CLINICAL AND MICROBIOLOGICAL EFFECTS OF CONTROLLED-RELEASE LOCALLY DELIVERED MINOCYCLINE IN PERIODONTITIS

THE CLINICAL EFFICACY OF MINOCYCLINE in a subgingival local delivery s ystem was evaluated alone (M) or as an adjunct to scaling and root pla ning (M+SRP), in comparison to scaling and root planing (SRP) or to no subgingival treatment (NoTx) in adult periodontitis. Fifty-one adult patients with greater than or equal to 7 mm periodontal pockets demons trating the presence by culture of Porphyromonas gingivalis (Pg), Prev otella intermedia (Pi), or Actinobacillus actinomycetemcomitans (Aa) w ere randomized into one of the above 4 treatment groups. Air sites gre ater than or equal to 5 mm in the most diseased quadrant in each patie nt received the therapy. Other quadrants were not treated. All patient s received standardized oral hygiene instructions at the beginning of the study. At 0, 1, 3, and 6 months following therapy the 7 mm experim ental sites were evaluated for selected periodontal pathogens by DNA p robe analysis. At these same time points, the plaque index, gingival i ndex, and bleeding on probing were evaluated as well as probing depth and relative clinical attachment level which were assessed by means of an automated probe. Probing depth reduction with M+SRP was significan tly greater than all other groups at one month and significantly great er than NoTx and SRP at 3 months. There were no differences in probing depth reduction among groups at 6 months. At 6 months the gain in cli nical attachment level was significantly greater for SRP than for eith er the NoTx or M groups. The prevalence of Pg decreased significantly in the M and M+SRP groups at one month. The prevalence of Pi decreased significantly from baseline at one month in the M group. No other sig nificant microbiological differences between groups were noted. In ter ms of clinical probing depth, subgingival minocycline as an adjunct to SRP may produce significant clinical benefits over SRP alone in patie nts with adult periodontitis. This benefit may be related to a decreas e in prevalence of Pg.