Mechanical SRP Versus Locally Applied Doxycycline

In a randomized controlled study, surgical and nonsurgical treatment of patients with recurring periodontal disease was compared with treatment by doxycycline alone. 

The study, originally in the American Journal of Dentistry, reported on 37 patients after treatment with subgingival debridement and compared the clinical effect of SRP versus a 14% doxycycline gel placement. Patients had at least one tooth with a 5-mm probing depth and bleeding on probing or a 6-mm pocket. Randomly, patients were treated with the 14% doxycycline gel or standard ultrasonic scaling and root-planing therapy. Measured at 3 and 6 months post-treatment, the results indicated that the plaque index re-mained stable, the gingival index was reduced significantly and stable, and the pocket depth and attachment gain were also significantly better for both groups. With 7-mm pockets, the depth decrease was better than with pockets of lesser depth. Smokers had lesser gains in total. Pathogenic activity was reduced in both groups except for A. actinomycetemcomitans in the SRP group at 3 and 6 months. For the doxycycline group, only P. gingivalis was significantly reduced. Results indicated that there was not a “statistically significant difference” in pathogens between both groups. Mechanical treatment yielded better microbial results than with the doxycycline application, though doxycycline treatment produced better clinical results. Both treatments reduced pocket depths better in deeper pockets than in shallower ones; however, there were no significant differences in periodontal pathogen elimination with either group.