The long-term efficacy of systemic doxycycline medication in the treatment of localized juvenile periodontitis.

The presence of Actinobacillus actinomycetemcomitans in the deep periodontal pockets of patients with localized juvenile periodontitis has been causally associated with active periodontal destruction. Thus, eradication of this microorganism has become the goal of treatment. It has been postulated that such eradication cannot be achieved without systemic antimicrobial treatment. The efficacy of a semisynthetic tetracycline (doxycycline) in a double-blind follow-up study of 14 patients with localized juvenile periodontitis was evaluated. For assessment of the periodontal status, probing depth and bleeding after probing at 4 sites of all teeth were recorded. The treatment consisted of instruction in oral hygiene, scaling and root planing, periodontal surgery and systemic medication for 2 weeks with either doxycycline (Doximycin) or placebo. A. actinomycetemcomitans was cultivated from subgingival samples taken from 4 sites. The periodontal condition and the prevalence of A. actinomycetemcomitans were monitored at the baseline and at 2, 8 and 20 months. The periodontal condition improved in both groups; the only significant difference was a greater reduction in the prevalence of A. actinomycetemcomitans 8 months after treatment with doxycycline as compared with the placebo.