Local Minocycline to Reduce Future Inflammation and Bone Loss in Periodontal Maintenance Patients

The over-arching goal of this application is to initiate a program to involve undergraduate
dental students and their patients in clinical research to evaluate the efficacy of dental
therapy. Specifically, the purpose of this study is to determine the effect of local
application of minocycline microspheres on the periodontal inflammation and bone loss
prevention in patients diagnosed with moderate-severe chronic periodontitis on periodontal
maintenance in the undergraduate clinic. Few studies evaluating locally-applied minocycline
during periodontal maintenance therapy have been reported even though the drug is commonly
used in this protocol. A 6-month treatment study by Meinberg et al. (2002), demonstrated that
in moderate-to-advanced chronic periodontitis patients, scaling and root planing with
subgingival minocycline resulted in improved pocket depths and less frequent bone height loss
over one year than conventional periodontal maintenance. The prevention of bone loss and
inflammation is key to maintaining teeth in function and comfort for the patient's lifetime.
Patients from the UNMC College of Dentistry (and eventually Creighton University School of
Dentistry) undergraduate periodontal clinic, who are already enrolled in periodontal
maintenance therapy, will be recruited to participate in this study. The selected patients
will continue their periodontal maintenance care but will be placed into either the test
group (receiving minocycline in a periodontally inflamed pocket along with subgingival
mechanical debridement) or the control group (receiving subgingival mechanical debridement
alone). Radiographs will be taken at baseline and at the study's completion (24 months) to
obtain bone loss data, and periodontal measurements and gingival crevicular fluid (GCF) will
be used to monitor markers of inflammation and bone resorption. The hypothesis to be tested
in this clinical trial is that the use of minocycline at baseline and 6 month intervals in
conjunction with subgingival mechanical debridement will reduce interproximal bone height
loss and periodontal inflammation more than mechanical debridement alone.

Inclusion Criteria:

- diagnosis of moderate-severe chronic periodontitis

- attending regular periodontal maintenance visits at UNMC COD

- one quadrant with at least one > 5 mm interproximal pocket and 3 posterior teeth

Exclusion Criteria:

- systemic diseases which impact periodontal inflammation and bone turnover

- drugs which significantly impact periodontal inflammation and bone turnover

- surgical periodontal therapy within the last year

- pregnant or breast-feeding females