The clinical effects of the combined administration of systemic doxycycline and ibuprofen as an adjunctive treatment for chronic periodontitis

Objectives: The pathogenesis of periodontal disease depends on a susceptible host and the presence of periodontal pathogens in a conducive environment. An effective therapy must simultaneously overcome each component of chronic periodontitis. The aim of this study was to evaluate the efficacy of the combination of an antibiotic (doxycycline) with a non-steroidal anti-inflammatory drug (ibuprofen), which were administered as an adjunct to non-surgical periodontal therapy, in order to target periodontal pathogens and affect the release of inflammatory mediators at the same time. Methods: 24 patients diagnosed with severe chronic periodontitis and having at least two teeth with 5 mm probing depth in each quadrant, were randomly divided into two groups. The first group was treated with oral doxycycline and ibuprofen for three weeks as follows: doxycycline 200 mg the first day followed by 100 mg per day, ibuprofen 800 mg per day. The second group served as the control group. Plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), and clinical attachment level (CAL) using an acrylic stent were recorded at baseline, and at the first and third months following scaling and root planning. Results: Analysis, using Pairs Sample test, demonstrated statistically significant improvements from baseline regarding all clinical parameters in both groups at the third months (p<0,05). The differences of the means of clinical parameters between the test and control groups were analysed using Student t-test. The reductions in PI and SBI from baseline did not show statistical significance between two groups (p>0,05). A higher reduction in PD at the third month from the first month and a higher gain in CAL were observed at the third months in the test group (p<0,05). Conclusions: It might be concluded that the adjunctive use of doxycycline combined with ibuprofen results in an imrovement in PD and CAL beyond that obtained by non-surgical therapy alone.