AL) > or = 2 mm and > or = 3 mm from baseline, and the per-patient percentage of tooth sites with bleeding on probing. Prior to analysis, tooth sites were stratified by the degree of disease severity evident at baseline

Results: In tooth sites with mild to moderate disease and severe disease (n = 183, intent-to-treat population), improvements in CAL and PD were significantly greater with adjunctive SDD than with adjunctive placebo at 3, 6, and 9 months (all P <0.05). In tooth sites with severe disease, the per-patient percentage of sites with AL > or = 2 mm from baseline to month 9 was significantly lower with adjunctive SDD than with adjunctive placebo (P<0.05). Improvements in clinical outcomes occurred without detrimental shifts in the normal periodontal flora or the acquisition of doxycycline resistance or multiantibiotic resistance. SDD was well tolerated, with a low incidence of discontinuations due to adverse events.

Conclusions: The adjunctive use of SDD with SRP is more effective than SRP alone and may represent a new approach in the long-term management of AP.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteria / drug effects
  • Dental Plaque / microbiology
  • Dental Prophylaxis
  • Dental Scaling*
  • Double-Blind Method
  • Doxycycline / administration & dosage
  • Doxycycline / adverse effects
  • Doxycycline / therapeutic use*
  • Female
  • Gingival Hemorrhage / classification
  • Gingival Hemorrhage / drug therapy
  • Gingival Hemorrhage / prevention & control
  • Humans
  • Male
  • Middle Aged
  • Periodontal Attachment Loss / classification
  • Periodontal Attachment Loss / drug therapy
  • Periodontal Attachment Loss / prevention & control
  • Periodontal Pocket / classification
  • Periodontal Pocket / drug therapy
  • Periodontal Pocket / prevention & control
  • Periodontitis / classification
  • Periodontitis / drug therapy
  • Periodontitis / prevention & control*
  • Placebos
  • Root Planing*
  • Safety
  • Statistics as Topic
  • Tetracycline Resistance
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Placebos
  • Doxycycline