Summary :
Aim: Determine the efficacy of 2-year continuous subantimicrobial dose doxycycline (SDD; 20 mg bid) on alveolar bone in post-menopausal osteopenic, oestrogen-deficient women undergoing periodontal maintenance in a 2-year double-blind, placebocontrolled, randomized clinical trial. Material and Methods: One-hundred and twenty-eight subjects randomized to SDD or placebo (n564 each). Posterior vertical bite wings taken at baseline, 1 and 2 years for alveolar bone density (ABD), using radiographic absorptiometry (RA) and computer-assisted densitometric image analysis (CADIA), and alveolar bone height (ABH). Statistical analyses utilized generalized estimating equations; primary analyses were intent to treat (ITT). Results are presented as SDD versus placebo. Results: Under ITT, there was no statistically significant effect of SDD on ABD loss (RA: p50.8; CADIA: p50.2) or ABH loss (p50.2). Most sites (81–95%) were inactive. For subgroup analyses, mean CADIA was higher with SDD for non-smokers (p50.05) and baseline probing depths X5mm (p50.003). SDD was associated with 29% lower odds of more progressive ABH loss in women 45 years post-menopausal (p50.05) and 36% lower among protocol-adherent subjects (p50.03). Conclusions: In post-menopausal osteopenic women with periodontitis, SDD did not differ overall from placebo. Based on exploratory subgroup analyses, additional research is needed to determine the usefulness of SDD in non-smokers, subjects 45 years post-menopausal and in deeper pockets.

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