Topical subgingival doxycycline for supportive periodontal therapy of furcation sites

Objectives: Evaluation of the clinical effect of topical subgingival application of doxycycline gel adjunctively to scaling and root planing (SRP) at furcation sites during supportive periodontal therapy (SPT).

Material and Methods: In 40 SPT patients exhibiting at least 4 pockets ≥ 5 mm with bleeding on probing SRP was rendered to all pockets ≥ 4 mm at baseline, 3, 6, and 12 months. Additionally 14% doxycycline gel was applied subgingivally in 20 patients after random assignment only at baseline (SRP&DOXY). Clinical parameters were assessed at baseline, 3, 6, and 12 months after therapy. Additional benefit of topical doxycycline was evaluated as i) short-term (3 months) improvement of furcation involvement and ii) influence on the frequency of re-instrumentation up to 12 months.

Results: A total of 323 furcation sites (class 0: 160; class I: 101; class II: 18; class III: 44) were treated (SRP: 165, SRP&DOXY: 158). SRP&DOXY resulted in better improvement of furcation involvement than SRP alone 3 month after treatment (p = 0.041). However, SRP&DOXY failed to show a significant difference between both groups in the number of re-instrumentations.

Conclusion: Subgingival doxycycline additionally to SRP has a short-term effect on furcation involvement. However, it fails to reduce the frequency of re-instrumentation up to 12 months at furcation sites when applied just once.

This research was supported by the Ivoclar Vivadent AG, Schaan, Liechtenstein.