Treatment of periodontitis by local administration of minocycline microspheres: A controlled trial

Background: Periodontitis is an inflammatory condition of tooth-supporting tissues that is usually treated by mechanical removal of plaque and microor ganisms that adhere to teeth. This treatment, known as scaling and root pla ning, is not optimally effective. Adjunctive therapy with locally delivered antimicrobials has resulted in improved clinical outcomes such as probing depth reduction. This article reports on the efficacy and safety of locally administered microencapsulated minocycline. Methods: Seven hundred forty-eight (748) patients with moderate to advanced periodontitis were enrolled in a multi-center trial and randomized to 1 of 3 treatment arms: 1) scaling and root planing (SRP) alone; 2) SRP plus veh icle; or 3) SRP plus minocycline microspheres. The primary outcome measure was probing depth reduction at 9 months. Clinical assessments were performe d at baseline and 1, 3, 6, and 9 months. Results: Minocycline microspheres plus scaling and root planing provided su bstantially more probing depth reduction than either SRP alone or SRP plus vehicle. The difference reached statistical significance after the first mo nth and was maintained throughout the trial. The improved outcome was obser ved to be independent of patients' smoking status, age, gender, or baseline disease level. There was no difference in the incidence of adverse effects among treatment groups. Conclusions: Scaling and root planing plus minocycline microspheres is more effective than scaling and root planing alone in reducing probing depths i n periodontitis patients.