ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Subantimicrobial-Dose Doxycycline (SDD) Periodontal Therapy Reduces Serum Biomarkers Of Systemic Inflammation And Can Increase High-Density Lipoprotein
Clinical Question In post-menopausal women with chronic periodontitis does a systemic dose of Doxycycline in comparison to placebo increase high-density lipoprotein (HDL) levels?
Clinical Bottom Line In post-menopausal women with chronic periodontitis Subantimicrobial-Dose Doxycycline Periodontal therapy reduces serum biomarkers of systemic inflammation and among women more than five years post-menopausal, the SDD regimen elevated their level of high-density lipoprotein (HDL) cholesterol. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21357860Payne/2011128 Post-menopausal women A randomized, double-masked, placebo-controlled clinical trial
Key resultsIn comparison to placebo a two year SDD treatment as an adjunct to periodontal maintenance therapy reduced median high-sensitivity C-reactive protein (hs-CRP) by 18 percent (P=.02) and reduced serum matrix metalloproteinases (MMP)-9 (P < .001), with no significant effect on serum lipids. However, among women more than five years post-menopausal, the SDD regimen elevated their level of high-density lipoprotein (HDL) cholesterol with P= .01.
Evidence Search Search doxycycline treatmentSearch periodontal therapy
Comments on
The Evidence
This study design was a randomized, double-masked, placebo controlled clinical trial for which 128 eligible post-menopausal women were selected and followed-up across a two-year span. The numbers of participants were similar at start and there was at least 80 percent completion rate of the study. There was adequate follow-up and compliance for each group and there was no recall bias or competing interest for the study.
Applicability We know that there is a correlation between chronic periodontitis and coronary artery disease. We are seeing an increased number of the older population with chronic periodontitis seeking dental care. Dentist can play a role in potentially reducing the risk of coronary artery disease through the management of the patient chronic periodontitis.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Postmenopausal Menopausal Periodontitis Subantimicrobial doxycyclineC-reactive proteinDoxycyclineInflammationSerum inflammatory biomarkersHigh-density lipoprotein cholesterol
ID# 856
Date of submission: 04/28/2011spacer
E-mail korous@livemail.uthscsa.edu
Author Dunia Korous
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ernest Valdez, DDS
Faculty mentor/Co-author e-mail VALDEZE@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Debbie Lee (San Antonio, TX) on 10/08/2014
A PubMed search on application of doxycycline in post-menopausal women with chronic periodontitis increasing HDL levels compared to placebo was completed September 2014. A more recent publication was found: Bretz, 2012, PubMed ID: 23253834. This study analyzed data from the same study published in this CAT. The analyzed data from the randomized controlled trial of 113 patients (control n=62; test n=51) found that even though the treatment modality that involved systemic doxycycline lowered systemic inflammation, there was no significant difference in the lipid profiles among the control and the test group. These results differ from those published in the CAT.
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