Evidence Table 1b. Effectiveness of Local Tetracycline as an Adjunct to Scaling and Root Planing to Treat Chronic Periodontitis

Study DescriptionStudy Design CharacteristicsDisease CharacteristicsExaminer CharacteristicsDescription of Scaling and Root PlaningEligible Study Groups and How Defined:Study Group CharacteristicsCompliance MonitoringBaseline MeasuresAssessment Time Interval(s)Outcomes AssessedAdverse EffectsStudy Group Attrition and ReasonsType of AnalysisOutcomes Accessed
(N of Pts)Attachment Level mm Image xoverbar.jpg (SD)Probing Depth mm Image xoverbar.jpg (SD)Spirochetes Image xoverbar.jpg% (SD)Comments
Darhous et al., 199550 Design Type: Severity: Number: SRP performed: Subject/Site allocation: Age: NABefore SRP3 times (at baseline and weeks 6 and 8) Clinical Measurement: NRNR Type of analysis reported: Baseline:Tetracycline irrigation gave less bacterial counts than the control group right after irrigation, however, after 2 weeks the bacterial counts increased again and were insignificantly different in the 2 groups
Study Period: Non-RCTModerateNRNR; modified Widman flap for all sites7 subjects, 2 sites (quadrants) per subjectRange: 35 to 65PlIFull participants onlyT:76.54 (0.18)5.54 (0.67)NA Quality Score:
8 weeks Subject/Site Allocation: Types of Teeth: Trained: Time spent: T: 7 subjects Gender: PDC:76.53 (0.16)5.73 (0.24)NA31; 31
Study/Treatment Site: UnknownNRNRNRC: 7 subjectsNRCALFinal: 8 weeks
Graduate Program University Clinic Blinding: Widman flap: Assigned to Subjects: Dose, Mode, Schedule: Race/Ethnicity: GIT:73.45 (0.25)1.82 (0.69)NA
Location: NRAlways on all patientsNRT: SRP plus irrigation with 100 mg/ml tetracycline HCl for 5 minutesNRGingival fluid flowC:75.24 (0.21)3.05 (0.24)NA
Cairo, Egypt Placebo: C: SRP only Radiographic Techniques: Change:
Patient Population: NoNRT:3.09 (0.35)3.72 (0.40)NA
Adult patients with 4 to 7 mm PD Split-mouth: Microbiological Methods: C:1.29 (0.31)2.68 (0.24)NA
YesPlaque microbiotaTest:NRNR
Subject Self Report: P value:NRNR
NR
Drisko et al., 199549 Design Type: Severity: Number: SRP performed: Subject/Site allocation: Age: YesBefore SRP6 times (at baseline and months 1, 3, 6, 9, and 12) Clinical Measurement: Yes, 12 adverse events:Poor compliance or unrelated illness (4); oral candidiasis (1); periodontal abscess 6 months after treatment (1) Type of analysis reported: Baseline:There were no clinically significant differences in probing depth nor in clinical attachment level in the 2 groups of subjects at any of the examination intervals
Study Period: RCTNR3 (1 at each center)Scaling and root planing under local anesthesia. Scaling could also occur after 10 days at fiber removal visit122 (116 completed)Mean: 45.1BOP/SBIsevere gingival redness, tongue pigmentation, glossitis, periodontal abscess, lympha-denopathy, oral candidiasisFull participants onlyT:NR4.94 (NR)NA Quality Score:
52 weeks Subject/Site Allocation: Types of Teeth: Trained: Time spent: T: 116 sitesRange: 25 to 73PlIC:NR4.96 (NR)NA62; 62
Study/Treatment Site: RandomNRCalibration (gold standard)5 minutes on each toothC: 116 sites Gender: PDFinal: 52 weeks
Dental Center and 2 universities Blinding: Widman flap: Assigned to Subjects: Dose, Mode, Schedule: Male: 68CALT:116NRNRNA
Location: Examiners blindNRSame examiner throughout studyT: SRP plus 17 mg tetracycline HCl fiber, removed at 10 daysFemale: 54 Radiographic Techniques: C:116NRNRNA
Eastman Dental Center; Placebo: C: SRP only Race/Ethnicity: NRChange:
Minneapolis, MNNoNR Microbiological Methods: T:NRNRNA
University of MN Split-mouth: NRC:NRNRNA
Kanas City, MOYes Subject Self Report: Test:NRNR
University of Missouri-KansasSubject Satisfaction P value:NSNS
USA
Patient Population:
Adult patients with 1–2 teeth with ≥ 5 mm PD and BOP. 46% were new to perio therapy, 54% were maintenance patients Approximately equal distribution between 3 centers
Friesen et al., 200258 Design Type: Severity: Number: SRP performed: Subject/Site allocation: Age: NABefore SRP4 times (at baseline and months 1, 3, and 6) Clinical Measurement: Bitter tasteLost to follow-up (3), removed due to antibiotic use (1) Type of analysis reported: T1 (Single Strip):Single and multiple fiber treatments resulted in a statistically significant reduction in probing depths (P = 0.333) compared to the scaling and untreated group, but the groups were not tested individually (one by one).
Study Period: RCTNRNRLocal anesthesia28 subjects enrolledMean: 43.6BOP/SBIIntent to treat Baseline: Quality Score:
26 weeks (6 months) Subject/Site Allocation: Types of Teeth: Trained: Time spent: 24 completedRange: 26 to 69PlIT:24NR6.26 (0.95)NA46; 38
Study/Treatment Site: Random site within subjectBothStandardizationMinimum of 5 minutes per tooth3 sites/subject Gender: PDC:24NR6.60 (1.10)NA
Graduate Program University Clinic Blinding: Widman flap: Assigned to Subjects: T1: 24 sitesMale: 13CAL Final: 26 weeks
Location: Examiners blindNRNRT2: 24 sitesFemale: 15GIT:24NRNRNA
USA Placebo: C: 24 sites Race/Ethnicity: Radiographic Techniques: C:24NRNRNA
Patient Population: No Dose, Mode, Schedule: NRNR Change: GainReduction
Adult patients with 4 non-adjacent teeth with 6–10 mm PD and BOP Split-mouth: T1: SRP plus single 13.5mg tetracycline strip inserted in pocket for 7 to 10 days Microbiological Methods: T:240.31 (0.92)1.41 (NR)NA
YesT2: SRP plus multiple 13.5mg tetracycline strips for 7 to 10 daysNRC:24- 0.13 (0.71)0.98 (NR)NA
C: SRP only Subject Self Report: Test:ANOVAANOVA
NR P value:NSNR
T2 (Multiple Strip):
Baseline:
T:24NR6.58 (1.23)NA
C:24NR6.60 (1.10)NA
Final: 26 weeks
T:24NRNRNA
C:24NRNRNA
Change: GainReduction
T:0.35 (0.68)1.85 (NR)NA
C:-0.13 (0.71)0.98 (NR)NA
Test:ANOVAANOVA
P value:NSNR
Author and Year: Design Type: Severity: Number: SRP performed: Subject/Site allocation: Mean Age: NABefore SRP6 times (at baseline and months 1, 3, 6, 9, and 12) Clinical Measurement: NRNR Type of analysis reported: Baseline:CAL reported differently in 2 tables. Difference not clear. PD reported only in highly summarized version, not included here.
Goodson et al., 198548 RCTCurrently active1Scaling on day of fiber placement and again on day of fiber removal (day 10)10 subjectsNRPDAll who completed treatmentT:NRNRNRNA Quality Score:
Study Period: Subject/Site Allocation Types of Teeth: Trained: Time spent on SRP: 4 quadrants/subject Gender Distribution: CALC:NRNRNRNA38; 31
52 weeksRandomNR, all in quadrant?NAMinimum of 45 min/quadT: 9 teeth (96 sites)Male: NR Radiographic Techniques: Final: 52 weeks
Site of Study: Blinding: Widman flap: Assigned to Subjects: C: 9 teeth (91 sites)Female: NRNRT:96 sitesNRNRNA
NRExaminer blindNoSame examiner throughout the study Dose, Mode, Schedule: Race/Ethnicity: Microbiological Methods: C:91 sitesNRNRNA
Location: Placebo: T: SRP plus 25% tetracycline fibers for 10 daysNRNRChange: n=9 Gain for initial PD of > 3 mm
NR (US authors)NoC: SRP only at baseline and day 10 Subject Self Report: T:1.19 (0.14 se)NRNA
Patients Selected: Split-mouth: NRC:0.85 (0.15 se)NRNA
Patients with currently active periodontal disease and attachment loss of ≥ 2 mm at ≥ 1 sitesYesTest:ANOVA
P value:NS
Change: n=7 Gain for initial PD of > 6 mm
T:2.04 (0.32 se)NRNA
C:1.71 (0.45 se)NRNA
Test:ANOVA
P value:NS
Jeong et al., 199433 Design Type: Severity: Number: SRP performed: Subject/Site allocation: Age: NAUnclear5 times (at baseline and weeks 2, 4, 8, and 12) Clinical Measurement: NRNR Type of analysis reported: T1 (Tetracycline)
Study Period: RCTModerate1Thorough root planing at baseline, previous receipt of supragingival scaling16 subjectsMean: NRSBIFull participants only Baseline:
12 weeks Subject/Site allocation: Types of Teeth: Trained: Time spent: T1: 16 teethRange: 28 to 58PlIT:165.06 (0.95)4.94 (0.77)8.7 (9.9)
Study/Treatment Site: Random (quadrant within subject)Single-rooted teethNA5 minutes each toothT2: 16 teeth Gender: Tooth MobilityC:165.07 (1.03)4.67 (0.62)7.2 (9.9)
NR Blinding: Widman flap: Assigned to Subjects: C: 16 teethMale: 6CAL Final: 12 weeks
Location: NRNRSame examiner throughout study Dose, Mode, Schedule: Female: 10PDT:163.31 (1.01)3.00 (0.73)1.7 (5.7)
NR Placebo: T1: SRP plus 5% tetracycline HCI gel, 1 application Race/Ethnicity: Radiographic Techniques: C:163.46 (0.74)3.00 (0.65)2.4 (5.0)
Patient Population: NoT2: SRP plus 5% tetracycline HCI plus citric acid in gel, 1 applicationNRNR Change:
Adult patients with 1 tooth in each quadrant with 4–6 mm PD Split-mouth: C: SRP only Microbiological Methods: T:1.75* (NR)1.94* (NR)7.0* (NR)
YesPlaque microbiota (% motile rods and spirochetes)C:1.61* (NR)1.67* (NR)4.8* (NR)
Subject Self Report: Test:NRNRNR
NR P value:NSNSNR
T2 (Tetracycline and Citric Acid)Significant decrease in probing depth was noted after 12 weeks in tetracycline and citric acid group compared to the other groups
Baseline: No difference between groups for CAL change
T:165.27 (0.73)5.07 (0.7)10.7 (13.4) Quality Score:
C:165.07 (1.03)4.67 (0.62)7.2 (9.9)38; 46
Final: 12 weeks
T:162.93 (0.96)2.47 (0.74)4.0 (8.5)
C:163.46 (0.74)3.0 (0.65)2.4 (5.0)
Change:
T:2.34* (NR)2.60* (NR)6.7* (NR)
C:1.61* (NR)1.67* (NR)4.8* (NR)
Test:NRNRNR
P value:NS< 0.05NRNR
Kinane and Radvar 199953 Design Type: Severity: Number: SRP performed: Subject/Site allocation: Age: NABefore SRP4 times (at baseline, 6 weeks and months 3 and 6) Clinical Measurement: Yes, found none1 subject dropped from control, reason not given Type of analysis reported: Baseline:The probing depth reduction at all time points was significantly greater in the SRP plus tetracycline fiber group than the SRP alone group (P < 0.01)
Study Period: RCTSevere, persistent pockets not responding to SRP1SRP under local anesthesia39 subjects,Mean: 45 ± 6.4BOP/SBIAll with any follow-upT:19NR5.402 (0.141 se)NAThis is a follow-up study
26 weeks (6 months) Subject/Site Allocation: Types of Teeth: Trained: Time spent: 4 sites/subject Gender: PlIAnalysis adjusted:C:20NR5.480 (0.175 se)NA Quality Score:
Study/Treatment Site: RandomNRNANRT: 19 subjectsMale: 29PDGLM, baseline value as continuous covariateFinal: 26 weeks54; 62
Dental Hospital, Dental Clinic Blinding: Widman flap: Assigned to Subjects: C: 20 subjectsFemale: 50CALT:19NRNRNA
Location: Examiner blindNRSame examiner throughout study Dose, Mode, Schedule: Race/Ethnicity: GIC:20NRNRNA
Glasgow, Scotland Placebo: T: SRP plus 25% tetracycline fibers, removed after 10 daysNRSupperationChange: Gain Reduction
Patient Population: NoC: SRP only Radiographic Techniques: T:0.687 (0.138 se)1.38 (0.166 se)NA
Patients with persistent pockets that did not respond to SRP with ≥ 4 pockets with ≤5 mm PD and BOP Split-mouth: NRC:0.537 (0.143 se)0.711 (0.188 se)NA
No Microbiological Methods: Test:GLMGLM
NR P value:NS= 0.008
Subject Self Report:
NR
Lie et al., 199834 Design Type: Severity: Number: SRP performed: Subject/Site allocation: Age: NANR3 times (at baseline and months 3 and 6) Clinical Measurement: NRNR Type of analysis reported: Defect SitesThere were no significant differences between the effects following topical application of the tetracycline ointment. Scaling and root planing alone appeared as effective as the drug augmented regiment
Study Period: RCTModerate to severe1Sonic instrument and curets, 2 sessions, 1 week apart18 subjectsRange: 36 to 77BOP/SBIFull participants onlyBaseline: P.g. was significantly reduced in the treatment group.
26 weeks Subject/Site Allocation: Types of Teeth: Trained: Time spent: T: 18 sites Gender: PDT:18 sites13.8 (2.5)5.2 (1.5)NA Quality Score:
Study/Treatment Site: RandomSingle-rootedNANRC: 18 sitesNRCALC:18 sites13.4 (1.8)5.1 (1.2)NA62; 62
University of Bergen, Department of Peridontology Blinding: Widman flap: Assigned to Patients: Dose, Mode, Schedule: Race/Ethnicity: Radiographic Techniques: Final: 26 weeks
Location: Examiner and patients blindNRSame examiner throughout studyT: SRP plus application of 3% tetracycline ointment after each SRP session, 1 week apartNRNRT:18 sites12.6 (2.0)3.5 (1.6)NA
Bergen, Norway Placebo: C: SRP only Microbiological Methods: C:18 sites13.2 (1.5)4.0 (1.4)NA
Patient Population: NoNRChange:
Patients with untreated PD ≥ 5 mm and BOP Split-mouth: Patient Self Report: T:1.2* (NR)1.7* (NR)NA
YesNRC:0.2* (NR)1.1* (NR)NA
Test:ANOVAANOVA
P value:NSNS
Nondefect Sites
Baseline:
T:13.1 (2.3)3.1 (0.6)
C:12.8 (1.6)3.2 (1.1)
Final: 26 weeks
T:12.5 (1.3)2.7 (0.9)
C:12.4 (1.5)2.5 (0.9)
Change:
T:0.6* (NR)0.4* (NR)
C:0.4* (NR)0.7* (NR)
Test:NRNR
P value:NSNS
Author and Year:Design Type:Severity:Number:SRP performed: Subject/Site allocation: Age: NABefore SRP4 times (at baseline, and weeks 8, 16, and 24) Clinical Measurement: NRNR Type of analysis reported: Tetracycline vs Saline Quality Score:
MacAlpine et al., 198531 Clinical trial Generalized chronic periodontitis 1 Supra and subgingival instrumentation under local anesthesia 11 subjectsRange: 25–67BOPAll who completed treatmentBaseline:38; 38
Study Period:Subject/Site Allocation:Types of Teeth:Trained:Time spent on SRP:4 or 8 sites per subject Gender Distribution: PlaqueT:16NR7.5 (0.5)36 (NR)
24 weeks Assignment method not reported Single root NA NR T: 16 sitesMales: 2PDC:16NR7.4 (0.6)39 (NR)
Site of Study:Blinding:Widman flap:Assigned to Subjects:C: 16 sitesFemales: 9CALFinal: 24 weeks
NR NR No Same examiner throughout study Dose, Mode, Schedule: Race/Ethnicity: Radiographic Techniques: T:16NR4.6 (1.3)1 (NR)
Location:Placebo:T: SRP plus subgingival irrigation with tetracycline solution 50mg/ml every 2 weeks for 22 weeksNRNRC:16NR4.9 (1.8)4 (NR)
NR (Swedish and US authors) Yes C: SRP plus saline irrigation, every 2 weeks for 22 weeks Microbiological Methods: Change: Gain Reduction
Patients Selected:Split-mouth:Plaque microbiota (% spirochetes)T:1.1 (1.4)2.9 (NR)
Patients with ≥ 6 mm PD demonstrated by loss of attachment BOP and subgingival calculus Yes Subject Self Report: C:0.8 (1.4)2.5 (NR)
NRTest:NRNR
P value:NSNR
Minabe et al., 199152 Design Type: Severity: Number: SRP performed: Subject/Site allocation:Age:NABefore SRP4 times (at baseline and weeks 4, 6, and 8) Clinical Measurement: NRNR Type of analysis Reported: Baseline:No sig difference between treatments at any test period for PD or CAL or spirochetes.
Study Period: RCTGeneralized periodontitisNRSingle episode of supra- and ultrasonic subgingival root planing performed under local anesthesia16 subjects providedMean: 46BOPFull participants onlyT:107.4 (2.22)6.60 (1.71)16.65 (14.1)Only reported PD and CAL for 4 weeks, (graphic presentation shows little difference from 8 weeks):
8 weeks Subject/Site allocation: Types of Teeth: Trained: Time spent: 46 total teeth, randomly allocated to 4 groups, only two groups included hereRange: NRPlIC:87.81 (2.33)6.03 (1.13)10.55 (9.96)CAL:
Study/Treatment Site: RandomTeeth bifurcated (molars) with furcation involvementNRNRT: 10 sitesGender:PDFinal: 8 weeksT: 5.4 (1.85)
Hospital dental clinic Blinding: Widman flap: Assigned to Subjects: C: 8 sitesMale: 8CALT:10NRNR2.39 (3.4)C: 7.0 (1.36)
Location: NRNRNRDose, Mode, Schedule:Female: 8GIC:8NRNR3.93 (5.89)PD :
Yokosuka, Kanagawa, Japan Placebo: T: SRP plus tetracycline-immobilized cross-linked collagen film administered at 1 week intervals at 4 timesRace/Ethnicity: Radiographic Techniques: Change:T: 3.8 (0.79)
Patient Population: NoC: SRP onlyNRNRT:NR2.7 (NR)NRC: 4.25 (0.71)
Adults attending hospital dental clinic Split-mouth: Microbiological Methods: C:NR2.0 (NR)NR Quality Score:
YesDensity of micro-organisms in periodontal pocketTest:Mann Whitney UMann Whitney UMann Whitney U23 ; 23
Subject Self Report: P value:NSNSNS
NR
Newman et al., 199457 Design Type: Severity: Number: SRP performed: Subject/Site allocation:Age:YesAfter SRP4 times (at baseline and months 1, 3, and 6) Clinical Measurement: NRMoved or could not complete the study due to unrelated illness (6); undated tooth fracture (1); data recording errors (1) Type of analysis reported: Baseline:Fiber therapy significantly enhanced the effectiveness of SRP
Study Period: Randomized in blocks of 4 such that 2 subjects within the block received control treatment in site with lower teeth and experimental treatment in the site with the higher tooth numberLocalized recurrent periodontitis in maintenance patients7Full mouth ultrasonic scaling and root planing in accepted mechanical procedure for treating periodontitis113 subjects startedMean: 51.0BOP/SBIAll with any follow-upT:NR7.77 (2.17)6.46 (1.01)NA Quality Score:
26 weeks (6 months) Subject/Site Allocation: Types of Teeth: Trained: Time spent: 105 completedGender:PDC:NR7.55 (2.19)6.31 (1.20)NA69; 69
Study/Treatment Site: RandomMolars, pre-molars, cuspids, incisorsCalibration (gold standard)NR2 teeth/subjectMale: 56CALFinal: (26 weeks)
7 private dental practices Blinding: Widman flap: Assigned to Subjects: T: 105 sitesFemale: 49RecessionT:105 (sites)NRNRNA
Location: Examiners blindNRSame examiner throughout studyC: 105 sitesRace/Ethnicity:Oral soft tissueC:105 (sites)NRNRNA
USA Placebo: Dose, Mode, Schedule:NR Radiographic Techniques: Change: Gain Reduction
Patient Population: NoT: SRP plus 12.1 cm of tetracycline HCl fiber applied for 10 daysNRT:1.56 (0.145 se)1.81 (0.121 se)NA
Periodontal maintenance patients receiving regular supportive periodontal therapy. Split-mouth: C: SRP only Microbiological Methods: C:1.08 (0.145 se)1.08 (0.121 se)NA
Pts had sites in 2 quadrants with 5–8 mm PD and BOPYesPlaque microbiotaTest:ANCOVAANCOVA
Subject Self Report: P value:< 0.05< 0.01
NR
Nylund and Egelberg, 199051 Design Type: Severity: Number: SRP performed: Subject/Site allocation: Mean Age: NABefore SRP7 times (at baseline, and months 1, 2, 3, 6, 9, and 12) Clinical Measurement: NRNR Type of analysis reported: Baseline:All data reported in graphs. No significant differences found between treatment and control for any subgroup (by baseline PD or furcation grade) at any time point
Study Period: Clinical trialGeneralized periodontitis1Single episode of crown and root debridement under local anesthesia using sonic, ultrasonic and various had instruments20 subjectsNRPDAll who completed treatment; t-tests on site data for subgroups of sites by baseline PD and furcation gradeT:65 teethNRNRNA Quality Score:
52 weeks Subject/Site Allocation: Types of Teeth: Trained: Time spent on SRP: T: 20 subjects (65 teeth) Gender Distribution: CALC:58 teethNRNRNA15; 23
Site of Study: NRMolars with furcation involvementNR6–9 minutes/toothC: 20 subjects (58 teeth)NRPlaqueFinal:
NR Blinding: Widman flap: Assigned to Subjects: Dose, Mode, Schedule: Race/Ethnicity: BOPT:NRNRNRNA
Location: Examiner not blindedNoSame examiner throughout studyT: SRP plus irrigation with 50mg/ml tetracycline solution once every two weeks for 3 monthsNR Radiographic Techniques: C:NRNRNRNA
NR Placebo: C: SRP plus irrigation with saline once every two weeks for 3 monthsNRChange:
Patients Selected: Yes Microbiological Methods: T:NRNRNA
Patients with loss of attachment, BOP, subgingival calculus, and 2+ molars with furcation involvement. No perio treatment for 3 years Split-mouth: NRC:NRNRNA
Yes Subject Self Report: Test:NRNR
NR P value:NSNS
Shiloah and Patters, 199454 Design Type: Severity: Number: SRP performed: Subject/Site allocation:Age:NABefore SRP3 times (at baseline, week 1 and month 1) Clinical Measurement: NRNR Type of analysis reported: Baseline:Data presented by figures only (bar charts) PD reduced 1–2mm, and CAL gained approx 1 mm in control and treatment groups.
Study Period: RCTModerate to severe chronic adult periodontitis1SRP of entire dentition performed with ultrasonic scaler and Gracey curettes under local anesthesia7 subjects (1 or 2 teeth per subject)Mean: 49.5PlIFull participants onlyT:NRNRNAMicrobial outcomes:
4 weeks (1 month) Subject/Site Allocation: Types of Teeth: Trained: Time spent: T: 12 sitesRange: 33 to 65GIC:NRNRNANot sig for P.g., A.a.
Study/Treatment Site: Random sites within subjectsBothCalibration (Gold standard)4 to 7 hours per subject over several visitsC: 12 sitesGender:PDFinal: 4 weeksNumbers of bacteria by type per site were also reduced in control and treatment groups, with no sig differences between groups.
Graduate Program University Clinic Blinding: Widman flap: Assigned to Subjects: Dose, Mode, Schedule:Male: 2CALT:12 sitesNRNRNA Quality Score:
Location: Examiner blindNRSame examiner throughout studyT: SRP plus 5% aqueous tetracycline, 2 cc irrigation/site, 1 applicationFemale: 5Gingival Fluid FlowC:12 sitesNRNRNA54; 54
USA Placebo: C: SRP plus saline irrigationRace/Ethnicity: Radiographic Techniques: Change:
Patient Population: YesNRNRT:NRNRNA
Adults with ≥ 5 non-adjacent sites with ≥ 5 mm PD and attachment loss Split-mouth: Microbiological Methods: C:NRNRNA
YesBacterial DNA probes for A.a., P.g., and P.i. Test:ANOVAANOVA
Subject Self Report: P value:NSNS
NR
Tonetti et al., 199835 Design Type: Severity: Number: SRP performed: Subject/Site allocation:Age:YesBefore SRP3 times (at baseline and months 3 and 6) Clinical Measurement: 7 subjects exhibited adverse events consisting of periodontal abscessesRoot fracture (1), abcess developed at experimental sites (3) Type of analysis reported: Baseline:Test treatment resulted in a 0.5 mm greater reduction of PD than the control at 3 months, the improvement was highly significant but its duration did not extend until the 6 months evaluation. No differences were observed in terms of changes in CAL
Study Period: RCTNR6, 1 per centerUsing sonic and hand instruments127 subjects enrolledMean: 49.7 (± 9.2)BOP/SBIFull participants onlyT:668.0 (2.0)6.3 (1.6)NA Quality Score:
26 weeks (6 months) Subject/Site Allocation: Types of Teeth: Trained: Time spent: 123 completedGender:PDC:618.1 (2.3)5.8 (1.7)NA69; 69
Study/Treatment Site: RandomMolars with furcation involvementStandardizationMinimum of 3 minutesT: 63 subjectsMale: 69CALFinal: 26 weeks (6 months)
Multicenter, 6 Private Periodontal Practices Blinding: Widman flap: Assigned to Subjects: C: 60 subjectsFemale: 56 Radiographic Techniques: T:637.1 (0.13 se)5.0 (1.5)NA
Location: Examiners blindNRSame examiner throughout the studyDose, Mode, Schedule:Race/Ethnicity:NRC:607.1 (0.14 se)4.9 (1.4)NA
Italy Placebo: T: SRP plus tetracycline fibers containing 25% w/w tetracycline HCl crystals dispersed into a copolymer of ethylene and vinyl-acetate fiber in place for 10 ± 3 daysNR Microbiological Methods: Change: Gain Reduction
Patient Population: NoC: SRP onlyPlaque microbiotaT:0.9* (NR)1.3* (NR)NA
Patients participating in regular periodontal supportive periodontal care programs, and presenting with at least 1 mandibular Class II furcation with persistent BOP, in maintenance care Split-mouth: Subject Self Report: C:1.0* (NR)0.9* (NR)NA
NoNRTest:ANOVAANOVA
P value:NSNS
Trombelli et al., 199655 Design Type: Severity: Number: SRP performed: Subject/Site allocation: Age: NABefore SRP3 times (at baseline, and days 30 and 60) Clinical Measurement: NRNR Type of analysis reported: T1 (Irrigation with Tetracycline):For PD, the 2 treatments differed from SRP alone (P = 0.011).
Study Period: RCTAdult advanced periodontitisNRSupragingival and subgingival ultrasonic scaling12 subjects with 63 sitesMean: 41.8BOPNRBaseline:For CAL, there is no significant difference btw treatment groups and control (P = 0.121)
8 weeks (60 days) Subject/Site Allocation: Types of Teeth: Trained: Time spent: T1: 20 sitesRange: 27 to 63PlIT:(20 sites)6.3 (1.9 se)5.8 (0.9 se)NA Quality Score:
Study/Treatment Site: RandomSingle-rooted teethNRNRT2: 24 sites Gender: PDC:(19 sites)6.3 (1.2 se)6.1 (1.3 se)NA38; 46
Department of Periodontology, University of Ferrara, School of Dentistry Blinding: Widman flap: Assigned to Subjects: C: 19 sitesMale: 4CALFinal: 8 weeks
Location: Examiners blindNRNR Dose, Mode, Schedule: Female: 8GIT:4.7 (1.7 se)3.6 (1.9 se)NA
Ferrara, Italy Placebo: T1: SRP plus irrigation with 100 mg/ml tetracycline solution, 15 ml delivered subgingivally, 1 application for 4 minutes Race/Ethnicity: Recession depthC:4.9 (1.9 se)4.3 (1.9 se)NA
Patient Population: NoT2: SRP plus vinyl acetate fibers with 25% tetracycline HCl by weight positioned in pockets and packed with blunt instrument. Removed after 10 daysNRO'Leary Plaque Control RecordChange:
Adults referred for treatment with at least 3 non-molar teeth in same arch, sites having ≥ 5 mm PD Split-mouth: C: SRP only Radiographic Techniques: T:1.8* (NR)2.2* (NR)NA
YesNRC:1.4* (NR)1.8* (NR)NA
Microbiological Methods: Test:ANOVAANOVA
NR P value:NSNS
Subject Self Report: T2 (Tetracycline Fibers):
NRBaseline:
T:(24 sites)7.3 (1.8 se)6.1 (1.1 se)NA
C:(19 sites)6.3 (1.2 se)6.1 (1.3 se)NA
Final: 8 weeks
T:5.5 (2.4 se)3.8 (1.4 se)NA
C:4.9 (1.9 se)4.3 (1.9 se)NA
Change:
T:1.6* (NR)2.3* (NR)NA
C:1.4* (NR)1.8* (NR)NA
Test:ANOVAANOVA
P value:NSNS
Unsal et al., 199459 Design Type: Severity: Number: SRP performed: Subject/Site allocation:Age:NRBefore SRP2 times (at baseline and at week 12) Clinical Measurement: None were reportedNR Type of analysis reported: Baseline:For both PD and CAL, the control experienced NS better outcomes than the tetracycline group.
Study Period: RCTModerate to advanced periodontitisNRAll subjects received hand and ultrasonic scaling and root planing; selected sites were mechanically debrided with hand instruments22 subjects invitedMean: 42Bleeding indexIntent to treat.T:7 (99 teeth)3.10 (1.21)4.25 (0.85)NA Quality Score:
12 weeks Subject/Site Allocation: Types of Teeth: Trained: Time spent: 15 subjects in relevant 2 groupsRange: 30 to 57PlIC:8 (110 teeth)3.66 (1.22)5.14 (1.45)NA38; 46
Study/Treatment Site: RandomNRNRNRT: 7 (99 sites)Gender:PDFinal: 12 weeks
Department of Peridontology, Faculty of Dentistry Blinding: Widman flap: Assigned to Subjects: C: 8 (110 teeth)Male: 10CALT:72.29 (0.96)2.85 (0.55)NA
Location: NRNRNRDose, Mode, Schedule:Female: 12GI/GI-SC:82.62 (1.24)3.31 (0.73)NA
University of Ankara, Turkey Placebo: T: SRP plus 40% tetracycline HCI (w/w) in white petroleum, single application of pasteRace/Ethnicity:Position of gingival marginChange:
Patient Population: NoC: SRP onlyNR Radiographic Techniques: T:0.81 (0.69)1.40 (0.32)NA
Adult patients referred to clinic for treatment of periodontal disease, with ≥ 3 teeth in each quadrant with 2 sites having periodontal disease Split-mouth: NRC:1.04 (0.16)1.83 (0.54)NA
≥ 4 mm, BOP, and radiographic evidence bone lossNo Microbiological Methods: Test:ANOVAANOVA
NR P value:NSNS
Subject Self Report:
NR
Yalcin et al., 199956 Design Type: Severity: Number: SRP performed: Subject/Site allocation:Age:NABefore SRP4 times (at baseline and weeks 1, 3, and 7) Clinical Measurement: Oral candidiasis (1); severe gingival redness on quadrants treated with fibers (2)NR Type of analysis reported: Baseline:Tetracycline fiber treatment as adjunct to SRP is effective in regard to probing depth and bleeding on probing
Study Period: RCTModerate to advanced periodontitis never treated1 examiner performed clinical measurementsNR17 subjectsRange: 25 to 52BOP/SBIAll with any follow-upT:210 (sites) CAL5.12 (2.53)4.71 (2.34)NA Quality Score:
7 weeks Subject/Site Allocation: Types of Teeth: 1 examiner did SRP Time spent: T: 221 sitesGender:PlI221 (sites) PD62; 69
Study/Treatment Site: RandomBoth single and multi-root teeth1 examiner placed fibersNRC: 191 sitesMale: 9PDC:179 (sites) CAL5.25 (2.59)4.55 (2.37)NA
Health Department Clinic Blinding: Widman flap: Trained: Dose, Mode, Schedule:Female: 8CAL191 (sites) PD
Location: Examiners blindNRNRT: SRP plus slow-release tetracycline fibers placed subgingivally for 10 daysRace/Ethnicity:GIFinal: 7 weeks
Istanbul, Turkey Placebo: Assigned to Subjects: C: SRP onlyNROral soft tissue examined to assess adverse effectsT:NRNRNRNA
Patient Population: NoNR Radiographic Techniques: C:NRNRNRNA
Patients with ≥ 2 sites in each of 4 quadrants with pocket depths of ≥ 5 mm Split-mouth: NRChange: Gain Reduction
Yes Microbiological Methods: T:0.95 (0.132 se)1.45 (0.14 se)NA
NRC:0.75 (0.158 se)1.04 (.0148 se)NA
Subject Self Report: Test:ANCOVAANCOVA
NR P value:NS= 0.047

From: Evidence Tables

Cover of Effectiveness of Antimicrobial Adjuncts to Scaling and Root Planing Therapy for Periodontitis
Effectiveness of Antimicrobial Adjuncts to Scaling and Root Planing Therapy for Periodontitis.
Evidence Reports/Technology Assessments, No. 88.
Bonito AJ, Lohr KN, Lux L, et al.

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