Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
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Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2009, vol. 46, nr 4, October-December, p. 470–476

Publication type: review article

Language: Polish

Zastosowanie małych dawek doksycykliny w leczeniu przewlekłego zapalenia przyzębia

Subantimicrobial Dose Doxycycline as Adjunctive Treatment of Chronic Periodontitis

Piotr Kondzielnik1,, Łukasz Gilowski1,, Rafał Wiench2,, Iwona Płocica2,, Tadeusz Faustyn Krzemiński1,

1 Katedra i Zakład Farmakologii w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach

2 Katedra i Zakład Stomatologii Zachowawczej z Endodoncją w Bytomiu, Śląski Uniwersytet Medyczny w Katowicach

Streszczenie

Doksycyklina w dawce 20 mg (subantimicrobial dose doxycycline – SDD) zmniejsza aktywność metaloproteinaz macierzy (matrix metalloproteinases – MMPs), enzymów kluczowych dla procesu destrukcji macierzy zewnątrzkomórkowej w przebiegu zapaleń przyzębia. W roku 1998 FDA (Food and Drug Administation) zatwierdziła w USA Periostat® (doksycyklina 20 mg) do stosowania doustnego dwa razy dziennie przez co najmniej 3 miesiące, jako terapię uzupełniającą skaling i wygładzenie powierzchni korzeni u pacjentów z przewlekłym zapaleniem przyzębia. Autorzy przedstawili najważniejsze wydarzenia, które doprowadziły do odkrycia roli SDD w leczeniu zapaleń przyzębia. Gruntownej ocenie została poddana skuteczność stosowania SDD w leczeniu przewlekłego zapalenia przyzębia. Badania wykazały występowanie korzystnych efektów klinicznych połączonego z SRP (scaling and root planing) stosowania SDD w terapii przewlekłego zapalenia przyzębia. Częstotliwość występowania działań niepożądanych podczas terapii SDD jest mała i nie różni się od placebo. Małe dawki doksycykliny nie prowadzą do powstania szczepów opornych na antybiotyki oraz nie mają wpływu na skład flory bakteryjnej w obrębie kieszonki przyzębnej.

Abstract

Subantimicrobial dose doxycycline (SDD) – 20 mg doxycycline, downregulates the activity of matrix metalloproteinases (MMPs) – the key destructive enzymes in periodontal disease. In 1998 FDA (Food and Drug Administation) approved Periostat® (20 mg doxycycline twice daily for at least 3 months) as an adjunct to scaling and root planning (SRP) in treatment of chronic periodontitis. The authors showed the most important events that led to the development of SDD as adjunctive treatment for periodontitis. They also reviewed the clinical, microbiological and safety data relating to the use of SDD in patients with periodontitis. Studies have demonstrated the clinical benefits of SDD, when prescribed as an adjunct to scaling and root planning (SRP), in treatment of chronic periodontitis. The frequency of adverse events during treatment with SDD does not differ significantly from placebo. SDD does not lead to the development of resistant strains and does not result in antibacterial effects.

Słowa kluczowe

zapalenie przyzębia, metaloproteinaza, mała dawka doksycykliny

Key words

periodontal diseases, metalloproteinases, subantimicrobial dose doxycycline

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